In this study of 3,000 males the statistical association of coronary artherosclerotic heart disease (CAHD) and smoking habits was most striking under the age of 51. In this group 21 (11.7%) of 179 heavy cigarette smokers had CAHD, whereas 100 (6.5%) of 1,521 other individuals had CAHD. The ratio of myocardial infarcts to isolated angina pectoris was 1.3:1 in heavy smokers, and 0.5:1 in other categories. Heavy cigarette smoking was also associated with higher serum cholesterol levels. It was suggested not so much as a factor in atherogenesis, but as a factor in precipitating acute clinical events in individuals with advanced CAHD. Cigar, pipe, and light cigarette smoking did not appear to be related to the problem.
Spain DM, Nathan DJ. Smoking Habits and Coronary Atherosclerotic Heart Disease. JAMA. 1961;177(10):683-688. doi:10.1001/jama.1961.03040360019003