Smoking cessation and subclinical atherosclerosis--results from the Heinz Nixdorf Recall Study.
BACKGROUND
Smoking accounts for more than 5 million years of potential life lost per year in the US alone. Leading causes of smoking attributable mortality are acute atherothrombotic complications of coronary heart disease (CHD). Smoking cessation is a key issue in preventive medicine, but quantitative data on its benefit for the coronary arteries are sparse.


METHODS
The Heinz Nixdorf Recall Study is an ongoing population-based, prospective cohort study, with 4814 participants aged 45-74 years (49.8% men). Baseline data of 4078 participants without history of established coronary heart disease or stroke are included in this report. Electron beam-computed tomography allows for non-invasive quantification of coronary artery calcium (CAC). We estimate the risk-related ageing of coronary arteries from multivariable regression of CAC on smoking behavior, sex, age and risk factors.


RESULTS
Smoking 20 cigarettes per day since the age of 16 is associated with a CAC burden which is found in a person 10 years older who has never smoked (both sexes). Smoking cessation at 45, 55 or 65 leads to CAC at the age of 75 that would have been reached 9, 6 or 3 years earlier, respectively, had smoking been continued.


CONCLUSIONS
In individuals without overt CHD, present smokers are about 10 years older in 'coronary artery age' than never smokers. The accumulation of CAC is accelerated by smoking and slows down after smoking cessation, but advanced CAC is persistent for a long period. These quantitative findings strongly support smoking cessation measures as early as possible, to prevent accelerated arterial ageing.
Jöckel
Karl-Heinz
KH
Institute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen, Germany. k-h.joeckel@uk-essen.de
Lehmann
Nils
N
Jaeger
Beate Roxanne
BR
Moebus
Susanne
S
Möhlenkamp
Stefan
S
Schmermund
Axel
A
Dragano
Nico
N
Stang
Andreas
A
Grönemeyer
Dietrich
D
Seibel
Rainer
R
Mann
Klaus
K
Volbracht
Lothar
L
Siegrist
Johannes
J
Erbel
Raimund
R
D000368:Aged; D000375:Aging; D050197:Atherosclerosis / Q000175:diagnosis* / Q000517:prevention & control*; D015331:Cohort Studies; D003327:Coronary Disease / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011315:Preventive Medicine / Q000379:methods; D011446:Prospective Studies; D012306:Risk; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation