Secondhand smoke exposure can increase the risk of first ischemic stroke: A 10.7-year prospective cohort study in China.

INTRODUCTION: Passive smoking is considered a major public health issue in China. Prospective evidence regarding the link between secondhand smoke (SHS) and ischemic stroke in China is scarce. METHODS: The China Kadoorie Biobank (CKB) study in Liuzhou City recruited 50,174 participants during 2004-2008. Of these 30,456 never-smokers were included in our study. The median follow-up period was 10.7 years. The incidence of ischemic stroke was obtained through the China Disease Surveillance Points (DSP) system and the Health Insurance (HI) database. Cox proportional risk models were used to evaluate the association between SHS exposure and ischemic stroke. RESULTS: During 320,678 person-years of follow-up, there were 2059 patients with ischemic stroke observed and the incidence of ischemic stroke was 6.42 per thousand person-years. Participants exposed to SHS daily faced a 21 % higher risk of ischemic stroke (HR = 1.21, 95 %CI: 1.09-1.34) compared to those exposed to SHS less than once a week. Subgroup analyses revealed that daily SHS exposure was linked to heightened risk of ischemic stroke among women, non-employed, and non-weekly tea drinkers. CONCLUSIONS: Daily SHS exposure was associated with higher risks of ischemic stroke. Proactive tobacco control strategies are necessary to decrease the risk of ischemic stroke in never smokers.

Healthy sleep pattern reduce the risk of cardiovascular disease: A 10-year prospective cohort study.

OBJECTIVE: To identify the association between quantified sleep factors and the incidence of cardiovascular disease (CVD) through a 10-year prospective cohort study. METHODS: A total of 45,919 individuals were recruited in this population-based prospective study. The healthy sleep score was constructed by four sleep measures (sleep duration, insomnia symptoms, snoring and daytime sleepiness), which were collected by questionnaire. The hazard ratio (HR) and 95% confidence intervals (CIs) were calculated by the multivariate-adjusted Cox proportional hazards model. Restricted cubic spline analysis was used to examine the dose‒response relationships between healthy sleep scores and outcomes. RESULTS: During a median follow-up of 10.73 years (interquartile range: 10.08-11.72 years), 10,523 cases of total CVD incidence, 3766 cases of CHD, and 3967 cases of stroke incidence were documented. Our results found that participants who maintained four healthy sleep measures (including no insomnia, snoring, or frequent daytime sleepiness and sleeping 7-8 h/d) had a 12% (HR: 0.88, 95% CI: 0.84-0.93) and 16% (HR: 0.84, 95% CI: 0.78-0.92) lower risk of developing CVD and CHD, respectively, but not stroke. There was a dose‒response relationship between sleep scores and the risk of cardiovascular events. With an increasing healthy sleep score, the risk of cardiovascular events decreases. Compared to those with a sleep score of 0-1, participants with a score of 4 had 27% (HR: 0.73, 95% CI: 0.67-0.79), 25% (HR: 0.75, 95% CI: 0.65-0.87), and 24% (HR: 0.76, 95% CI: 0.66-0.86) reduced risks of CVD, CHD, and stroke, respectively. CONCLUSIONS: In this large prospective cohort study, a healthy sleep pattern effectively reduced the risk of CVD, CHD, and stroke.