Major Finding: Cigarette-smoking women had a 14-fold increased risk for symptomatic peripheral artery disease during 13 years of follow-up, compared with never-smokers. Women who stopped smoking at least a year before entering the study had a threefold increased risk.
Data Source: Prospective follow-up of 39,825 women enrolled in the Women's Health Study with smoking data at baseline.
Disclosures: Dr. Conen said he had no financial conflicts.
STOCKHOLM – A history of either current or former smoking posed a major risk for peripheral artery disease in the Women's Health Study, a prospective epidemiologic assessment of nearly 40,000 health professional women who were followed for almost 13 years.
The results “underscore the importance of smoking as a risk factor for developing symptomatic PAD,” Dr. David Conen said at the congress.
Although smoking cessation substantially reduced PAD risk, former smokers who were abstinent for longer than 1 year still had about a threefold higher risk for PAD than did never-smokers in the study, said Dr. Conen, a cardiologist at University Hospital Basel (Switzerland).
The analysis included 39,825 women who were enrolled in the Women's Health Study and had smoking data available at baseline. All women in the study were at least 45 years old (average age, 55 years) and free of cardiovascular disease at entry. In all, 51% had never smoked at baseline, 36% smoked in the past, 5% currently smoked fewer than 15 cigarettes daily, and 8% smoked at least 15 cigarettes daily. During an average 12.7 years of follow-up, 178 women developed symptomatic PAD, either intermittent claudication or need for peripheral artery surgery. The study included no data on subclinical or asymptomatic PAD.
In a multivariate model that adjusted for age, hypertension, diabetes, hypercholesterolemia, body mass index, alcohol use, and physical activity, women who currently smoked at least 15 cigarettes daily had a 17-fold higher risk for symptomatic PAD than did never-smokers. Current smokers of fewer than 15 cigarettes daily had a ninefold higher risk, and past smokers had a threefold higher risk.
When data were analyzed in a slightly different way, all current smokers had a 14-fold higher risk, compared with never-smokers; women who quit within the past year at baseline had an 11-fold increased risk; and women who had been off cigarettes longer than 1 year at baseline had a threefold higher risk for PAD. Dr. Conen said he had no disclosures.