Presentation The negative association in women between cigarette smoking and uncomplicated angina pectoris in the Framingham heart study data

Abstract

As a result of a more complete analysis of available Framingham Heart Study data on the association of cigarette smoking to incidence of uncomplicated angina pectoris than has previously been published in Framingham papers, it was determined that there is a consistently negative risk factor association for women at every follow-up period from 12 to 30 years, with Framingham women cigarette smokers experiencing 30–40% lower rates of uncomplicated angina pectoris than non-smokers, the rates also declining with increasing amounts of cigarettes smoked. Our analysis confirms the absence of a predictive risk factor association in the case of men previously indicated by Framingham investigators. The published declarations by Framingham investigators of an absence of association between cigarette smoking and angina pectoris in Framingham women, is a failure to publicly recognize the distinctive negative association present in the Framingham female data. The Framingham data on the relationship of smoking to angina incidence is clearly at variance with the Surgeon General's sketchy finding of an inconsistent positive association for men and an uncertain relationship for women. It is suggested that special attention should be directed to these results of the Framingham data because of the preeminence of Framingham material world wide, because angina pectoris is the most common manifestation of coronary heart disease, because it will improve the “conventional wisdom” on this subject, and because the negative relationship found for Framingham women does not lend support to the belief held by some that smoking enhances the degree of cornonary atherosclerosis.