• Amiya A Ahmed, Kanan Patel, Margaret A Nyaku, Raya E Kheirbek, Vera Bittner, Gregg C Fonarow, Gerasimos S Filippatos, Charity J Morgan, Inmaculada B Aban, Marjan Mujib, Ravi V Desai, Richard M Allman, Michel White, Prakash Deedwania, George Howard, Robert O Bonow, Ross D Fletcher, Wilbert S Aronow, and Ali Ahmed.
• From the Departments of Biology (A.A.A.), Medicine (M.A.N., V.B., A.A.), and Biostatistics (C.J.M., I.B.A., G.H.), University of Alabama at Birmingham; Department of Medicine, University of California, San Francisco (K.P.); Center for Health and Aging and Office of the Chief of Staff, Washington DC Veterans Affairs Medical Center (A.A., R.E.K., R.D.F.); Department of Medicine, George Washington University, Washington, DC (R.E.K.); Department of Medicine, University of California, Los Angeles (G.C.F.); Department of Medicine, University of Athens, Athens, Greece (G.S.F.); Department of Medicine, New York Medical College, Valhalla (M.M., W.S.A.); Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.V.D.); Geriatrics and Extended Care Services, Department of Veterans Affairs, Washington DC (R.M.A.); Department of Medicine, University of Montreal, Montreal, QC, Canada (M.W.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); and Department of Medicine, Northwestern University, Chicago, IL (R.O.B.).
• Circ Heart Fail. 2015 Jul 1;8(4):694-701.

BackgroundAccording to the 2004 Surgeon General's Report on Health Consequences of Smoking, after >15 years of abstinence, the cardiovascular risk of former smokers becomes similar to that of never-smokers. Whether this health benefit of smoking cessation varies by amount and duration of prior smoking remains unclear.Methods And ResultsOf the 4482 adults ≥65 years without prevalent heart failure (HF) in the Cardiovascular Health Study, 2556 were never-smokers, 629 current smokers, and 1297 former smokers with >15 years of cessation, of whom 312 were heavy smokers (highest quartile; ≥32 pack-years). Age-sex-race-adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for centrally adjudicated incident HF and mortality during 13 years of follow-up were estimated using Cox regression models. Compared with never-smokers, former smokers as a group had similar risk for incident HF (aHR, 0.99; 95% CI, 0.85-1.16) and all-cause mortality (aHR, 1.08; 95% CI, 0.96-1.20), but former heavy smokers had higher risk for both HF (aHR, 1.45; 95% CI, 1.15-1.83) and mortality (aHR, 1.38; 95% CI, 1.17-1.64). However, when compared with current smokers, former heavy smokers had lower risk of death (aHR, 0.64; 95% CI, 0.53-0.77), but not of HF (aHR, 0.97; 95% CI, 0.74-1.28).ConclusionsAfter >15 years of smoking cessation, the risk of HF and death for most former smokers becomes similar to that of never-smokers. Although this benefit of smoking cessation is not extended to those with ≥32 pack-years of prior smoking, they have lower risk of death relative to current smokers.© 2015 American Heart Association, Inc.

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