title: Secondhand smoke exposure and coronary artery calcification among nonsmoking participants of a population-based cohort.
abstract: BACKGROUND
  Secondhand smoke (SHS) consists of fine particulate matter, carcinogens, and various toxins that affect large parts of the population. SHS increases the risk for acute cardiovascular events and may contribute to the development of atherosclerosis.
  
  
  OBJECTIVE
  We investigated the association of SHS with coronary artery calcification (CAC).
  
  
  METHODS
  In this cross-sectional analysis, we used baseline data (2000-2003) from 1,766 never-smokers without clinically manifested coronary heart disease, 45-75 years of age, from the Heinz Nixdorf Recall Study, an ongoing, prospective, population-based cohort study in Germany. Self-reported frequent SHS at home, at work, and in other places was assessed by questionnaire. CAC scores were derived based on electron-beam computed tomography. We conducted multiple linear regression analysis using exposure to SHS as the explanatory variable and ln(CAC+1) as the response variable. We conducted logistic regression to estimate the odds ratio (OR) for presence of any CAC.
  
  
  RESULTS
  Frequent exposure to SHS was reported by 21.5% of participants. After adjustment for age, sex, and socioeconomic status, CAC + 1 was 21.1% [95% confidence interval (CI): -5.5%, 55.2%] higher in exposed than in unexposed participants. After adjusting for other cardiovascular risk factors, the association was attenuated (15.4%; 95% CI: -9.6%, 47.2%). SHS exposure was also associated with a CAC score > 0 (fully adjusted OR = 1.38; 95% CI: 1.03, 1.84).
  
  
  CONCLUSIONS
  Self-reported frequent exposure to SHS was associated with subclinical coronary atherosclerosis in our cross-sectional study population. Considering the widespread exposure and the clinical relevance of coronary atherosclerosis, this result, if confirmed, is of public health importance.
authors: Institute for Medical Informatics, Biometry, and Epidemiology, University Duisburg-Essen, Essen, Germany.
authors: Frank
authors: F
authors: Peinemann
authors: Susanne
authors: S
authors: Moebus
authors: Nico
authors: N
authors: Dragano
authors: Stefan
authors: S
authors: Möhlenkamp
authors: Nils
authors: N
authors: Lehmann
authors: Hajo
authors: H
authors: Zeeb
authors: Raimund
authors: R
authors: Erbel
authors: Karl-Heinz
authors: KH
authors: Jöckel
authors: Barbara
authors: B
authors: Hoffmann
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D014028:Tobacco Smoke Pollution