Evidence map›Paper›PMID 40887303›Full record

ArticleJournal of atherosclerosis and thrombosis2026

Joint Impact of Smoking and Metabolic Syndrome on Cardiovascular Disease: A Cohort Study.

Huan Hu, Tohru Nakagawa, Toru Honda, Shuichiro Yamamoto, Hiroko Okazaki, Hiroshi Ide, Seitaro Dohi, Toshiaki Miyamoto, Makoto Yamamoto, Naoki Gommori and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of atherosclerosis and thrombosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Huan HuResearch Center for Prevention from Radiation Hazards of Workers, National Institute of Occupational Safety and Health.
Tohru NakagawaHitachi Health Care Center, Hitachi, Ltd.
Toru HondaHitachi Health Care Center, Hitachi, Ltd.
Shuichiro YamamotoHitachi Health Care Center, Hitachi, Ltd.
Hiroko OkazakiMitsui Chemicals, Inc.
Hiroshi IdeMitsui Chemicals, Inc.
Seitaro DohiMitsui Chemicals, Inc.
Toshiaki MiyamotoNIPPON STEEL CORPORATION, EAST NIPPON WORKS Kimitsu Area.
Makoto YamamotoYAMAHA CORPORATION.
Naoki GommoriEast Japan Works (Keihin), JFE Steel Corporation.
Takeshi KochiFurukawa Electric Co., Ltd.
Takayuki OgasawaraMitsubishi Fuso Truck and Bus Corporation.
Maki KonishiDepartment of Epidemiology and Prevention, Center for Clinical Sciences, Japan Institute for Health Security.
Isamu KabeKUBOTA Corporation.
Tetsuya MizoueDepartment of Epidemiology and Prevention, Center for Clinical Sciences, Japan Institute for Health Security.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThis study examined whether or not the coexistence of smoking and metabolic syndrome synergistically increases the risk of cardiovascular disease (CVD) beyond their individual effects.

methodsThis prospective cohort study included 68,743 workers from the Japan Epidemiology Collaboration on Occupational Health Study. The participants were categorized into four groups based on their smoking status and metabolic syndrome. Biological interactions were evaluated using relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S).

resultsDuring a mean follow-up of 7.2 (range: 0.1-10.9) years, 346 participants developed CVD. Current smokers with metabolic syndrome had the highest CVD risk (hazard ratio: 6.45, 95% confidence interval [CI]: 4.73-8.80). Approximately 35% of CVD cases among individuals exposed to both factors were attributed to their biological interactions (RERI: 2.27, 95% CI: 0.56-3.98; AP: 0.35, 95% CI: 0.15-0.55; S: 1.71, 95% CI: 1.16-2.52). An analysis of CVD subtypes revealed a significant biological interaction for myocardial infarction (RERI: 5.14, 95% CI: 0.65-9.62; AP: 0.52, 95% CI: 0.26-0.78; S: 2.38, 95% CI: 1.22-4.62) but not for stroke (RERI: 1.34, 95% CI: -0.46-3.13; AP: 0.25, 95% CI: -0.03-0.53; S: 1.44, 95% CI: 0.89-2.34).

conclusionSmoking and metabolic syndrome interact synergistically to elevate CVD risk, particularly for myocardial infarction. Targeting both factors is essential for CVD prevention.

Indexed as

Cardiovascular DiseasesMetabolic SyndromeSmokingAdultCohort StudiesFemaleFollow-Up StudiesHumansJapanMaleMiddle AgedProspective StudiesRisk FactorsBiological interactionCardiovascular diseaseMetabolic syndromeSmoking

Identifiers

PMID40887303
PMCPMC12883432

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.