Older smokers still helped by quitting.

Older smokers still helped by quitting

Many physicians have suspected that smokers approaching retirement age -- especially those suffering substantial heart disease -- gain little by giving up their cigarettes. But a six-year analysis of 1,893 people who participated in the national Coronary Artery Surgery Study shows it's never too late to quit smoking. Compared with those who continued smoking, men and women who gave up the habit in their middle 50s or later dramatically reduced -- in some cases halved -- their risk of heart attacks or early death.

What makes this risk reduction doubly impressive, say the researchers who conducted the study, is that by each of the four measures used to gauge the initial severity of coronary artery disease in these patients, the group that quit smoking started out sicker.

"The benefits of quitting were similar for men and women," report researchers at the University of Washington's Center for Health Promotion in Older Adults, in Seattle, and the Mayo Clinic in Rochester, Minn. More surprising, points out Bonnie Hermanson of the Seattle team, the beneficial effect showed no sensitivity to age: Those 65 and older derived every bit as much benefit as quitters between 35 and 55 -- a reduction of 40 to 50 percent in their heart-attack/early-death risk. A report of the work appears in the Nov. 24 NEW ENGLAND JOURNAL OF MEDICINE.

Smoking, while a potent force in heart-disease risk, is by no means the only major one. Another study described in the same issue quantifies physical fitness as a significant, independent, predictive risk factor in cardiovascular death. Again, the beneficial effects showed no relation to age.

It's hardly startling that fit bodies face less risk of death from heart disease. However, points out study coauthor Lars-Goran Ekelund of the University of North Carolina in Chapel Hill, this accepted link between fitness and reduced heart-disease risk comes largely from studies assessing fitness from questionnaires. What makes his study "unique," he says, is that it followed, at 10 North American clinics for roughly 8-1/2 years, 4,276 randomly selected men aged 30 to 69--many apparently quite healthy. The findings suggest that heart-performance scores during treadmill tests can, like cholesterol levels, serve as a predictive measure of heart-disease death risk. Moreover, the data suggest, poor fitness can be about as risky as smoking.

Why fitness is so beneficial remains a mystery, Ekelund says, since its well-known effect on blood pressure and serum lipids can't explain the magnitude of observed protection.