Association of cigarette smoking with chronotropic incompetence and prognosis in the Framingham Heart Study.
Background In this study, we sought to determine whether cigarette smoking is associated with chronotropic incompetence and to explore prognostic implications of this association.
Methods and Results Members of the Framingham Offspring Study (1468 men and 1642 women) underwent graded exercise.
Chronotropic incompetence was assessed in two ways : (1) failure to achieve an age-predicted target heart rate and (2) a low chronotropic index, a heart rate response measure that accounts for effects of age, resting heart rate, and physical fitness.
Smokers were more likely to fail to reach target heart rate than were nonsmokers (men, 25% versus 15%, odds ratio [OR], 1.97 ; 95% confidence interval [CI], 1.51 to 2.56 ; women, 32% versus 18% ; OR, 2.10 ; 95% CI, 1.63 to 2.61) and were more likely to have a low chronotropic index (men, 17% versus 12% ; OR, 1.50 ; 95% CI, 1.12 to 2.03 ; women, 17% versus 8% ; OR, 2.28 ; 95% CI, 1.68 to 3.09).
These associations persisted after adjustment for age, cardiovascular risk factors, pulmonary function, and ST-segment response to graded exercise.
During 8 years of follow-up, there were 48 deaths and 90 incident coronary heart disease events among the men.
After adjustment for the same confounders, men who were smokers and failed to achieve target heart rate were at particularly high risk for death (adjusted relative risk [RR], 2.45 ; 95% CI, 1.14 to 5.24) and for coronary heart disease (adjusted RR, 4.92 ; 95% CI, 2.84 to 8.53). (...)
Mots-clés Pascal : Athérosclérose, Cardiopathie coronaire, Trouble rythme cardiaque, Exercice physique, Tabagisme, Epidémiologie, Facteur risque, Pronostic, Homme, Etats Unis, Amérique du Nord, Amérique, Appareil circulatoire pathologie, Vaisseau sanguin pathologie
Mots-clés Pascal anglais : Atherosclerosis, Coronary heart disease, Arrhythmia, Physical exercise, Tobacco smoking, Epidemiology, Risk factor, Prognosis, Human, United States, North America, America, Cardiovascular disease, Vascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0437400
Code Inist : 002B03E. Création : 19/12/1997.