PMID- 19678933 OWN - NLM STAT- MEDLINE DCOM- 20091117 LR - 20231213 IS - 1471-2458 (Electronic) IS - 1471-2458 (Linking) VI - 9 DP - 2009 Aug 13 TI - Impact of cigarette smoking on the relationship between body mass index and coronary heart disease: a pooled analysis of 3264 stroke and 2706 CHD events in 378579 individuals in the Asia Pacific region. PG - 294 LID - 10.1186/1471-2458-9-294 [doi] AB - BACKGROUND: Elevated levels of body mass index (BMI) and smoking are well established lifestyle risk factors for coronary heart disease (CHD) and stroke. If these two risk factors have a synergistic relationship, rigorous lifestyle modification may contribute to greater reduction in cardiovascular burden than previously expected. METHODS: A pooled analysis of individual participant data from 38 cohorts, involving 378,579 participants. Hazards ratios (HRs) and 95% confidence intervals (CIs) for BMI by cigarette smoking status were estimated using Cox proportional hazard models. RESULTS: During a mean follow-up of 3.8 years, 2706 CHD and 3264 strokes were recorded. There was a log-linear, positive relationship of BMI with CHD and stroke in both smokers and non-smokers with evidence of a synergistic effect of smoking on the association between BMI and CHD only: HRs (95% CIs) associated with a 2 kg/m2 higher BMI were 1.13 (1.10-1.17) in current smokers and 1.09 (1.06-1.11) in non-smokers (p-value for interaction=0.04). CONCLUSION: Smoking amplifies the positive association between BMI and CHD but not stroke. If confirmed, these results suggest that effective strategies that target smoking cessation and weight loss are likely to have a greater impact than anticipated on reducing the burden of CHD. CN - Asia Pacific Cohort Studies Collaboration LA - eng GR - WT_/Wellcome Trust/United Kingdom GR - MC_U130059821/MRC_/Medical Research Council/United Kingdom PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20090813 PL - England TA - BMC Public Health JT - BMC public health JID - 100968562 SB - IM MH - Asia/epidemiology MH - *Body Mass Index MH - Cohort Studies MH - Coronary Disease/epidemiology/*physiopathology MH - Follow-Up Studies MH - Humans MH - Proportional Hazards Models MH - Risk Factors MH - *Smoking MH - Stroke/epidemiology/*physiopathology MH - *Nicotiana PMC - PMC2734855 FIR - Woodward, M IR - Woodward M FIR - Fang, X IR - Fang X FIR - Gu, D F IR - Gu DF FIR - Huxley, R IR - Huxley R FIR - Imai, Y IR - Imai Y FIR - Lam, T H IR - Lam TH FIR - Pan, W H IR - Pan WH FIR - Rodgers, A IR - Rodgers A FIR - Suh, I IR - Suh I FIR - Kim, H C IR - Kim HC FIR - Ueshima, H IR - Ueshima H FIR - Okayama, A IR - Okayama A FIR - Ueshima, H IR - Ueshima H FIR - Maegawa, H IR - Maegawa H FIR - Aoki, N IR - Aoki N FIR - Nakamura, M IR - Nakamura M FIR - Kubo, N IR - Kubo N FIR - Yamada, T IR - Yamada T FIR - Wu, Z S IR - Wu ZS FIR - Yao, C H IR - Yao CH FIR - Wu, Z S IR - Wu ZS FIR - Luszcz, Mary IR - Luszcz M FIR - Welborn, T A IR - Welborn TA FIR - Tang, Z IR - Tang Z FIR - Liu, L S IR - Liu LS FIR - Xie, J X IR - Xie JX FIR - Norton, R IR - Norton R FIR - Ameratunga, S IR - Ameratunga S FIR - MacMahon, S IR - MacMahon S FIR - Whitlock, G IR - Whitlock G FIR - Knuiman, M W IR - Knuiman MW FIR - Christensen, H IR - Christensen H FIR - Zhou, J IR - Zhou J FIR - Yu, X H IR - Yu XH FIR - Wu, X G IR - Wu XG FIR - Tamakoshi, A IR - Tamakoshi A FIR - Pan, W H IR - Pan WH FIR - Sritara, P IR - Sritara P FIR - Wu, Z L IR - Wu ZL FIR - Chen, L Q IR - Chen LQ FIR - Shan, G L IR - Shan GL FIR - Gu, D F IR - Gu DF FIR - Duan, X F IR - Duan XF FIR - MacMahon, S IR - MacMahon S FIR - Norton, R IR - Norton R FIR - Whitlock, G IR - Whitlock G FIR - Jackson, R IR - Jackson R FIR - Li, Y H IR - Li YH FIR - Lam, T H IR - Lam TH FIR - Jiang, C Q IR - Jiang CQ FIR - Kiyohara, Y IR - Kiyohara Y FIR - Arima, H IR - Arima H FIR - Iida, M IR - Iida M FIR - Woo, J IR - Woo J FIR - Ho, S C IR - Ho SC FIR - Hong, Z IR - Hong Z FIR - Huang, M S IR - Huang MS FIR - Zhou, B IR - Zhou B FIR - Fuh, J L IR - Fuh JL FIR - Ueshima, H IR - Ueshima H FIR - Kita, Y IR - Kita Y FIR - Choudhury, S R IR - Choudhury SR FIR - Suh, I IR - Suh I FIR - Jee, S H IR - Jee SH FIR - Kim, I S IR - Kim IS FIR - Giles, G IR - Giles G FIR - Hashimoto, T IR - Hashimoto T FIR - Sakata, K IR - Sakata K FIR - Dobson, A IR - Dobson A FIR - Imai, Y IR - Imai Y FIR - Ohkubo, T IR - Ohkubo T FIR - Hozawa, A IR - Hozawa A FIR - Jamrozik, K IR - Jamrozik K FIR - Hobbs, M IR - Hobbs M FIR - Broadhurst, R IR - Broadhurst R FIR - Nakachi, K IR - Nakachi K FIR - Fang, X H IR - Fang XH FIR - Li, S C IR - Li SC FIR - Yang, Q D IR - Yang QD FIR - Chen, Z M IR - Chen ZM FIR - Tanaka, H IR - Tanaka H FIR - Kita, Y IR - Kita Y FIR - Nozaki, A IR - Nozaki A FIR - Ueshima, H IR - Ueshima H FIR - Horibe, H IR - Horibe H FIR - Matsutani, Y IR - Matsutani Y FIR - Kagaya, M IR - Kagaya M FIR - Hughes, K IR - Hughes K FIR - Lee, J IR - Lee J FIR - Heng, D IR - Heng D FIR - Chew, S K IR - Chew SK FIR - Zhou, B F IR - Zhou BF FIR - Zhang, H Y IR - Zhang HY FIR - Shimamoto, K IR - Shimamoto K FIR - Saitoh, S IR - Saitoh S FIR - Li, Z Z IR - Li ZZ FIR - Zhang, H Y IR - Zhang HY FIR - Norman, P IR - Norman P FIR - Jamrozik, K IR - Jamrozik K FIR - He, Y IR - He Y FIR - Lam, T H IR - Lam TH FIR - Yao, S X IR - Yao SX FIR - Huxley, Rachel R IR - Huxley RR FIR - Nakamura, Koshi IR - Nakamura K FIR - Lam, T H IR - Lam TH FIR - Barzi, Federica IR - Barzi F FIR - Batty, G David IR - Batty GD FIR - Czernichow, Sebastien IR - Czernichow S FIR - Ueshima, Hirotsugu IR - Ueshima H FIR - Kim, Hyeon Chang IR - Kim HC FIR - Wong, Jean Woo IR - Wong JW FIR - Fang, Xianghua IR - Fang X FIR - Feigin, Valery IR - Feigin V FIR - Woodward, Mark IR - Woodward M EDAT- 2009/08/15 09:00 MHDA- 2009/11/18 06:00 PMCR- 2009/08/13 CRDT- 2009/08/15 09:00 PHST- 2009/03/23 00:00 [received] PHST- 2009/08/13 00:00 [accepted] PHST- 2009/08/15 09:00 [entrez] PHST- 2009/08/15 09:00 [pubmed] PHST- 2009/11/18 06:00 [medline] PHST- 2009/08/13 00:00 [pmc-release] AID - 1471-2458-9-294 [pii] AID - 10.1186/1471-2458-9-294 [doi] PST - epublish SO - BMC Public Health. 2009 Aug 13;9:294. doi: 10.1186/1471-2458-9-294.