Abstract P068: Cigarette Smoking and Peripheral Arterial Disease in African Americans of the Jackson Heart Study

Abstract

Introduction: African Americans are more than twice as likely to develop peripheral arterial disease (PAD) compared to whites. Increased rates of hypertension, obesity and diabetes may account for some of these differences; however other factors such as cigarette smoking, which is understudied in African Americans, may play an important role. Aim: To evaluate the relationship between cigarette smoking and PAD in African Americans in the Jackson Heart Study (JHS). Methods: JHS participants (n=5,301) were classified by self-reported smoking status into current, past (smoked at least 400 cigarettes/life) or never smokers. Multivariate logistic and robust linear regression models were used to estimate the associations between smoking status at baseline and measures of subclinical PAD [carotid intimal medial thickness (CIMT, visit 1), ankle-brachial index (ABI, visit 1) and aortic calcium by computed tomography (visit 2)] to yield odds ratios (OR) and β-coefficients (estimated adjusted difference) to compare each smoking status to never smokers (reference group). Results: There were 3579 never smokers, 986 past smokers and 693 current smokers identified at baseline. After adjustment for covariates, past and current smokers had an increased risk of ABI < 1, increased CIMT and increased abdominal aortic and aorto-iliac calcium (all p<0.05, Table). Furthermore, current smokers smoking more than 20 cigarettes daily (1 pack) had a higher risk of PAD by all of these measures compared to current smokers smoking 1-19 cigarettes daily suggesting a dose-dependent relationship. Conclusions: In a large prospective African American cohort, current cigarette smoking was independently associated with measures of PAD in a dose-dependent manner. Furthermore, cigarette smoking was most strongly associated with abdominal aortic and aorto-iliac calcification. Current smoking is a strong predictor of subclinical PAD in African Americans and smoking cessation should be recommended.