Secondhand smoke (SHS) exposure is associated with circulating markers of inflammation and endothelial function in adult men and women.
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.
Jefferis
B J
BJ
Department Primary Care & Population Health, UCL Medical School, Rowland Hill St, NW3 2PF, London, UK. b.jefferis@pcps.ucl.ac.uk
Lowe
G D O
GD
Welsh
P
P
Rumley
A
A
Lawlor
D A
DA
Ebrahim
S
S
Carson
C
C
Doig
M
M
Feyerabend
C
C
McMeekin
L
L
Wannamethee
S G
SG
Cook
D G
DG
Whincup
P H
PH
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*
D014028:Tobacco Smoke Pollution; D003367:Cotinine
Addiction. 2008 Sep;103(9):1553-61
18783507
Metabolism. 1995 Dec;44(12):1536-9
8786720
Clin Chem Lab Med. 2004 Apr;42(4):408-14
15147151
BMJ. 2004 Jul 24;329(7459):200-5
15229131
Tob Control. 2001 Dec;10(4):368-74
11740030
Arch Intern Med. 1989 Feb;149(2):386-9
2916883
Eur Heart J. 2002 Nov;23(22):1764-70
12419296
Epidemiol Rev. 1996;18(2):188-204
9021312
Int J Epidemiol. 2004 Dec;33(6):1185-92
15319395
Eur Heart J. 2005 Sep;26(17):1765-73
15817606
J Epidemiol Community Health. 2003 Feb;57(2):134-40
12540690
Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):570-4
1892296
Am J Epidemiol. 1998 May 15;147(10):932-9
9596471
Thromb Haemost. 2000 Oct;84(4):553-8
11057849
BMJ. 2006 May 6;332(7549):1064-9
16603565
Circulation. 2005 May 24;111(20):2684-98
15911719
Eur Heart J. 2004 Feb;25(3):252-9
14972427
N Engl J Med. 2004 Apr 1;350(14):1387-97
15070788
J Lab Clin Med. 1985 Apr;105(4):479-83
3884719
Am J Epidemiol. 1996 Dec 15;144(12):1151-4
8956627
Nicotine Tob Res. 2007 Feb;9(2):305-7
17365762
Ann Intern Med. 2003 Jun 3;138(11):891-7
12779299
Neuroepidemiology. 2004 Jan-Apr;23(1-2):38-44
14739566
Circulation. 1991 Jan;83(1):1-12
1984876
Prev Med. 2004 May;38(5):637-41
15066367
Am J Med. 2004 Feb 1;116(3):145-50
14749157
Circulation. 2007 Feb 27;115(8):990-5
17296856
Diabetes Care. 2008 May;31(5):995-1000
18235054
PLoS Med. 2008 Apr 8;5(4):e78
18399716
Stroke. 2002 Sep;33(9):2170-6
12215582
N Engl J Med. 1999 Mar 25;340(12):920-6
10089185
BMJ. 1997 Oct 18;315(7114):973-80
9365294
Arterioscler Thromb Vasc Biol. 2000 Jan;20(1):271-9
10634829
N Engl J Med. 1996 Jan 18;334(3):150-4
8531969