title: Serum albumin and risk of stroke, coronary heart disease, and mortality: the role of cigarette smoking.
abstract: OBJECTIVE
  Lower levels of serum albumin are associated with increased risk of all-cause and cardiovascular mortality as well as with coronary heart disease and stroke incidence. These relationships have been examined with specific focus on the role of cigarette smoking.
  
  
  METHODS
  A prospective study of 7,690 British men aged 40-59 years, with 16.8 years mean follow-up.
  
  
  RESULTS
  Cigarette smoking was strongly and inversely associated with serum albumin concentrations that reverted to levels seen in never smokers after 5 years' cessation. Only in current and former smokers were there significant inverse relationships between serum albumin and risk of major CHD and stroke events even after adjustment for potential confounders. Only in current smokers was a significant inverse relationship seen between serum albumin and mortality from cardiovascular disease, cancer, and all causes.
  
  
  CONCLUSIONS
  The inverse association between serum albumin concentration and disease outcome appears to be related to the effects of cigarette smoking on serum albumin concentration.
authors.affiliation: Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Rowlands Hill Street, London NW3 2PF, UK. agshaper@wentworth.u-net.com
authors.forename: A Gerald
authors.initials: AG
authors.lastname: Shaper
authors.forename: S Goya
authors.initials: SG
authors.lastname: Wannamethee
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
mesh_terms: D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000097:blood* / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D012907:Smoking / Q000009:adverse effects* / Q000401:mortality; D020521:Stroke / Q000097:blood* / Q000401:mortality
chemical_list: D015415:Biomarkers; D012709:Serum Albumin