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Aug 25, 2022
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Smoking causes more damage to the heart than previously thought

Smoking causes more damage to the heart than previously thought

Smokers have weaker hearts than non-smokers, according to a study presented at ESC 2022. The study found that the more people smoked, the worse their heart function got. Some functions were restored when people gave up this habit.

“Smoking is well known to cause clogging of the arteries, leading to coronary heart disease and stroke,” said study author Dr. Eva Holt of Herlev and Gentofte Hospital, Copenhagen, Denmark. “Our study shows that smoking also makes the heart thicker and weaker. This means that smokers have less blood volume in the left chamber of the heart and less power to pump it to the rest of the body. The more you smoke, the worse the heart gets. If you quit smoking, your heart can recover to some extent, so it’s never too late to quit.”

According to the World Health Organization, tobacco kills more than eight million people every year. Cigarette smoking is responsible for 50% of all avoidable deaths in smokers, half of which are due to atherosclerotic cardiovascular diseases such as heart attack and stroke. The detrimental effect of smoking on the arteries and arterial diseases such as heart attack and stroke is well known.

Studies have also shown that smoking is associated with an increased risk of heart failure, when the heart muscle does not pump blood around the body as well as it should, usually because it is too weak or stiff. This means that the body is not getting the oxygen and nutrients it needs to function properly. The relationship between smoking and the structure and function of the heart is not fully understood. Therefore, this study examined whether smoking is associated with changes in the structure and function of the heart in people without cardiovascular disease, as well as the impact of changing smoking habits.

The study used data from the 5th Copenhagen City Heart Study, which examined risk factors and cardiovascular disease in the general population. The study involved 3874 people aged 20 to 99 years without cardiovascular disease. A self-administered questionnaire was used to obtain information on smoking history and calculate pack-years—the number of cigarettes smoked in a lifetime. One pack-year is defined as 20 cigarettes smoked daily for one year.

Participants underwent an ultrasound of the heart, called an echocardiogram, which provides information about its structure and how well it is working. The researchers compared echocardiography scores of current smokers and never-smokers after adjusting for age, sex, body mass index, hypertension, high cholesterol, diabetes, and lung function.

The average age of the participants was 56 years, 43% of them were women. Nearly one in five study participants was a current smoker (18.6%), 40.9% were ex-smokers, and 40.5% had never smoked. Compared to those who never smoked, current smokers had thicker, weaker, and heavier hearts. The increase in the number of packs per year was associated with less blood being pumped. Dr. Holt explained:

“We found that current smoking and history of smoking were associated with deterioration in the structure and function of the left heart chamber, the most important part of the heart. What’s more, we found that over a 10-year period, those who continued to smoke had a thicker, heavier, and pumped blood weaker and worse compared to those who never smoked, and those who quit smoking during this period”

She concluded:

“Our study shows that smoking not only damages blood vessels, but also causes direct damage to the heart. The good news is that some of the damage can be repaired by quitting.”

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