SMOKING: It doubles the risk of heart failure for 30 years

Heart failure is a progressive disease in which the heart loses its ability to pump enough blood to meet the body’s needs. It is one of the leading causes of disability and death in rich countries. In addition to smoking, risk factors for heart failure include obesity, high blood pressure, diabetes, coronary artery disease and advanced age.

Therefore, smokers are twice as likely to develop heart failure, and this high incidence applies to the two main subtypes of heart failure.

“Smoking casts a shadow on heart health”

2 types of heart failure: with reduced ejection fraction or preserved ejection fraction.

  • In heart failure with a reduced ejection fraction, the left ventricle – the heart’s main pump – does not contract sufficiently when pumping blood. Heart failure with reduced ejection fraction is more closely related to coronary artery disease. Treatment includes several drugs that improve prognosis.
  • In heart failure with preserved ejection fraction, the left ventricle does not relax sufficiently after contraction. Treatment of heart failure with preserved ejection fraction is very limited, making its prevention crucial. At the same time, the risk factors are less clear. Previous studies have linked smoking to a higher risk of preserved ejection fraction.

The study analyzed the records of 9,335 participants in the ARIC (Atherosclerosis Risk In Communities) cohort. Introduced in 1987, ARIC includes middle-aged and older adults, ages 61 to 81, who have not been diagnosed with heart failure since 2005.

  • Over a median follow-up of 13 years, 1,215 cases of heart failure were identified, including 492 cases with reduced ejection fraction and 555 cases with preserved ejection fraction;
  • in smokers, both subtypes of heart failure were diagnosed with a 2.28 times higher incidence of preserved ejection fraction and 2.16 times higher incidence of reduced ejection fraction;
  • the association with smoking shows a “dose-response relationship”;
  • Quitting smoking reduces the risk of heart failure, but not at the same level as never-smokers: ex-smokers are, on average, 31% and 36% more likely than non-smokers to have preserved an ejection fraction and smokers, respectively.

Former smokers retain a significantly increased risk for both types of heart failure for nearly 30 years, says the study’s lead author, Dr. Kunihiro Matsushita, associate professor in the Bloomberg School’s Department of Epidemiology. “We hope these results will give current smokers new motivation to quit as soon as possible.”

“A Shadow on Heart Health” concludes the main author.

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