Researchers from Laval University Heart and Lung Institute, Canada, have reported that findings from the Heart Outcomes Prevention Evaluation (HOPE) have confirmed that smoking cigarettes increases the risk of stroke and cardiovascular disease (CVD). They have also found that giving up can have beneficial effects even in high-risk patients.
“In recent large cardiovascular trials done in stable patients, 14–31% of the participants were smokers,” note the authors of the study. However, they added, “the consequences of smoking in these trials using medications known to reduce cardiovascular events have not been assessed.”
The investigators decided to evaluate the outcomes in 8905 patients included in the HOPE trial whose smoking status was known. All had stable CVD, or diabetes and at least one other cardiovascular risk factor.
The patients were followed for 4.5 years, during which time 358 strokes occurred in the group. A total of 1021 participants died – 641 from cardiovascular causes.
Analysis of these results revealed that those who smoked were at a significantly increased risk of stroke, and an elevated risk of cardiovascular morbidity and mortality. This was true even after medication use was taken into account. Interestingly, the risk in those patients who had been former smokers but had quit was not significantly different to the risk for those who had always been nonsmokers.
“Smoking increased the risk of mortality and morbidity among high-risk patients despite the use of medications known to reduce cardiovascular events,” the researchers concluded.
They recommended that: “Smoking cessation programs should be reinforced even for patients participating in clinical trials.”