Cigarette Smoking, Incident Coronary Heart Disease, and Coronary Artery Calcification in Black Adults: The Jackson Heart Study

• Published in: Journal of the American Heart Association Vol. 10; no. 7; p. e017320
• Main Authors: Oshunbade, Adebamike A, Kassahun-Yimer, Wondwosen, Valle, Karen A, Hamid, Arsalan, Kipchumba, Rodney K, Kamimura, Daisuke, Clark, 3rd, Donald, White, Wendy B, DeFilippis, Andrew P, Blaha, Michael J, Benjamin, Emelia J, O'Brien, Emily C, Mentz, Robert J, Rodriguez, Carlos J, Fox, Ervin R, Butler, Javed, Keith, Rachel J, Bhatnagar, Aruni, Marie Robertson, Rose, Correa, Adolfo, Hall, Michael E
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 06-04-2021; Wiley
• Subjects: Black adults; Black or African American - psychology; Black or African American - statistics & numerical data; cigarette smoking; Cigarette Smoking - epidemiology; coronary artery calcification; Coronary Artery Disease - diagnosis; Coronary Artery Disease - ethnology; Coronary Artery Disease - prevention & control; Coronary Artery Disease - psychology; coronary heart disease; Coronary Vessels - pathology; Female; Heart Disease Risk Factors; Humans; Jackson Heart Study; Longitudinal Studies; Male; Middle Aged; Non-Smokers - statistics & numerical data; Original Research; Risk Assessment; Smokers - statistics & numerical data; United States - epidemiology; Vascular Calcification - diagnosis; Vascular Calcification - epidemiology; United States; Jackson Heart Study; cigarette smoking; coronary heart disease; coronary artery calcification; Black adults
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.120.017320

Background Although Black adults are more likely to die from coronary heart disease (CHD) compared with White adults, few studies have examined the relationship between cigarette smoking and CHD risk among Black adults. We evaluated the relationship between cigarette smoking, incident CHD, and coronary artery calcification in the JHS (Jackson Heart Study). Methods and Results We classified JHS participants without a history of CHD (n=4432) by self-reported baseline smoking status into current, former (smoked at least 400 cigarettes/life) or never smokers at baseline (2000-2004). We further classified current smokers by smoking intensity (number of cigarettes smoked per day [1-19 or ≥20]) and followed for incident CHD (through 2016). Hazard ratios (HR) for incident CHD for each smoking group compared with never smokers were estimated with adjusted Cox proportional hazard regression models. At baseline, there were 548 (12.4%) current, 782 (17.6%) former, and 3102 (70%) never smokers. During follow-up (median, 13.8 years), 254 participants developed CHD. After risk factor adjustment, CHD risk was significantly higher in current smokers compared with never smokers (HR, 2.11; 95% CI, 1.39-3.18); the difference between former smokers and never smokers (HR, 1.37; 95% CI, 1.0-1.90) did not achieve statistical significance. Among current smokers, we did not observe a dose-response effect for CHD risk. Additionally, in multivariable logistic regression models with a subset of our analytic cohort, current smokers had greater odds of coronary artery calcification score >0 compared with never smokers (odds ratio, 2.63; 95% CI, 1.88-3.68). Conclusions In a large prospective cohort of Black adults, current smoking was associated with a >2-fold increased risk of CHD over a median follow-up of greater than a decade.