title: Secondhand smoke (SHS) exposure is associated with circulating markers of inflammation and endothelial function in adult men and women.
abstract: OBJECTIVE
  Secondhand smoke (SHS) exposure is associated with elevated CHD risks. Yet the pathways through which this may operate have not been investigated in epidemiologic studies with objective SHS exposure measures and a wide range of CHD risk factors associated with active smoking. Therefore we investigate associations between SHS exposure and CHD risk factors, to clarify how SHS exposure may raise risk of CHD.
  
  
  METHODS
  Cross-sectional population-based study of 5029 men and women aged 59-80 years from primary care practices in Great Britain. Smoking, behavioural and demographic information was reported in questionnaires; nurses made physical measurements and took blood samples for analysis of serum cotinine and markers of inflammation, hemostasis and endothelial dysfunction.
  
  
  RESULTS
  Active cigarette smokers had lower albumin and higher triglycerides, CRP, IL-6, white cell count, fibrinogen, blood viscosity, factor VIII, VWF and t-PA than non-smokers. Among non-smokers, serum cotinine levels were independently positively associated with CRP, fibrinogen, factor VIII, VWF and t-PA and inversely associated with albumin, after adjustment for age, gender, social and behavioural factors. The differences in CRP, fibrinogen and albumin between cotinine < or =0.05 and >0.7 ng/ml were one-third to one half the size of differences between cotinine < or =0.05 ng/ml and current smokers, but were of similar magnitude for VWF and t-PA.
  
  
  CONCLUSIONS
  Endothelial, inflammatory and haemostatic markers related to CHD risk showed independent associations with SHS exposure in the same direction as those for active smoking. Results aid understanding of the associations between SHS exposure and elevated CHD risks.
authors.affiliation: Department Primary Care & Population Health, UCL Medical School, Rowland Hill St, NW3 2PF, London, UK. b.jefferis@pcps.ucl.ac.uk
authors.forename: B J
authors.initials: BJ
authors.lastname: Jefferis
authors.forename: G D O
authors.initials: GD
authors.lastname: Lowe
authors.forename: P
authors.initials: P
authors.lastname: Welsh
authors.forename: A
authors.initials: A
authors.lastname: Rumley
authors.forename: D A
authors.initials: DA
authors.lastname: Lawlor
authors.forename: S
authors.initials: S
authors.lastname: Ebrahim
authors.forename: C
authors.initials: C
authors.lastname: Carson
authors.forename: M
authors.initials: M
authors.lastname: Doig
authors.forename: C
authors.initials: C
authors.lastname: Feyerabend
authors.forename: L
authors.initials: L
authors.lastname: McMeekin
authors.forename: S G
authors.initials: SG
authors.lastname: Wannamethee
authors.forename: D G
authors.initials: DG
authors.lastname: Cook
authors.forename: P H
authors.initials: PH
authors.lastname: Whincup
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology*; D003367:Cotinine / Q000097:blood; D005260:Female; D006487:Hemostasis; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012306:Risk; D012737:Sex Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution; D003367:Cotinine
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