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Smokeless tobacco (snus) and risk of heart failure: results from two Swedish cohorts
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. (Akut- och internmedicin)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.ORCID iD: 0000-0003-2256-6972
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
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2012 (English)In: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 19, no 5, 1120-1127 p.Article in journal (Refereed) Published
Abstract [en]

Background:

Oral moist snuff (snus) is discussed as a safer alternative to smoking, and its use is increasing. Based on its documented effect on blood pressure, we hypothesized that use of snus increases the risk of heart failure.

Design:

Two independent Swedish prospective cohorts; the Uppsala Longitudinal Study of Adult Men (ULSAM), a community-based sample of 1076 elderly men, and the Construction Workers Cohort (CWC), a sample of 118,425 never-smoking male construction workers.

Methods:

Cox proportional hazards models were used to investigate possible associations of snus use with risk of a first hospitalization for heart failure.

Results:

In ULSAM, 95 men were hospitalized for heart failure, during a median follow up of 8.9 years. In a model adjusted for established risk factors including past and present smoking exposure, current snus use was associated with a higher risk of heart failure [hazard ratio (HR) 2.08, 95% confidence interval (CI) 1.03-4.22] relative to non-use. Snus use was particularly associated with risk of non-ischaemic heart failure (HR 2.55, 95% CI 1.12-5.82). In CWC, 545 men were hospitalized for heart failure, during a median follow up of 18 years. In multivariable-adjusted models, current snus use was moderately associated with a higher risk of heart failure (HR 1.28, 95% CI 1.00-1.64) and non-ischaemic heart failure (HR 1.28, 95% CI 0.97-1.68) relative to never tobacco use.

Conclusion:

Data from two independent cohorts suggest that use of snus may be associated with a higher risk of heart failure.

Place, publisher, year, edition, pages
2012. Vol. 19, no 5, 1120-1127 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-164695DOI: 10.1177/1741826711420003ISI: 000309527700022PubMedID: 21828223OAI: oai:DiVA.org:uu-164695DiVA: diva2:469146
Note

De två första författarna delar förstaförfattarskapet.

Available from: 2011-12-22 Created: 2011-12-22 Last updated: 2017-12-08Bibliographically approved

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Arefalk, GabrielIngelsson, ErikÄrnlöv, JohanMichaëlsson, KarlLind, LarsSundström, Johan

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