Association of smoking with coronary artery disease depending on other cardiovascular risk factors

Aim . To study the possibility of the presence of coronary artery disease (CAD) depending on the smoking status, as well as to estimate the association of smoking with other traditional risk factors in residents of Kemerovo region aged 25 –64 years. Materials and methods. We analyzed the results of the multicenter epidemiological study “Epidemiology of cardiovascular diseases and their risk factors in the Russian Federation” in Kemerovo region obtained from a random sample of 1,599 subjects aged 25–64 years. Besides the smoking status, the following parameters were analyzed: gender, age, education, diabetes mellitus (DM) and arterial hypertension (AH) history, hypercholesterolemia, hypertriglyceridemia, high level of low-density lipoproteins, low level of high-density lipoproteins (HDL), hyperglycemia, obesity, alcohol abuse, and depression. Results. Three groups were formed depending on the smoking status: group 1 included 484 (30.3%) current smokers, group 2 had 317 (19.8%) former smokers and group 3 had 798 (49.9%) individuals who had never smoked. The groups did not differ in the prevalence of CAD. When determining the rank significance of the impact of risk factors on the possibility of CAD development in the overall population, it was revealed that the age affected the risk of CAD the most, while smoking and low HDL had minimal impact. The impact of the smoking factor on CAD was higher in the representatives of the older age group; however, even in the subjects aged ≥ 50 years, the smoking factor was not the leading one and followed DM, hypertriglyceridemia, depression, and obesity. The possibility of CAD development in smokers, as opposed to individuals who had never smoked, increased when smoking was accompanied by hypercholesterolemia, hypertriglyceridemia, male sex, lack of higher education, depression, and age of ≥ 50 years. The possibility of CAD development in former smokers as opposed to nonsmokers increased when smoking was accompanied by hyperglycemia. Conclusion . Smoking is not the primary risk factor in CAD detection in the studied sample. In the presence of additional risk factors, the impact of smoking on the possibility of CAD detection increases.