title: Impact of smoking: all-cause and cardiovascular mortality in a cohort of 55-year-old Swedes and Estonians.
abstract: OBJECTIVE
  In the 1990s, several studies noted a large gap in life expectancy between Western and Eastern European countries. It was speculated that this could be explained by environmental pollution, socioeconomic factors, lifestyle and psychosocial stress. A weakness in addressing the issue has been the lack of prospective studies with mortality as end point.
  
  
  METHODS
  We used the national population registries (between 1996 and 1998) to screen a cohort of 269 55-year-old subjects in Sweden and Estonia. We assessed conventional risk factors, lifestyle and socio-economic factors. A 13-year follow-up regarding all-cause and cardiovascular mortality was done.
  
  
  RESULTS
  Smoking and, to a lesser extent, plasma levels of interleukin-6 were significant predictors for CVD and non-CVD mortality in men, but none of the other conventional risk factors reached statistical significance. During the follow-up period, 22 of the 52 male smokers died compared to 8 of the 85 male non-smokers (p<0.01). Ten of the smokers died of CVD compared to three of the non-smokers (p<0.002). In total, only two women died.
  
  
  CONCLUSIONS
  These data emphasize that smoking prevention is extremely important in preventing premature death. Although smoking prevalence is diminishing, it is still the most important risk factor to treat.
authors.affiliation: Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden mats.jensen-urstad@ki.se.
authors.forename: Mats
authors.initials: M
authors.lastname: Jensen-Urstad
authors.affiliation: Institute of Cardiovascular Medicine, Tallinn University of Technology, Centre of Cardiology, North Estonia Medical Centre, Tallinn, Estonia.
authors.forename: Margus
authors.initials: M
authors.lastname: Viigimaa
authors.affiliation: Department of Public Health, University of Tartu, Tartu, Estonia.
authors.forename: Sirje
authors.initials: S
authors.lastname: Sammul
authors.affiliation: Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Lenhoff
authors.affiliation: Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Johansson
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death / Q000639:trends*; D004957:Estonia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology
chemical_list: D015850:Interleukin-6
keywords: All-cause mortality; cardiovascular disease; coronary heart disease; interleukin-6; smoking