ASSOCIATION OF AUTOANTIBODIES WITH SMOKING, CARDIOVASCULAR MORBIDITY, AND DEATH IN THE BUSSELTON POPULATION

Abstract

Among 3407 "normal" adults of Busselton, Western Australia, serum autoantibodies were found to be related to cigarette smoking, vascular disease, and subsequent mortality. Antinuclear autoantibodies (A.N.A.) were more common than expected in male and female smokers of all ages, while the prevalence of rheumatoid factor (R.F.) in men was increased in young smokers and older non-smokers. A.N.A. and R.F. were slightly more common than expected in women who had used oral contraceptives. Thyroid and gastric autoantibodies (T.G.A.), smooth-muscle antibody (S.M.A.), and A.N.A. were more common than expected amongst men, especially younger men, with angina or with symptoms of cerebrovascular disease. In contrast, these tissue autoantibodies were less common than expected amongst young women with severe cerebrovascular symptoms. R.F. was more common than expected amongst people with raised blood-pressure, and also amongst women with dyspnœa, angina, or cerebrovascular symptoms. Allowance for the effects of smoking did not remove the associations between autoantibodies and vascular disease. In a follow-up over 30 months, T.G.A. were found in 3 of the 5 men dying from ischæmic heart-disease before the age of 60 years. It is suggested that "normal" tissue autoantibodies could be markers of vascular disease in men, that R.F. could be a marker of vascular disease in women, and that the vascular risk associated with smoking may be related in part to autoantibody induction.