Cigarette Smoking and Risk of Atrial Fibrillation: The Rotterdam Study
Background: Cigarette smoking is an important risk factor for cardiovascular disease, but it is unknown whether it also contributes to the risk of atrial fibrillation.
Methods and results: The study is part of the Rotterdam Study, a population-based cohort study among subjects aged ≥55 years. The association between cigarette smoking and the risk of atrial fibrillation was examined in 5,668 subjects without atrial fibrillation at baseline. During a median follow-up of 7.2 years, 371 cases of atrial fibrillation were identified. Relative risks (RR) were calculated with 95% CIs using the Cox proportional hazards model, adjusted for age, gender, body mass index, hypertension, systolic blood pressure, serum cholesterol level, diabetes mellitus, left ventricular hypertrophy on the electrocardiogram, prevalent and incident myocardial infarction, prevalent heart failure, and the use of pulmonary medication.
After multivariate adjustment, current smokers and former smokers had increased risks of atrial fibrillation as compared to never smokers (RR 1.51, 95% CI 1.07-2.12; and RR 1.49, 95% CI 1.14-1.97, respectively). No differences were found between men and women.
Conclusions: The results of this prospective, population-based study show that current and former smoking of cigarettes are associated with increased risk of atrial fibrillation.
Tobacco smoking is the best-documented preventable risk factor for cancer and cardiovascular disease. Tobacco smoking harms the heart through several mechanisms. In general, smoking causes or aggravates endothelial dysfunction and atherosclerosis and causes cardiac rhythm disorders through the combined effects of nicotine, carbon monoxide, and polycyclic aromatic hydrocarbons. Tobacco smoking may thus change the myocardial substrate as well as action potentials. Both processes provoke and facilitate atrial fibrillation. Several case reports are presented on the onset of atrial fibrillation after the ingestion of nicotine, but the results of population-based studies on the association between smoking and atrial fibrillation are conflicting. Therefore, we investigated the association of cigarette smoking with the onset of atrial fibrillation in a large prospective population-based study, the Rotterdam Study.
Abstract and Introduction
Abstract
Background: Cigarette smoking is an important risk factor for cardiovascular disease, but it is unknown whether it also contributes to the risk of atrial fibrillation.
Methods and results: The study is part of the Rotterdam Study, a population-based cohort study among subjects aged ≥55 years. The association between cigarette smoking and the risk of atrial fibrillation was examined in 5,668 subjects without atrial fibrillation at baseline. During a median follow-up of 7.2 years, 371 cases of atrial fibrillation were identified. Relative risks (RR) were calculated with 95% CIs using the Cox proportional hazards model, adjusted for age, gender, body mass index, hypertension, systolic blood pressure, serum cholesterol level, diabetes mellitus, left ventricular hypertrophy on the electrocardiogram, prevalent and incident myocardial infarction, prevalent heart failure, and the use of pulmonary medication.
After multivariate adjustment, current smokers and former smokers had increased risks of atrial fibrillation as compared to never smokers (RR 1.51, 95% CI 1.07-2.12; and RR 1.49, 95% CI 1.14-1.97, respectively). No differences were found between men and women.
Conclusions: The results of this prospective, population-based study show that current and former smoking of cigarettes are associated with increased risk of atrial fibrillation.
Introduction
Tobacco smoking is the best-documented preventable risk factor for cancer and cardiovascular disease. Tobacco smoking harms the heart through several mechanisms. In general, smoking causes or aggravates endothelial dysfunction and atherosclerosis and causes cardiac rhythm disorders through the combined effects of nicotine, carbon monoxide, and polycyclic aromatic hydrocarbons. Tobacco smoking may thus change the myocardial substrate as well as action potentials. Both processes provoke and facilitate atrial fibrillation. Several case reports are presented on the onset of atrial fibrillation after the ingestion of nicotine, but the results of population-based studies on the association between smoking and atrial fibrillation are conflicting. Therefore, we investigated the association of cigarette smoking with the onset of atrial fibrillation in a large prospective population-based study, the Rotterdam Study.
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