|
 "These findings suggest if you have heart failure or you have risk
factors for heart failure such as early markers for heart damage
like a thicker heart or a weak heart, you should specifically be
targeted for smoking cessation strategies," said the study's senior
author, Dr. Michael E. Hall, an associate professor of medicine at
the University of Mississippi Medical Center in Jackson.
In heart failure, the muscles of the heart weaken and enlarge so the
organ can no longer pump blood efficiently, leading to shortness of
breath and water retention. Heart failure is most often the result
of damage from coronary artery disease, a buildup of fatty material
within the heart arteries associated with heart attack and stroke.
High blood pressure, excess weight, infection and several other
factors can also contribute to heart failure.
Cigarette smoking is clearly associated with coronary artery
disease, but its relationship with heart failure is not as well
known, especially among African Americans, Hall's team writes in the
journal Circulation.
Blacks in the U.S. have double the incidence of heart failure as
other groups, the researchers note. While smoking in this community
has declined, it is still at 18 percent of adults, they add.
To investigate the potential role of smoking in heart failure risk,
the researchers analyzed data on 4,129 black adults in Mississippi
who participated in the Jackson Heart Study. Their average age was
54, and all were free of heart disease when they enrolled. Twelve
percent reported being smokers, 18 percent were ex-smokers and 70
percent had never smoked.
Compared to never-smokers, the smokers had more enlargement of the
left ventricle, the heart's main pumping chamber, and worse left
ventricular function. Levels of a hormone released by the heart that
indicates heart failure, called brain natriuretic peptide (BNP),
were higher in smokers than never-smokers, and those levels
increased with the intensity and duration of smoking.
[to top of second column] |
Once the authors took factors associated with both smoking and heart
failure, such as coronary artery disease, into account, they found
that smokers were almost three times more likely than non-smokers to
be hospitalized for heart failure during eight years of follow-up.
People who smoked at least 20 cigarettes a day saw their risk
increase about 3.5-fold. Those who had smoked the equivalent of a
pack or more a day for 15 or more years were twice as likely as
never-smokers to be hospitalized for heart failure.
Physicians will typically ask patients with coronary artery disease
about smoking, and urge them to quit if they do, Hall said in a
telephone interview. But heart failure seems to be a less obvious
cue to many doctors.
"We probably in the health community need to do a better job of
recommending cessation strategies for people who have risk factors
for heart failure," Hall said. "If they have risk factors, they
should be strongly counseled to quit, that should be a no-brainer."
He acknowledged that lack of health insurance and other factors can
be barriers to effective smoking cessation treatment. But the costs
of drugs proven to help people quit have declined, Hall noted, and
many are now available for less than a pack-a-day smoker spends in a
month on cigarettes.
In future research, he and his colleagues plan to examine whether
newer nicotine delivery devices, like e-cigarettes, have similar
effects on the heart.
SOURCE: https://bit.ly/2HpaAOV Circulation, online April 16, 2018.
[© 2018 Thomson Reuters. All rights
reserved.] Copyright 2018 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
