吸烟与心脏PPT.ppt

For those with a previous history of CVD, smoking cessation provides the greatest reduction in risk of death (all cause mortality) compared with different interventions controlling blood pressure and cholesterol. References Critchley, JA. Mortality Risk Reduction Associated with Smoking Cessation in Patients with Coronary Heart Disease. JAMA, 2003;290(1):86-97. Blood Pressure Lowering Treatment Trialists’ Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet, 2003; 362: 1527–35. Vrecer, M. Use of Statins in Primary and Secondary Prevention of Coronary Heart Disease and Ischemic Stroke. International Journal of Clinical Pharmacology and Therapeutics, 2003;41:567-577. Cholesterol Treatment Trialists’ (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90 056 participants in 14 randomised trials of statins. Lancet, 2005; 366: 1267–78. Key Point Quitting smoking reduces the risk of cardiovascular events. Background Quitting smoking substantially reduces the risk of all-cause mortality in individuals with CHD. A 2003 review of 9 electronic databases containing data from 1966 to 2003 for prospective cohort studies of patients with CHD, found that those who quit smoking had a 36% reduction in odds of all-cause mortality.1 A reduction in risk of cardiac events is evident even among those who recently quit. In a German study of 967 patients aged 30–70 years who already had experienced an acute coronary event, Twardella et al found that the odds ratio (OR) for subsequent cardiovascular events decreased according to smoking status. Based on serum cotinine levels, patients were classified as never smokers, former smokers, and current smokers. Patients who said they smoked but who were negative for cotinine were classified as recent quitters. Assigning an OR of 1.00 for current smokers,