title: Secondhand Smoke Exposure and Subclinical Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis.
abstract: Few studies have evaluated the association between secondhand smoke (SHS) and subclinical cardiovascular disease among ethnically diverse populations. This study assesses the impact of SHS on inflammation and atherosclerosis (carotid intima-media thickness, coronary artery calcification, and peripheral arterial disease).
  
  
  
  We examined 5032 nonsmoking adults aged 45 to 84 years without prior cardiovascular disease participating in the Multi-Ethnic Study of Atherosclerosis (MESA) from 2000 to 2002. SHS exposure was determined by self-report, and urinary cotinine was measured in a representative subset (n=2893). The multi-adjusted geometric mean ratios (95% CIs) for high-sensitivity C-reactive protein and interleukin-6 comparing 407 participants with SHS ≥12 h/wk versus 3035 unexposed participants were 1.13 (1.02-1.26) and 1.04 (0.98-1.11), respectively. The multi-adjusted geometric mean ratio for carotid intima-media thickness was 1.02 (0.97-1.07). Fibrinogen and coronary artery calcification were not associated with SHS. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.9 or ≥1.4) was associated with detectable urinary cotinine (odds ratio, 2.10; 95% CI, 1.09-4.04) but not with self-reported SHS. Urinary cotinine was not associated with inflammation or carotid intima-media thickness.
  
  
  
  Despite limited exposure assessment, this study supports the association of SHS exposure with inflammation and peripheral arterial disease.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD mjone132@jhu.edu.
authors.forename: Miranda R
authors.initials: MR
authors.lastname: Jones
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Hoda S
authors.initials: HS
authors.lastname: Magid
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.|Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Al-Rifai
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.|Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD.
authors.forename: John W
authors.initials: JW
authors.lastname: McEvoy
authors.affiliation: Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Kaufman
authors.affiliation: Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA.
authors.forename: Karen D
authors.initials: KD
authors.lastname: Hinckley Stukovsky
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.affiliation: Department of Radiology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Polak
authors.affiliation: Division of Public Health Sciences, Wake Forest School of Medicine, Winston- Salem, NC.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Burke
authors.affiliation: Division of Cardiology, Johns Hopkins University, Baltimore, MD.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.|Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.|Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Ana
authors.initials: A
authors.lastname: Navas-Acien
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D055109:Ankle Brachial Index; D001213:Asian; D050197:Atherosclerosis / Q000208:ethnology / Q000209:etiology*; D015415:Biomarkers / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000208:ethnology / Q000209:etiology*; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000208:ethnology / Q000209:etiology*; D011446:Prospective Studies; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D061205:Vascular Calcification / Q000208:ethnology / Q000209:etiology*; D044465:White People / Q000208:ethnology
chemical_list: D015415:Biomarkers; D014028:Tobacco Smoke Pollution
keywords: ankle‐brachial index; atherosclerosis; carotid intima‐media thickness; coronary artery calcium; inflammation; peripheral artery disease; secondhand smoke; smoking