title: Age at onset of smoking is an independent risk factor in peripheral artery disease development.
abstract: OBJECTIVE
  The potential effects of age at onset of smoking on cardiovascular diseases have been studied little, in contrast to the well-established evidence supporting a causal role of cigarette smoking in these diseases. We sought to analyze the relationship between age at smoking onset and development of symptomatic peripheral arterial occlusive disease (PAOD).
  
  
  METHODS
  A population-based sample of 573 active or former male smokers aged 55 to 74 years were studied. Present or previous symptomatic PAOD was confirmed by noninvasive testing.
  
  
  RESULTS
  Sixty-one subjects (10.6%) had symptomatic PAOD. Prevalence of disease increased with earlier starting age (15.6% if <or=16 years versus 5.4% if >16 years) of smoking. After controlling for risk factors that meet confounding factor criteria (ie, subject age and number of pack-years), men who started smoking at age 16 or earlier had a substantially higher risk for development of PAOD (odds ratio, 2.19; 95% CI, 1.15-4.15; P =.016) than men who began to smoke at a later age.
  
  
  CONCLUSIONS
  A starting age for smoking of 16 years or earlier more than doubles the risk of future symptomatic PAOD regardless of the amount of exposure to cigarette smoking.
authors.affiliation: Pubilla Casas Primary Health Center, Barcelona, Spain.
authors.forename: Adriana
authors.initials: A
authors.lastname: Planas
authors.forename: Alberto
authors.initials: A
authors.lastname: Clará
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
authors.forename: José-María
authors.initials: JM
authors.lastname: Pou
authors.forename: Anna
authors.initials: A
authors.lastname: Gasol
authors.forename: Anna
authors.initials: A
authors.lastname: de Moner
authors.forename: Carmen
authors.initials: C
authors.lastname: Contreras
authors.forename: Francesc
authors.initials: F
authors.lastname: Vidal-Barraquer
mesh_terms: D000367:Age Factors; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000209:etiology; D007866:Leg / Q000098:blood supply / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013030:Spain / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood; D014504:Urban Health
chemical_list: D014280:Triglycerides