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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1989 Sep;43(3):214–217. doi: 10.1136/jech.43.3.214

Smoking and myocardial infarction in women: a case-control study from northern Italy.

A Gramenzi 1, A Gentile 1, M Fasoli 1, B D'Avanzo 1, E Negri 1, F Parazzini 1, C La Vecchia 1
PMCID: PMC1052838  PMID: 2607297

Abstract

STUDY OBJECTIVE: To examine the relationship between smoking and myocardial infarction in women. DESIGN: Case-control study over 5 years. SETTING: Cases were women admitted to 30 coronary care units in northern Italy. Controls were admitted to the same hospitals with other acute disorders. PARTICIPANTS: These were 262 young and middle aged women with acute myocardial infarction (median age 49 years, range 24-69) and 519 controls with other acute disorders unrelated to ischaemic heart disease (median age 47 years, range 22-69). MEASUREMENTS AND MAIN RESULTS: Stratification and the Mantel-Haenszel procedure, and unconditional multiple logistic regression were used to obtain relative risks according to levels of cigarette smoking. The regression equations included terms for age, education, coffee and alcohol consumption, diabetes, hypertension, hyperlipidaemia, body mass index and oral contraceptive use. Compared to life long non-smokers, relative risk was not significantly above unity for ex-smokers but among current smokers showed a significant trend to increasing risk with larger numbers of cigarettes smoked, with risk estimates of 2.3, 5.9 and 11.0 for less than 15, 15-24 and greater than or equal to 25 cigarettes per day respectively. Smoking related risks were consistently raised across strata of hyperlipidaemia, hypertension and increased alcohol and coffee intake. CONCLUSIONS: In terms of population attributable risk, about 48% of all myocardial infarctions in young and middle aged Italian women were attributable to cigarette smoking, which is therefore by far the most important preventable determinant of the disease.

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Selected References

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  1. Bruzzi P., Green S. B., Byar D. P., Brinton L. A., Schairer C. Estimating the population attributable risk for multiple risk factors using case-control data. Am J Epidemiol. 1985 Nov;122(5):904–914. doi: 10.1093/oxfordjournals.aje.a114174. [DOI] [PubMed] [Google Scholar]
  2. Doll R., Gray R., Hafner B., Peto R. Mortality in relation to smoking: 22 years' observations on female British doctors. Br Med J. 1980 Apr 5;280(6219):967–971. doi: 10.1136/bmj.280.6219.967. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Doll R., Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. doi: 10.1136/bmj.2.6051.1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Hammond E. C., Garfinkel L. Coronary heart disease, roke, and aortic aneurysm. Factors in the etiology. Arch Environ Health. 1969 Aug;19(2):167–182. [PubMed] [Google Scholar]
  5. Hammond E. C. Smoking in relation to the death rates of one million men and women. Natl Cancer Inst Monogr. 1966 Jan;19:127–204. [PubMed] [Google Scholar]
  6. La Vecchia C., Decarli A. Trends in ischemic heart disease mortality in Italy, 1968-78. Am J Public Health. 1986 Apr;76(4):454–456. doi: 10.2105/ajph.76.4.454. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. La Vecchia C., Franceschi S., Decarli A., Pampallona S., Tognoni G. Risk factors for myocardial infarction in young women. Am J Epidemiol. 1987 May;125(5):832–843. doi: 10.1093/oxfordjournals.aje.a114599. [DOI] [PubMed] [Google Scholar]
  8. MANTEL N., HAENSZEL W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959 Apr;22(4):719–748. [PubMed] [Google Scholar]
  9. Mann J. I., Doll R., Thorogood M., Vessey M. P., Waters W. E. Risk factors for myocardial infarction in young women. Br J Prev Soc Med. 1976 Jun;30(2):94–100. doi: 10.1136/jech.30.2.94. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Mann J. I., Inman W. H. Oral contraceptives and death from myocardial infarction. Br Med J. 1975 May 3;2(5965):245–248. doi: 10.1136/bmj.2.5965.245. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Rosenberg L., Kaufman D. W., Helmrich S. P., Miller D. R., Stolley P. D., Shapiro S. Myocardial infarction and cigarette smoking in women younger than 50 years of age. JAMA. 1985 May 24;253(20):2965–2969. [PubMed] [Google Scholar]
  12. Rosenberg L., Miller D. R., Kaufman D. W., Helmrich S. P., Van de Carr S., Stolley P. D., Shapiro S. Myocardial infarction in women under 50 years of age. JAMA. 1983 Nov 25;250(20):2801–2806. [PubMed] [Google Scholar]
  13. Rosenberg L., Shapiro S., Kaufman D. W., Slone D., Miettinen O. S., Stolley P. D. Cigarette smoking in relation to the risk of myocardial infarction in young women. Modifying influence of age and predisposing factors. Int J Epidemiol. 1980 Mar;9(1):57–63. doi: 10.1093/ije/9.1.57. [DOI] [PubMed] [Google Scholar]
  14. Willett W. C., Green A., Stampfer M. J., Speizer F. E., Colditz G. A., Rosner B., Monson R. R., Stason W., Hennekens C. H. Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes. N Engl J Med. 1987 Nov 19;317(21):1303–1309. doi: 10.1056/NEJM198711193172102. [DOI] [PubMed] [Google Scholar]

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