Quitting smoking cuts heart attack risk by 50% – cutting back does little

Research presented at the ESC Congress 2024 has highlighted a crucial finding: if you have stable coronary artery disease and quit smoking after your diagnosis, you can reduce your risk of a major cardiovascular event by nearly 50%. However, merely cutting back on smoking does little to lower your cardiovascular risk, according to the study.

The study draws on data from the international CLARIFY registry, which followed 32,378 patients with coronary artery disease. The researchers analyzed the occurrence of major adverse cardiovascular events (MACE) during a five-year follow-up period. MACE includes serious incidents like cardiovascular death or myocardial infarction.

At the time they were included in the study, the patients had, on average, been living with coronary artery disease for about 6.5 years. Of these, 13,366 patients (41.3%) had never smoked, 14,973 (46.2%) were former smokers, and 4,039 (12.5%) were still smoking. Among the former smokers who had been smoking when they were first diagnosed with coronary artery disease, 72.8% quit within the first year after their diagnosis. The remaining 27.2% quit in later years.

The first year following your diagnosis is a critical window for quitting smoking. Dr. Jules Mesnier of Hospital Bichat-Claude Bernard in Paris, France, emphasized this point, stating, “At the time of diagnosis, we should emphasize the importance of quitting and support patients in this challenge.”

The study found that patients who quit smoking after being diagnosed with coronary artery disease saw a significant improvement in their cardiovascular outcomes, regardless of when they quit. Specifically, there was a 44% reduction in the risk of experiencing a major cardiovascular event (adjusted hazard ratio [HR] 0.56; 95% confidence interval [CI] 0.42–0.76; p<0.001).

On the other hand, for those who merely reduced the amount they smoked, the risk of MACE did not change significantly compared to those who continued smoking at their usual level (adjusted HR 0.96; 95% CI 0.74–1.26; p=0.78).

The data also revealed that continuing to smoke after a coronary artery disease diagnosis leads to an 8% increase in the risk of MACE for each additional year of active smoking (adjusted HR 1.08; 95% CI 1.04–1.12 per year). Even though quitting smoking substantially lowers your risk compared to continuing to smoke, it doesn’t entirely erase the elevated risk. Patients who quit never fully reach the lower cardiovascular risk level of those who have never smoked, even after many years of abstinence.

Dr. Mesnier reinforced the importance of quitting smoking as soon as possible, noting, “I like to tell my patients that it is never too soon or too late to stop smoking, though the sooner a patient stops, the better to lower cardiovascular risk.” He also pointed out that simply reducing smoking isn't enough to make a significant impact on your heart health.

The message for smokers at every medical appointment should be clear and direct: quit smoking. He added, “Telling patients they can cut their risk of a subsequent major event or death by half – as we have shown here – is a powerful message.”

To help you quit smoking, several measures can be employed, including brief advice during medical visits, counseling, behavioral interventions, and pharmacological therapies. These tools are designed to support you in your journey toward a healthier life, free from the risks associated with smoking, particularly if you're dealing with coronary artery disease.

This research underscores the importance of smoking cessation as a key component in managing coronary artery disease. Quitting smoking not only significantly lowers your risk of severe cardiovascular events but also supports overall better health outcomes. The sooner you stop, the more you stand to gain, making it a crucial step in your ongoing healthcare plan.

Quitting smoking can significantly reduce the risks for several serious health conditions. Here are some key benefits:

Other Cardiovascular Diseases: Smoking is a major cause of heart disease, stroke, and other cardiovascular conditions. When you quit, your risk of heart attack and stroke drops dramatically. Within a year of quitting, the risk of coronary heart disease is cut in half.

Lung Diseases: Smoking is the leading cause of chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Quitting smoking slows the progression of these diseases and reduces the risk of developing lung cancer, which is also strongly linked to smoking.

Cancer: Smoking is linked to many types of cancer, including lung, throat, mouth, esophagus, pancreas, bladder, and kidney cancers. After quitting, your risk of developing these cancers decreases, and the longer you stay smoke-free, the lower your risk becomes.

Respiratory Infections: Smokers are more susceptible to respiratory infections like pneumonia and chronic bronchitis. Quitting smoking improves lung function and decreases the frequency of these infections.

Reproductive Health: In both men and women, smoking can negatively affect fertility. Quitting smoking can improve fertility, reduce the risk of complications during pregnancy, and promote healthier outcomes for babies.

Diabetes: Smoking increases the risk of developing type 2 diabetes and can make it more difficult to manage the condition. Quitting can help lower this risk and improve blood sugar control.

Osteoporosis: Smoking can lead to weakened bones and increase the risk of fractures. Quitting smoking can help slow bone density loss and reduce the risk of osteoporosis.

Gum Disease: Smoking is a major cause of gum disease, which can lead to tooth loss. Quitting smoking improves gum health and reduces the risk of tooth loss.

Vision Loss: Smoking increases the risk of age-related macular degeneration, cataracts, and other eye conditions that can lead to vision loss. Quitting smoking can help preserve vision.

Overall, the benefits of quitting smoking begin almost immediately and continue to grow over time, significantly improving your overall health and longevity.

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