TY - JOUR
T1 - The contribution of smoking to differences in cardiovascular disease incidence between men and women across six ethnic groups in Amsterdam, the Netherlands
T2 - The HELIUS study
AU - Bolijn, Renee
AU - Muilwijk, Mirthe
AU - Nicolaou, Mary
AU - Galenkamp, Henrike
AU - Stronks, Karien
AU - Tan, Hanno L.
AU - Kunst, Anton E.
AU - van Valkengoed, Irene G. M.
N1 - Funding Information: The HELIUS study is conducted by the Amsterdam University Medical Centers, location AMC, and the Public Health Service of Amsterdam. Both organizations provided core support for HELIUS. The HELIUS study is also funded by the Dutch Heart Foundation, the Netherlands Organization for Health Research and Development (ZonMw), European Union (FP-7), and the European Fund for the Integration of non-EU immigrants (EIF). The work of Renee Bolijn and Irene G.M. van Valkengoed was supported by the ZonMw Gender and Health (grant number 849200008) and Gender and Prevention (grant number 555003016) programmes. Hanno L. Tan has received funding from the European Union's Horizon 2020 research and innovation programme under acronym ESCAPE-NET (grant number 733381), and the COST Action PARQ (grant agreement number CA19137) supported by COST (European Cooperation in Science and Technology). Funding Information: We are most grateful to the participants of the HELIUS study and the management team, research nurses, interviewers, research assistants and other staff who have taken part in gathering the data of this study. The HELIUS study is conducted by the Amsterdam University Medical Centers, location AMC, and the Public Health Service of Amsterdam. Both organizations provided core support for HELIUS. The HELIUS study is also funded by the Dutch Heart Foundation, the Netherlands Organization for Health Research and Development (ZonMw), European Union (FP-7), and the European Fund for the Integration of non-EU immigrants (EIF). The work of Renee Bolijn and Irene G.M. van Valkengoed was supported by the ZonMw Gender and Health (grant number 849200008) and Gender and Prevention (grant number 555003016) programmes. Hanno L. Tan has received funding from the European Union's Horizon 2020 research and innovation programme under acronym ESCAPE-NET (grant number 733381), and the COST Action PARQ (grant agreement number CA19137) supported by COST (European Cooperation in Science and Technology). Publisher Copyright: © 2023 The Authors
PY - 2023/2/1
Y1 - 2023/2/1
N2 - It is unclear to what extent differences in cardiovascular disease (CVD) risk between men and women are explained by differences in smoking, and whether this contribution to risk is consistent across ethnic groups. In this prospective study, we determined the contribution of smoking to differences in CVD incidence between men and women, also in various ethnic groups. We linked baseline data of 18,058 participants of six ethnic groups from the HELIUS study (Amsterdam, the Netherlands) to CVD incidence data, based on hospital admission and death records from Statistics Netherlands (2013–2019). The contribution of smoking to CVD incidence, as estimated by the population attributable fraction, was higher in men than in women, overall (24.1% versus 15.6%) and across most ethnic groups. Among Dutch participants, however, the contribution of smoking was higher among women (21.0%) than men (16.2%). Using Cox regression analyses, we observed that differences in smoking prevalence explained 22.0% of the overall lower hazard for CVD in women compared to men. Smoking contributed minimally to the lower hazards for CVD in women among participants of Dutch (0%), Ghanaian (4.9%) and Moroccan origin (0%), but explained 28.6% and 48.6% of the lower hazards in women in South-Asian Surinamese and African Surinamese groups, respectively. While smoking prevention and cessation may lead to lower CVD incidence in most groups of men and women, it may not substantially reduce disparities in CVD risk between men and women in most ethnic groups.
AB - It is unclear to what extent differences in cardiovascular disease (CVD) risk between men and women are explained by differences in smoking, and whether this contribution to risk is consistent across ethnic groups. In this prospective study, we determined the contribution of smoking to differences in CVD incidence between men and women, also in various ethnic groups. We linked baseline data of 18,058 participants of six ethnic groups from the HELIUS study (Amsterdam, the Netherlands) to CVD incidence data, based on hospital admission and death records from Statistics Netherlands (2013–2019). The contribution of smoking to CVD incidence, as estimated by the population attributable fraction, was higher in men than in women, overall (24.1% versus 15.6%) and across most ethnic groups. Among Dutch participants, however, the contribution of smoking was higher among women (21.0%) than men (16.2%). Using Cox regression analyses, we observed that differences in smoking prevalence explained 22.0% of the overall lower hazard for CVD in women compared to men. Smoking contributed minimally to the lower hazards for CVD in women among participants of Dutch (0%), Ghanaian (4.9%) and Moroccan origin (0%), but explained 28.6% and 48.6% of the lower hazards in women in South-Asian Surinamese and African Surinamese groups, respectively. While smoking prevention and cessation may lead to lower CVD incidence in most groups of men and women, it may not substantially reduce disparities in CVD risk between men and women in most ethnic groups.
KW - Cardiovascular disease
KW - Ethnicity
KW - HELIUS study
KW - Sex and gender differences
KW - Smoking
UR - http://www.scopus.com/inward/record.url?scp=85146005394&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.pmedr.2022.102105
DO - https://doi.org/10.1016/j.pmedr.2022.102105
M3 - Article
C2 - 36820382
SN - 2211-3355
VL - 31
JO - Preventive medicine reports
JF - Preventive medicine reports
M1 - 102105
ER -