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82


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84


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85


CARDIOVASCULAR

APPENDIX TABLES

87


Mlllr and   414 white male      Undcflned.                 10-19   SO-59
Purlpr,                                                 GO-69 70 or over 10-49   SO-59   oo-co 70 or *"cl
        coronary deaths.                           (5(i)   (135)   (153)
19Kl.                                                        (130)   (216)   (188)   (114)   (MX)
        Controlr: 606               NS  ., ., . ,I,14    G.GG   lb.30   33.84    19.91   24.41
U.S.A.                                                                       35.09   64.12
        white males.               All cixPrettc8  . ..11. . ..83.93   82.23   49.02   18.44    10.83   69.94   43.86   16.41
(l3ll.                          Pipes, cigars  ,. _. 8.83   11.11   32.68   4l.SO    9.26   16.47   21.05   29.41

Bucchley   Malrs rcvoriin~     Question-    NS  . . . . . . . . . . . . . .?0.4 (23)
et r.1..     CIID to California                                              NS  . . . . . . . . . . .42.1(61)
                      naire snd   520  . . . . . . . Cl.1 (69)
1058.                                                         S?O ., ,. I.. .46.3(S)
        IIrnlth Survey      interview.   >20  . ,, .* *. *.. ,18.6 (21)
U.S.A.                                                           >20  . . . . .11.6(10
        with mntched
(33).     contm3ls from
        slmr I"rvCY
         (included there
        surviving Arot
         myocardi~l
         infarction).


\D
0

                             rctrospectiuc studies (cont.)
TAULE AG.-Coronaq hnrt discusc morbidity and worlulity-
                (Actual number OC casca ahown in pnrcnthesn)'
          [ SM = Smokers       NS = Nonsmokers       EX = Ex-smokers1

Author.
year.
COUntrY,
rcrrrence

Number nnd
type of
Donulntiu"

Dstn
collcctian

Cnscs (percent)

Controls (percent)         Comments

Rusrsk and 97 mule and 3       Interviews           Tobacco ~<anyc>jU cigurctkalday                             Psticnts
Zohmrn.   lcmalc coronary     bs       70 percent.                             35 percent.                included 83
199.     pntientl. Controls:    authors.                                                           with chwical
U.S.A.    100 healthy control3                                                                  mkucnrdiut
(165).    of similar "g-2.                                                                     iliiairliu"
        sex. occupation.                                                                    nnd II WlLh
        and ethnic origin.                                                                   sngtna pcctorin.

SDai" and  269 males identified   3,000 mr1es   NS .,....., .30.0 (81)                   29.0 (772)
Nnthe",   8s hnving CHID by    in New    <lo/day ,,.. 29.0 (7.8)                   33.0 (870)
1961,     physical cxunlinntio"  York City   >40/day ,. .13.0 (33)                   9.0 (234) (D<o.ob)
U.S.A.    nnd history. Controla: Inter.     EX ,..,....,, . ..14.0 (301                   14.0 (361)
1176).    2,63?/3,000 male3     viewed and  Cigar. P~DC .ll.O (38)                   16.0 (400)
        iilcnrifirrl LLI       cxnmined       Tlltnl  ,100,0(2601                  100.0(2.637)
        "<lt hsvinv CHD     by medical
                      UW"P.

NS ..,,.,,.,.,.. rsa (is)
Shl  ,. ,., ,. .00.75l3CB)
EX ..,I ,.. ,. 4.15 (10)
Total  ..,....,,, 100.00~400)

Schwartz   612 male pntient3    Interview,    Average amount
et RI.,     with angina or     laboratory,    per day 89
1966.     myocardiel        and       cigarettes  .18.6
France    infarction.        clinlcel FX-  All SM  , . . .86.0
(169).    612 cue-matched     amindona.  Inhalers .59.0
         contrals.

15.5 (p<0.0001)
X6.0

Data snply O"IY lo
those under 55
ycurs or auc.

45.0(D<O.O0001)


TABLE A&-Coronary hart discnsc morbidity awl mortnlify- rcfrospecfiuc studies (cont.)

      (Actud number of canes shown In p8rc"thnc.a)'
ISM = Smoken       NS = Nonamokcrs       EX = Ex-smokers]

Number nnd
type or
DOpUlUtiWl

lhta
collection                Caacs (Percent)                 Controla (percent)         Comnrrnta

DBrkcn,   205 mah up to 44    Dcsthcer-    NS ,. . ,. 1.0 (2)                   18.4 (76)              Ex.smokrrr 11stcd
1967.     years of nge with    tlfmte re-   Cigorefti L'"ifr                                               undrl. nunsmukcr~.
Germany   mvocnrdial infsrc-    view. In-    1-6 ,,,...,.,.... 1.6 (3)                   10.4 (43)                Smokiua it!luln~nlii,"
(59).     tin" or sudden      tcrview of   IO-16  ,. . . . .32.2 (621                   46.5(192)                nvnilnblc o"ly on
        death (139 deceased,   patient    20-30  . . . . . . . . . ...43.6 (84)                   22.5 (83)                1?3/205. Thrsc
        6G living). Co"trols   or kin.     >36  . . . . . . . . . . ...21.8 (42)                    2.2 (9)               ciK(olrPLtc CnLcKOrir8
        -Hnmburp ngr-                       100.0~193)                 ~ 100.0(413)               i"rllldP n~ihr,Ll 01 cisnr
        matchcvl citizens '               (only 28 were mixed                     (G2 wcrc mixed nr           sm<,krrn ri~,ils.ulntrd
        selected randomly.               or cigar smokers)                      cigar smokers1            as LLI nutnhcr cbt CLKLL.
                                                                           I.P~~LY No vntir,ntr
                                                                           or controls brnilkcd
                                                                           "ii'rn cxcIu5i\rly.

    Dbrken,    33 females up to     Death cer-    Cioaretlcs prr dau
     1967.     44 yrnrsofngc      tificotcs,    0  . . . . . . . . . . ,.... 6.1  (2)                   63.?(841 (P<O.OOl)
     CettlWly   with myocsrdial     in tcr-      1-S                           1X3(23)
     (55).     infnrction or sudden   view.      6-15 ~~ .,......, 43.5 (ICI                   16.5(22)
             dcnth. Controls-133          ?O-30 . ..I....... 10.4 (13)                    3.0 14)
             fcmnlcn 27-44 YCR~R           >36  . . . . ..~.. c.1  (2)                   
             of time frcam clinic
           without CVD or lung
Lc7            CLi"CFt.
P                                                                           _--


TABLE A&-Coronary heasl disease morbidily and mortalily--7etro~ective studies (cont.)
               (Aeturl number of cum shown In ~nrenthesn)~
         [Shl = Smokers       NS = Nonsmokers       EX = Ex.smokeral

Cl3CO (pcrccnt)

Cummcntl

refcrcncc      population

Hybms    79 maln Iurvivino.    Interviews NS  . *... . . . . . . . 10.1  (S)                   21.0 (33)
et al,     myocsrdial infnrc-    by trained   l-9 eiearettes
1967,     lion. 167 age.       DW3Otltl.d.    perday 1.0  (6)                   10.5 (13)
Jkpnn    matched controls            lo-15 .._..., ,,,., 26.4 (18)                   33.9 (42)
(87).     hospilalired for nan-           16-20 ,..,..., ,. .35.2 (25)                   26.8 (37.)
        CVD but include             21-34  . . . 22.6 (1G)                   17.7 (22)
        hypcrtenaive diaeare.          >36  . 9.Y  (7)                   12.1 (15)
                              AllSbl  . . . . . . . . . . 100.0 (71)                  100.0(1!40
                                                -
Mulcahy    100 fet"ak DSthltS   Hospital     sm . . . . . . . I .I., 63.0 (63)                   45.6(261)               Smoking on controlr
et al.,     less than GO yesrs    interviews. NS  .,.....,,..,,, 33.0 (33)                   45.3(2511)                obtsinrd from
1967,     of age admitted t0            EX . . . . . . . . . . . . . 4.0  (4)                    0.1 (52)                stulisticn of
Ireland    hospital with CHD.               Total  . . . ..100.0(100)                  100.0(572)                smoking in
(IJIb.                                                                           Irish I~rpulrl~c.
                                                                           Sudclrn dvn\h
                                                                           ""1 IrlCIIIIICII.

Stejfa,    70 maleand        Direct               Plcvolcncc Of risk factora                              Authurs then fullowcd
19G7.     female patient3      interview.   Angina patient.,                         Control DIOllD             lhr 70 pnlirnts for
Poland    with recent onrct                60.0                                                  3 yrnr, and rrutcd
(179,.    exertional angina                                               48,1(p>O.l)              Lhnl amgaktng sinnifi.
        Deftotis. 54 control3                                                                  canlly inilurnr*,<l
        of same age.                                                                      the incidrncc ~1
                                                                           rormary ocrlurion.

Schimmler 603 males with      Hospital     NS ..,.....,,.,. 9.0 (40                   Z&0(187) (p<O.OOl)
et al..     healed myocsrdisl    interviewa.  EX  . .12.0 (59)
1968.                                                          2o.otl42) (p<o.oo1l
        infnrctiona. 714 mr~lc          Cisar, pipe ,. .12.0 (62)                   11.0 (711
Ccrmany   controll of same age           <IO cignrettel ,. .25,0(129)                   14 O(lOl) (n<O.OOl)
(IG7).    without dctcctable            >20  ..I. .42 0(2(13)                   29.or2oiI (P<O.OOl)
        hc.rt discaac.                  Total   100.0(503)                  100.0(714)
                         ,


Hood et al., 230 mnlel ru~viving   InlCrViCW                  (230)                      (8651
IOGP,     enrIy first myocsrdinl  snd exam-   Never smoked  .I.75                      24.2
SWdWl    infnrclion. Controls:   ination.    EX before
(8s).     855 raniiomly aelccted           Infarction ._ .I.75                      19.7
        mnlex 50 year3 of             EX nftcr
        B&-C.                     infarction  .2I1.1                       
                             <16 cignrottea .28.3                       27.4
                             >I6 cigarettes .22.6                       20.0
                              All ,, ,,. ., .EO.O                       47.4
                              Pipe   16.5                       8.8

JOUVC     1.229 CIID patients:   Interview.               43.0                      13.0~P<0.0001)
et al.,     802 malcs.427
1961.     fcmsics. Controls:
FranCe    743 individuals of
(91).     both BCXCJ: age.
        sex. and socinl
        class matcbedd.

Icrst1.     275 mrde railway     Interview    NS  . . . . . . . . . I... .ZO.O 1.55)                   29.8 (82)
1969.     FmploycPr UP to 65    and ex-    Z-20 cigarettes or
Germany   years of e.gc sur-     amina-      UD to 6 cigars.. .32.O (88)                   63.3 (82)
(98).     viving myocnrdial    tion.      >20 CigaretleS or
        infarction. 215 con-           >S cigars.  . . . . . ..48.0(132)                    6.9 119)
        trol employees with
        minor circulstory
        diaturbanccs.

    ' Unless otherwise specified. disparities pween the total number of case9
    and the sum of the individual smoking categories are due to the exclusion of
u    tither occuionrl, miacellaneoua. mixed, or ex-smokera.
w

-


TABLE A?`.-Differences in sertcm lipids betlceen sl,iokers and nonsmokers
         (Aciusl number of ind\vlduslo shown in parrnthm)'
             [Sat = Smukcn    NS = Nonsmokers]

Author. year.       Number and
countrv.          type of

Results

Comments

                      Diflermcc bctu,ern S,!l and NS          tSf relrrs to S~edbere
              ngca 90-19       Ages JO-S9        Apt-a4049     flotation unit8 of
Lipid:           f NS 55. SM 37)    (NS 66. SM 67)     (NS 17. Shl 44)   centrlfugcd lil,iaproteins.
tsr  o-12 . . . . ,. +59.9 lJ<O.OOI     +19.9 p<o.o5     + 3.9 P<O.OS
sr 12-20 .., .t.. + 9.4 p<o.o01     + 6.4 p<o.os     - 3.5 p<o.o5
Sl 20-100  +20.0 D<O.O25     f 9.1 D<o.o6     + 8.5 P<O.O5
Sf 100-400  ., ,. +1s.s P<O.O26     +12.1 p<o.os     - 4.5 D<o.os
Cholesterol t21.2 P<O.OS      f 9.0 p<a.o5     - 4.8 P<O.O5


TABLE A7.--l~i~crc~cccs in scrttn~ li?Jids between s7tlokeTs nntl 71ons7nokcrs (cont.)
           (Actual numbrr of Individuals shown in pnrtnthnrr)'
                I SM = Smuhe1.r    NS = Nonamokerrl

Ul~im~trnn~i      7C mlinrizyxutic       I. Mmozyrzutes discordnnt fur smoking: Smokers showed slightly lower levels  The auLhur> concludu from the
antl I.unrlmnn,    tbvin ~:LIIS nnd        of cholesterol. triRlyccridcs, and pho~pholiyid~ than nonsmokers.        di!Trring 512 and DZ rc~ult~
I !I 1: G ,         k7 <IIzygulic       II. Dizygatcs discordant fur Ymoking:  Smokers showed aignificsntly higher   that ronstituti~mal fnclore
S~t~llrn        twin nuir$ obtained      levels of phoupholipids. No diflcrencPs for cholnterol and triglycerldee.    are probnbly mum imporlnnt
(2'7).         from Swedish Twin                                                     than amuking in dctrnnlning
            Registry.                                                         lipid lcvcia.


200 clinicdly
hcnlthy males
20-50 years of
UKB.

             Strum cholcatcrol   Phorpholipidr     Total lipid8    Serum cholNLerol alao noted
               mg. percent      mp. pcmcnt      mg. pcrccnt     to increwe with increnrinv
NS(100)  . . .   110.2   P<O.Ol   26R.l          1.234.8        intensity and duration uf
Shl 100)  ,.,..*.....   224.0 I        257.6   p>o.o5   1.362.1 I  p<o.o1   amuking.
         j
                       11, lo-lapoprotc~iu
            Totnl fully acidr   ;Jcrccrlt 01 tot01
               mL7. vcrcrut      I~~~oirrotciu~

NS(100)  . . . . . . . . . . .  707.i
Shl 100)  . . . .   BG0.3 \  D<o.ol    43.1
                           4D.O   p10.01


           TABLE A7.-Diffcrcnccs in scmn~ lipids 6elwccn smokers and nonsmokers (cont.)
                            (Actual number of individuals shown in parcnthmcs)'
                                  [SM = Snrokers    NS = NonJmok<,rsl
                                               -
Author, year.
   country.    Nut;;:`o;nd                         Rnulls                               Commenls
  rcfcrcnce        papulatiun

llirgina        5,03U mnk und                                   Mnlcr          Fcmafer
and Kjrlrberp.    lcmolc reridcntd     NS I.... ,.,e. . . ,, . ,, ..t.,. .I...  209.0  (360)       210.1~1.439)
lVJ7.         uf Trcumsoh.      Clgnrette  . ,.a . I. * 3 I. I. . I,.  212.6(1,426)       212.4 (110)
U.S.A.         blichiann. 16-79
(al).         Yrnrs 01 BKC,

Pincherly
and Wright,
,967.
Ennisnd
(150).

2.000 ml.?"
participating in
executive benlth
examinations
28-10 years of
iwe.

                                Percentage with 8-m  The authors noted that amokcrs
                      Serum cholcslrrol   chofeaterol>270     ahownl significantly biphcr
                        tng. petcni1      mg.pcrcmlt       (p<O.OOl) .erum ChulLnlcrol
NS(G71)  . . . . .  ?36.2           19.0         levels than nonsmokers.
Ex-smoker(388)  _. . . . . _. ., ._ _, .,  24C.0           28.0
1-19 cigaretteslday(424)  . . .  239.2           24.0
>20 cigarettes/duy(Sll)    249.4           30.0

Van Buchem.
1967,
Netherlands
(19Pl.

--
Quvlr ct al..
19BM. .
U.S.A.
i la ) .

918 randomly chowen                            Strum clLolcafcrol              The nuthon found no
maks 40-SY yearn                O-209 mg. portent PIO-249 mg. percent >250 mg. percent   correlution bctwwn smokbnu
of age for entry     NS .,t...,.....,..... 12.4 (32)       14.0 (40       14.2 (41)      and serum chokntrrol Icvela.
Into prospective     Ciparettc SM    `lt.6(184)       67.8(213)       68.2(197)
study.          Other  . . . .  16.0 (41)       18.2 (61)       17.6 (61)

1.10% male lnctory                         Snum chorcslcrd   Strum Bclo-liyoprotcin Dcta-lipoprotrins were found
rmaloyem 20.64                           mg, pcrccllt         mp. pcrccnt      to increase with age. but
Y*nrl Of age.       NS . . . . . . . . . . . . . . . . .  243(519)                         smokers had hivhcr lcvcl~
              SM                   251(576)  p<o.oos
                 . ,                               than nonsmoker at nil 86~~.

    Ceganova       49 mf1k8 living                           Sunlm cliolcslcrol   Strum Beta-lipoprotein
     ct al..         in youth hostel,                           mg. percc,,l        mo, pcrccnt
     1968.         21.6 BYerage aye.     NS(34)  . . . . . . . . .I. .
     Czechoslovakia                           188.20)        359.80 (
                            SM (15) . . . . . . . . . . . . . . . . ., 214.2oj "<".025    498.4Oj P<O.OOl
      (36).                                                   Drla.ldyhn lipoprotein ratio
                              NS(34)  .l.....I...........................,..,I..II.I.  1.16
                              SM(16)                                   D<".026
                                    . . . . . . . . . ,... .,.... . ...,..., ,,..  1.66
a
-4


TABLE A'l.-Differcnccs in serum lip'ds between smokers and nonsmokers (cont.)
           (Actunl number al Individual3 shown In pnrcnlhwcs)l
                IShl = Smukcrv    NS = Nonsmokcrsl


T~BLC A&--Blood pressure differences between smoker8 and nonsmokers
    (Actual number of indlviduab ahown in parenthneaa)'
         [Shf c Smokers    NS = Nonsmokera]

Karvonen et d.,  625 malea in                                     Svrfolir blood preuurc        No dutn on P~PC nnd
19.50. Finland   various regions                            Weal Fiulnrtd    Earl Finland     Hclrirlki   cigar amokcra. No
(97).        of Finland        NS  ,,. . . .t ..I .  139.2(64)      142.6 (39)      132.8 (62)  statistical rigniticnncc
           2&59 ye*rs of      Shf ..,,.,.....,.,.,................ 133.2(91)      135.4 (103)     129.8(166)  noted.
           age.                                        Diastolic blood prcarure
                         NS  , . . . . . . . . . .  84.7         6G.B         89.6
                         Shf  . ,I. . . . ,. I,. ..a . ., . .  81.9         84.1         86.8

Clark et al..    1.859 male civil                                 hlcan ayatolic         Afean diurtolic Nonsmoker and smoker
1967. IJ S.A.    wrvarits.                                    blood-preanrrc        bloo&~rcsa~~re  groups wercof similar


TABLE AL-Blood pressure difemnces between smokers and nommohre (cont.)
           (Actual number of individusla shown In aarentheeea)1
                [SM = Smokers    NS = Nonsmokers1

HIpgins and    6.030 male and                   Age c.dituted                Age adjusted
KjcLburo.     female r&dent@             mean wrtdic blood PICMUW        mran diwlolic blood r)rcdru~e
1967, U.S.A.   b! Tecumseh, MLrhlpan.           M&8      Femokr        Maka     Ft?V&#
(JJI.        lb-79 P?aII al .&!e.   NS  . . . . . . . .137.8 (960)   84.6(14391     136.6 (WI)
                        Clparetk , ..196.4(1426)   81.4 (010)      131.6(1426)

Reid et ti..     676 mak Brlthh

1967. Enoland   and O?G male
(JS6),       American POSW
          worken (D-69
          YCnrl of age.

        (djualcd/or diflnencc in wcigld)
         UK Ncan watolic blood yr-rd

                     U.S.A.
NS . . . . .128.2 (46)        124.8 (80)
I-14~ramc 130.2 (27)        133.0 (60)
16-24 trama 128.6(232)        127.7(169)
>26 PT~UIB 127.9 (`JO)        128.1(218)
All amounta 129.1(619)        128.6 (447 I

The author did notz

MUX diadtoldic b&d yrcrrvrc    Shf-NS blood "rcaeurr dlf-
    UK       Lf.5.A.    lcrmcm prior to
    70.9        81.0     rnntrolling fur wciuht.
    19.4        62.1     but nut sltcr such cuntrol.
    78.6        71.3
    71.6        17.1
    78.7        77.8
             -
JS'O-J70/            Numbers in parcnthcwa
Ioo-Iro(zro~ >J7sl>IJs(rs,  reurewnt tatnl in blood
   25.5        34.7      yrcllure group.
   26.6        18.7      The nulhor noted
   15.6        17.3     a stcpwiue dwrcue with
   10.0         4.0      ICI,@1 01 blood pwsJ"re

Tibblin. 1967.   896 m&3 In
SW&tl      GGtebn?, SW&J&
(Jar).       born in 1913.

           L?locd prcrr,rre    J JS-145/
          ~110/~70(a9)    7*95 (468)
NS  . . . . . . . . . . . .t. . . . . IP:O        23.0
l-14 clgaretta,  *....,..... 29.2        21.2
>I6 cigar&k-a  . . . . . . . . . . . 28.1        20.9
Pipe and cigar  , . ,, 11.2         8.6

ditiduala and the aum cl tbc individual smoking categories are due to the
excluioa of either oeeuional, mlrel+oua, mhd, or ex-smokera.