DESIGN: Individual participant meta-analysis using data from 25 cohorts participating in the CHANCES consortium. Data were harmonised, analysed separately employing Cox proportional hazard regression models, and combined by meta-analysis.
RESULTS: Overall, 503,905 participants aged 60 and older were included in this study, of whom 37,952 died from cardiovascular disease. Random effects meta-analysis of the association of smoking status with cardiovascular mortality yielded a summary hazard ratio of 2.07 (95% CI 1.82 to 2.36) for current smokers and 1.37 (1.25 to 1.49) for former smokers compared with never smokers. Corresponding summary estimates for risk advancement periods were 5.50 years (4.25 to 6.75) for current smokers and 2.16 years (1.38 to 2.39) for former smokers. The excess risk in smokers increased with cigarette consumption in a dose-response manner, and decreased continuously with time since smoking cessation in former smokers. Relative risk estimates for acute coronary events and for stroke events were somewhat lower than for cardiovascular mortality, but patterns were similar.
CONCLUSIONS: Our study corroborates and expands evidence from previous studies in showing that smoking is a strong independent risk factor of cardiovascular events and mortality even at older age, advancing cardiovascular mortality by more than five years, and demonstrating that smoking cessation in these age groups is still beneficial in reducing the excess risk.
METHODS: Serum samples from asymptomatic children tested for H. pylori seropositivity using an ELISA test.
RESULTS: Five hundred and fourteen healthy urban Malaysian children aged 0.5 to 17 (mean 5.9) years from three different racial groups had their blood tested for H. pylori antibodies. The overall prevalence was 10.3%. There was no significant difference in the prevalence of infection between boys and girls, but a significant rise was noted with increasing age (P = 0.009). Seropositivity was most common in the Indians and lowest in the Malays (P = 0.001). Father's level of education did not affect the child's rate of H. pylori seropositivity.
CONCLUSION: The prevalence of H. pylori seropositivity among asymptomatic urban Malaysian children is lowest in Malays. Intermediate in Chinese and highest in Indians. The racial differences found in children are consistent with those found in Malaysian adults.