Protective effect of smoking cessation on subsequent myocardial infarction and ischemic stroke independent of weight gain: A nationwide cohort study

Jung Hwan Cho, Hye Mi Kwon, Se Eun Park, Jin Hyung Jung, Kyung Do Han, Yong Gyu Park, Yang Hyun Kim, Eun Jung Rhee, Won Young Lee

Research output: Contribution to journalArticle

Abstract

Smoking cessation reduces the cardiovascular risk but increases body weight. We investigated the risk of subsequent myocardial infarction and ischemic stroke according to weight gain after smoking cessation, using a nationwide population based cohort. We enrolled 3,797,572 Korean adults aged over 40 years who participated in national health screenings between 2009 and 2010. Subjects who quit smoking were classified into three subgroups according to the weight change between baseline and 4 years prior. Myocardial infarctions and ischemic strokes were followed until the end of 2015. We compared the hazard ratios among smoking cessation subgroups, non-smokers, and current smokers. The mean changes in weight (1.5 ± 3.9 kg) of the smoking cessation group were higher than those of the other groups (p < 0.0001). A total of 31,277 and 46,811 subjects were newly diagnosed with myocardial infarction and ischemic stroke, respectively. Regardless of weight change, all subgroups of smoking cessation had significantly less risk than current smokers. The subgroup of smoking cessation with weight gain over 4kg showed the lowest risk for myocardial infarctions (hazard ratio 0.646, 95% confidence interval 0.583–0.714, p < 0.0001) and ischemic strokes (hazard ratio 0.648, 95% confidence interval 0.591–0.71, p < 0.0001) after multivariable adjustment. In conclusion, weight gain after smoking cessation did not adversely affect the cardiovascular protective effect.

Original languageEnglish
Article numbere0235276
JournalPloS one
Volume15
Issue number7 July
DOIs
Publication statusPublished - 2020 Jul

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Cho, J. H., Kwon, H. M., Park, S. E., Jung, J. H., Han, K. D., Park, Y. G., Kim, Y. H., Rhee, E. J., & Lee, W. Y. (2020). Protective effect of smoking cessation on subsequent myocardial infarction and ischemic stroke independent of weight gain: A nationwide cohort study. PloS one, 15(7 July), [e0235276]. https://doi.org/10.1371/journal.pone.0235276