Association Between Smoking Status And Carotid Plaque At Two Rural Areas In Eastern China

Objective To investigate the association of cigarette smoking status with carotid plaque in rural population residing at rural area of two cities in Eastern China, and interaction between smoking status and age in association with carotid plaque.Methods Between July and September of 2013, an epidemiological survey was carried out in residents aged 40 years or above who were enrolled randomly in rural areas of Anqing, Anhui Province and Lianyungang, Jiangsu Province. The data on epidemiological characteristics including smoking status, physical examination and carotid ultrasonography were collected using standardized protocol and questionnaire survey by trained interviewers. the incidence of carotid plaque was compared among never smokers,former smokers and current smokers. Logistic regress analysis was used to estimate the effect of smoking on carotid plaque by adjusting potential confounding.Results A total of 1639 participants were included in the data analysis. Of there are 625 males(38.1%) and 1014 females(61.9%). The average age of the total population were 62.9±7.3, men:64.4±6.9), women:62.0±7.4. The previlace rates of never, former and current smokers were 20.7%(339/1639), 8.7%(142/1639), 70.7%(1158/1639). In men were 51.4%(321/625), 21.3%(133/625), 27.4%(171/625). In women were 1.8%(18/1014), 0.9%(9/1014), 97.3%(987/1014). The prevalence rates of carotid plaque was 24.6%(404/1639), in men 32.0%(200/625), in women 20.1%(204/1014).In total samples, comparing with never smokers(20.2%), the prevalence rate of carotid plaques was significantly higher in current smokers(35.7%, P<0.001) and former smokers(34.6%, P<0.001). In men, comparing with never smokers(23.4%) the prevalence rate of carotid plaques was significantly higher in current smokers(35.2%, P=0.007) and former smokers(35.3%, P=0.022). In women, comparing with never smokers(19.7%), the prevalence of carotid plaques was significantly higher in current smokers(44.4%, P=0.016).After adjustment for age, sex, alcohol, body mass index, systolic blood pressure, total cholesterol, blood glucose, high-density lipoprotein and regional, current smoker was significantly associate with carotid plaque, in total samples:(OR=1.99, 95%CI:1.31~3.01, P=0.001), in male:(OR=1.90, 95%CI:1.18~3.06, P=0.009), in women:(OR=2.45, 95%CI:0.89~6.76, P=0.084). Multiple logistic regression analysis showed that there was a significant interaction between current smoking and age in association with carotid plaque. Compared with the young(<60 yrs and never smoking group, the prevalence rate of carotid plaque among the elderly(?70 yrs) and smoking group was significantly higher, in total was(57.4% versus 11.6%, OR=7.89, 95%CI:4.05~15.39, P<0.001), in men(55.7% versus 7.9%, OR=10.69, 95%CI:2.82~40.51, P<0.001),in women(71.4% versus 12.0%, OR=13.41, 95%CI:2.41~74.48, P=0.003).Conclusion Our study found that cigarette smoking was associated with increased risk of carotid plaque and there was a joint effect of age and smoking in rural population residing in Eastern part.of China.Given a high smoking rate in Chinese rural, tobacco control should be further enhanced to reduce the risk of cardiovascular diseases.