Secondhand Smoke Exposure and Coronary Artery Calcification Among Nonsmoking Adults

Abstract

PP-31-002 Background/Aims: Exposure to secondhand smoke (SHS) is an exposure to air pollution of fine particulate matter, carcinogens, and various toxins, affecting large parts of the population. SHS increases the risk for acute cardiovascular events and may contribute to the development of atherosclerosis. We investigate the association of SHS with coronary artery calcification (CAC). Methods: In the present cross-sectional analysis, we used baseline data (2000–2003) of 1891 never smokers, aged 45–75 years, from an ongoing, prospective, population-based cohort study in Germany. Frequent SHS at home, at work, and in other places was assessed by questionnaire. CAC was measured by electron-beam computed tomography. We conducted multiple linear regression analysis using exposure to SHS (any location) as the explanatory variable and ln(CAC+1) as the response variable, adjusting for gender, age, socioeconomic status, and cardiovascular risk factors. Results: Frequent exposure to SHS was reported by 21.7% of respondents. After adjustment for age, gender, and socioeconomic status, (CAC+1) was 25.9% (95% confidence interval [CI]: −1.0% to 60.2%) higher in the exposed than in the unexposed. Inclusion of further cardiovascular risk factors (diabetes, cholesterol, body mass index, physical activity) reduced the estimate (19.7%; 95% CI: −5.4% to 51.5%). Highest effects were seen for exposure at home (35.8%; 95% CI: −2.8% to 89.8%). The effect of SHS was comparable to up to 3 years of older vascular age, depending on age range and sex. Conclusion: Our study provides first suggestive evidence of an association between exposure to SHS and coronary atherosclerosis. Considering the widespread exposure and the clinical relevance of coronary atherosclerosis, this result, if confirmed, is likely to be of high public health importance.