Cigarette smoking is a strong risk factor for higher left ventricular mass and systolic dysfunction and HF hospitalization among black adults, according to new data published in Circulation.
Although cigarette smoke is a well-known risk factor for CVD, the influences on cardiac structure and function may not be fully recognized due to the strong association with CHD, the researchers wrote in the study background.
“Previous research has focused on smoking and atherosclerosis, or hardening of the arteries, but not enough attention has been given to the other bad effects of smoking on the heart,” Michael E. Hall, MD, MS, a cardiologist at the University of Mississippi Medical Center in Jackson, said in a press release. “With increasing rates of heart failure, particularly among African-Americans, we wanted to look at the link between smoking and heart failure.”
The researchers analyzed 4,129 black participants from the Jackson Heart Study with no history of HF or CHD at baseline.
Smoking may increase the risk of HF among black adults
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Hall and colleagues also investigated relationships between cigarette smoking and LV structure and function in 1,092 participants using cardiac MRI, between cigarette smoking and brain natriuretic peptide levels in 3,325 participants and between cigarette smoking and incident HF hospitalization in 3,633 participants with complete data.
The researchers found after adjusting for confounding factors that current smoking was linked to higher mean LV mass index and lower mean LV circumferential strain (P < .05 for both) compared with never smoking.
Smoking status, intensity and burden were associated with higher mean brain natriuretic peptide levels (P < .05 for all), according to the researchers.
During median follow-up of 8 years, there were 147 incident HF hospitalizations in the cohort.
Hall and colleagues found that for ever smokers, current smoking (HR = 2.82; 95% CI, 1.71-4.64), smoking intensity among current smokers (HR for 20 or more cigarettes per day = 3.48; 95% CI, 1.65- 7.32) and smoking burden (HR for 15 or more pack-years = 2.06; 95% CI, 1.29-3.3) were significantly linked to incident HF hospitalization compared with never smokers after adjustment for traditional risk factors and incident CHD.
“Blacks are disproportionately affected by cardiovascular diseases including heart failure and they are more likely to die of smoking-related disease than whites,” the researchers wrote. “Our findings suggest that smoking is associated with structural and functional left ventricular abnormalities that lead to heart failure in blacks and that smoking cessation should be encouraged in those with risk factors for heart failure.” by Dave Quaile
Disclosures: The authors report no relevant financial disclosures.