January 23, 2019
1 min read

PAD risk greater in black individuals with smoking history

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A history of cigarette smoking was associated with measures of subclinical peripheral artery disease in a cohort of black individuals, according to findings published in the Journal of the American Heart Association.

Research performed by Donald Clark III, MD, MPH, assistant professor of medicine at the University of Mississippi Medical Center, and colleagues analyzed 5,306 participants from the Jackson Heart Study who were classified by self-reported smoking history.

“Cigarette smoking is a powerful predictor for the development of PAD with a magnitude of association even greater than that reported for coronary heart disease,” Clark and colleagues wrote. “There are limited data directly assessing the association of cigarette smoking on PAD in African-Americans.”

Researchers identified 3,579 never smokers, 986 past smokers and 693 current smokers through self-reporting, with participants smoking more than 400 cigarettes in their lifetime being considered as ever smokers.

With the adjustment of covariates, Clark and colleagues identified that smokers had increased risk for ankle-brachial index less than 1 (OR = 2.2; 95% CI, 1.5-3.3). Smokers also had increased risk for abdominal aortic calcium (OR = 8.4; 95% CI, 5.8-12) and aortoiliac calcium (OR = 9.6; 95% CI, 6.7-13.7) compared with never smokers.

When the researchers stratified participants by smoking intensity, participants smoking more than a pack a day had a higher likelihood of subclinical PAD compared with lower-intensity smokers, suggesting a dose-dependent relationship (P for trend for ankle-brachial index < .05; P for trend for calcium measures < .001).

Researchers wrote self-reported use of tobacco products such as dip and snuff, pipes and cigars were low and there were a lack of data for secondhand and thirdhand smoke.

“These data provide further evidence of the deleterious health effects of smoking in African-Americans and support further research exploring the impact of interventions on smoking cessation to reduce PAD in this population,” Clark and colleagues wrote. – by Earl Holland Jr.

Disclosures: Clark reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.