Exposure to parental smoking early in life associated with greater carotid IMT in adulthood

10/03/2014

Carotid intima media thickness greater in adults exposed to both parents smoking in childhood or adolescence. This effect was independent of CV risk factors in adulthood.

 Exposure to parental smoking in childhood or adolescence is associated with increased carotid intima-media thickness in young adults: evidence from the Cardiovascular Risk in Young Finns study and the Childhood Determinants of Adult Health Study
Literature - Gall et al., Eur Heart J. 2014 - Eur Heart J. 2014 Mar 4


Gall S, Huynh QL, Magnussen CG, et al.,
Eur Heart J. 2014 Mar 4. [Epub ahead of print]

Background

Passive exposure to cigarette smoke has been shown to affect vascular health, including impaired endothelial function [1,2], arterial stiffness [3] and greater arterial intima-media thickness (IMT)[2,4]. The largest source of passive smoke is parental smoking.
It has recently been demonstrated that exposure to parental smoking in childhood or adolescence is associated with lower brachial artery flow-mediated dilatation (FMD) in adulthood, independent of own smoking status and traditional cardiovascular (CV) risk factors [5]. The current study examined the role of exposure to parental smoking in childhood or adolescence on carotid IMT in adulthood, using the Cardiovascular Risk in Young Finns Study (YFS) cohort [6] and the Childhood Determinants of Adult Health (CDAH) cohort [7], with follow-up periods of up to 25 years.

Main results

  • Exposure to both parents smoking earlier in life was associated with greater carotid IMT in adulthood in pooled analyses (mean carotid IMT: 0.653 vs. 0.637 with no smoking parents, P=0.001), as well as in cohort-specific analyses. This association was maintained after adjustment for confounders in childhood and adulthood (0.652 vs. 0.637, P=0.003).
  • Having one smoking parent was not associated with carotid IMT in adulthood in pooled analyses (mean carotid IMT: 0.638 with either parent smoking vs. 0.637 with none smoking, P=0.729).
  • Adult smoking status did not modify the association between parental smoking in childhood and adult carotid IMT.
  • Greater exposure to parental smoking (based on number of smokers) was associated with a significantly greater carotid IMT in adulthood, in both cohorts. This association was largely unaffected by adjustment for age and sex, sociodemographic and health factors at baseline and follow-up, and CV risk factors at follow-up.

Conclusion

Two independent cohorts reveal that adults who were exposed to both parents smoking in childhood or adolescence, had greater carotid IMT than those with one or no parent who smoked. This effect was largely independent of CV risk factors, indicating an irreversible impact of smoke exposure on arterial health later in life. Considering this pervasive effect of cigarette smoke on endothelial function later in life, reducing young people’s exposure to tobacco smoke is a public health priority.

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References

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2. KallioK, Jokinen E, Saarinen M,et al. Arterial intima-media thickness, endothelial function, and apolipoproteins in adolescents frequently exposed to tobacco smoke. Circ Cardiovasc Qual Outcomes 2010;3:196–203.
3. Kallio K, Jokinen E, Hamalainen M, et al. Decreased aortic elasticity in healthy 11-year-old children exposed to tobacco smoke. Pediatrics 2009;123:e267 – e273.
4. Geerts CC, Bots ML, van der Ent CK, et al. Parental smoking and vascular damage in their 5-year-old children. Pediatrics 2012;129:45–54.
5. Juonala M, Magnussen CG, Venn A, et al. Parental smoking in childhood and brachial artery flow-mediated dilatation in young adults: the Cardiovascular Risk in Young Finns study and the Childhood Determinants of Adult Health study. Arterioscler Thromb Vasc Biol 2012;32:1024 – 1031.
6. Raitakari OT, Juonala M, Ronnemaa T, et al. Cohort profile: the Cardiovascular Risk in Young Finns Study. Int J Epidemiol 2008;37: 1220 – 1226.
7. Magnussen CG, Raitakari OT, Thomson R, et al. Utility of currently recommended pediatric dyslipidemia classifications in predicting dyslipidemia in adulthood: evi- dence from the Childhood Determinants of Adult Health (CDAH) study, Cardio- vascular Risk in Young Finns Study, and Bogalusa Heart Study. Circulation 2008; 117:32 – 42.

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