Risk of myocardial infarction in young female smokers
N R Dunna, B Faragherb, M Thorogoodc, L de Caesteckerd, T M MacDonalde, C McCollumf, S Thomasg, R Manna
a Drug Safety Research
Unit, Bursledon Hall, Southampton SO31 1AA, UK, b Department of Organisational
Health Psychology, Manchester School of Management, UMIST, PO Box 88, Manchester M60 1QD, UK, c London
School of Hygiene and Tropical Medicine, Keppel Street, London WC1
6FH, UK, d Department
of Public Health, Greater Glasgow Health Board, Dalian House, 350 St
Vincent Street, Glasgow G3 8YU, UK, e Medicines Monitoring Unit, Department of
Clinical Pharmacology and Therapeutics, Ninewells Hospital Medical
School, Dundee DD1 9SY, UK, f Department of Surgery, South Manchester
University Hospital, Nell Lane, West Didsbury, Manchester M20 8LR, UK, g Wolfson Unit of Clinical
Pharmacology, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
Correspondence to: Dr Dunn. email: ndunn{at}dsru.u-net.com
Accepted for publication 4 June 1999
OBJECTIVES
To
determine the extent of risk of myocardial infarction from cigarette
smoking in young women, and to examine the relation of smoking with
other putative risk factors.
DESIGNCommunity based
case control study.
SETTINGEngland,
Scotland, and Wales.
PATIENTSWomen
(n = 448) between 16 and 44 years old with a diagnosis of incident
myocardial infarction between 1 October 1993 and 16 October 1995. Controls (n = 1728) were age and general practice matched women
without a diagnosis of myocardial infarction.
OUTCOMES MEASURESOdds
ratios for risk of myocardial infarction associated with smoking and
other risk factors.
RESULTSOdds ratios
for myocardial infarction in smokers versus non-smokers showed a strong
dose response, from 2.47 (95% confidence interval (CI) 1.12 to 5.45)
in smokers of 1-5 cigarettes per day to 74.6 (95% CI 33.0 to 169) in
smokers of 
40 cigarettes per day. There was no interaction of
smoking with use of oral contraceptives, but there were additive risks
with other clinical risk factors such as hypertension and diabetes. It
is estimated that if all women aged 16-44 years were able to stop
smoking, 400 cases of myocardial infarction per annum (of whom 112 would die) would be prevented.
CONCLUSIONSIn young
women the risk of myocardial infarction from smoking was considerable,
and heavy smokers with other risk factors were especially at risk.
Keywords: myocardial infarction; smoking; risk factors
© 1999 by Heart
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