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Table 7 Multivariable Adjusted Rate Ratios for Smoking, Alcohol Consumption, and Physical Activity by Family History of Premature MI in the CAREMA Cohort, 1987-2003

From: Smoking, alcohol consumption, physical activity, and family history and the risks of acute myocardial infarction and unstable angina pectoris: a prospective cohort study

 

Acute Myocardial Infarction

Unstable Angina Pectoris

 

No family history (n = 15,980)

Family historya(n = 3,116)

No family history (n = 15,980)

Family history (n = 3,116)

 

Cases/person-years

RR

95% CI

Cases/person-years

RR

95% CI

Cases/person-years

RR

95% CI

Cases/person-years

RR

95% CI

Smoking status b

            

Never

43/60,695

1

reference

14/9,971

1.78

0.96, 3.28

43/60,695

1

reference

12/9,971

1.71

0.89, 3.29

Ex

76/45,928

1.36

0.93, 1.98

17/8,710

2.01

1.14, 3.55

68/45,928

1.34

0.90, 1.98

18/8,710

2.50

1.43, 4.37

Current

212/69,412

3.11

2.22, 4.36

58/14,857

5.25

3.51, 7.84

105/69,412

1.63

1.13, 2.36

28/14,857

2.86

1.76, 4.64

P interactionc

     

0.89

     

0.97

Alcohol consumption d

           

Never

49/22,647

1

reference

14/4,173

1.71

0.94, 3.11

33/22,647

1

reference

7/4,173

1.44

0.63, 3.25

Ex

9/2,229

0.86

0.42, 1.77

4/448

2.58

0.92, 7.20

6/2,229

1.10

0.46, 2.66

1/448

1.49

0.20, 10.98

Occasionally

60/40,094

0.91

0.62, 1.33

17/8,123

1.42

0.81, 2.48

42/40,094

0.98

0.62, 1.56

15/8,123

2.16

1.16, 4.01

Regular

213/111,065

0.66

0.47, 0.92

54/20,794

1.05

0.70, 1.58

135/111,065

0.70

0.46, 1.05

35/20,794

1.21

0.73, 2.00

P interaction

     

0.79

     

0.84

Occupational activity e

           

Men

            

None to light

185/55,603

1

reference

37/9,587

1.47

1.03, 2.11

111/55,603

1

reference

21/9,587

1.49

0.93, 2.40

Moderate to heavy

56/18,971

1.23

0.90, 1.68

24/3,878

2.92

1.88, 4.54

30/18,971

1.13

0.74, 1.72

11/3,878

2.35

1.24, 4.45

P interaction

     

0.12

     

0.44

Women

            

None to light

67/73,701

1

reference

15/14,758

1.08

0.61, 1.92

57/73,701

1

reference

18/14,758

1.79

1.04, 3.09

Moderate to heavy

2/13,319

0.24

0.06, 0.99

4/2,759

1.98

0.71, 5.55

5/13,319

0.72

0.29, 1.83

2/2,759

1.29

0.31, 5.36

P interaction

     

0.03

     

0.99

Non-occupational activity e

           

Men

            

None to light

91/25,465

1

reference

24/5,071

1.48

0.94, 2.34

58/25,465

1

reference

14/5,071

1.53

0.85, 2.76

Moderate to heavy

150/49,109

0.97

0.75, 1.27

37/8,394

1.86

1.26, 2.74

83/49,109

0.72

0.51, 1.03

18/8,394

1.27

0.74, 2.17

P interaction

     

0.40

     

0.73

Women

            

None to light

28/36,894

1

reference

4/8,176

0.58

0.20, 1.70

20/36,894

1

reference

8/8,176

1.86

0.81, 4.30

Moderate to heavy

41/50,126

1.43

0.87, 2.38

15/9,340

2.75

1.45, 5.23

42/50,126

1.57

0.91, 2.72

12/9,340

2.75

1.33, 5.67

P interaction

     

0.06

     

0.91

  1. CI, confidence interval; n, number; RR, rate ratio. All RRs were adjusted for age at baseline (years), baseline cohort (PPHVZ or MORGEN), level of education (primary school/junior vocational education, secondary vocational education or vocational college/university), diabetes mellitus (yes/no), total and HDL cholesterol levels (mmol/L), systolic blood pressure (mmHg), and body mass index (kg/m2).
  2. Table summary: None of the interactions between family history of premature MI and the lifestyle factors smoking, alcohol consumption, and physical activity were statistically significant on a multiplicative scale for both AMI and UAP, except for occupational physical activity and the AMI risk in women (p interaction 0.03). Nevertheless, the highest risks of both coronary endpoints were found in subjects with both a positive family history and the most unfavorable level of the lifestyle factors.
  3. a Positive family history was defined as at least one parent with a premature MI, i.e. age at diagnosis ≤60 years for the father and ≤65 years for the mother.
  4. b RRs additionally adjusted for sex and alcohol consumption (glasses/day).
  5. c P interaction refers to the significance of the interaction between the determinant and family history of premature MI on a multiplicative scale.
  6. d RRs additionally adjusted for sex, smoking status (never, ex- or current smoker), smoking frequency (cigarettes/day), and smoking duration (years).
  7. e RRs additionally adjusted for smoking status (never, ex- or current smoker), smoking frequency (cigarettes/day), smoking duration (years), and alcohol consumption (glasses/day). Furthermore, occupational and non-occupational physical activity were mutually adjusted.
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BMC Cardiovascular Disorders

ISSN: 1471-2261

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