Smoking and heart health: Smoking damages the structure of the heart

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New research suggests that smoking directly affects the heart. Image credit: sankai/Getty Images.
  • Over 8 million people worldwide die each year from tobacco use.
  • Researchers from Herlev and Gentofte Hospital in Copenhagen found that smoking weakens the structure of the heart, affecting its functioning.
  • The research team also found that quitting smoking helped the heart to recover.

Tobacco use, including smoking, claims more than 8 million lives around the world every year.

Past research shows that smoking has a negative impact on a person blood vessels – more than 30% of deaths from coronary heart diseases occur from active smoking or secondhand smoke exposure.

Smoking doubles a person’s risk of heart attack and triples their risk of stroke.

Now, researchers from Herlev and Gentofte Hospital in Copenhagen, Denmark, have found evidence to suggest that smoking not only affects a person’s blood vessels, but also weakens the structure of the heart itself, affecting its function.

The researchers recently presented their findings at the European Society of Cardiology (ESC) 2022 Congress.

Past research shows that smoking negatively affects a person’s blood vessels, potentially causing heart problems.

For example, nicotine in cigarettes can cause blood vessels narrow, limiting the amount of blood that is allowed to flow through them. Nicotine can also significantly increase a person’s level blood pressure.

“We know that smoking causes coronary artery disease and heart failure,” explained Dr. Eva Holt from Herlev and Gentofte Hospital, Copenhagen, Denmark, lead author of this study.

“But the purpose of this study was to investigate whether smoking had an independent effect on cardiac structure and function in a large general population without known heart disease,” she specified.

Dr. Holt and her team evaluated data from more than 3,800 participants of the fifth Copenhagen City Heart Study. This study looked at cardiovascular disease and risk factors in the general population. Study participants ranged in age from 20 to 93 and had no history of heart disease.

Data collected during the study included a questionnaire addressing participants’ smoking history, as well as a echocardiogram or ultrasound of the heart.

The researchers determined that the current smokers in the participant group had thicker, heavier and weaker hearts compared to those who had never smoked. The study also found a correlation between increased cigarette “package years– 1 pack year is equivalent to 20 cigarettes smoked every day for 1 year – and the heart’s ability to pump blood decreases.

“We found that both current smoking and accumulated pack-years were associated with deterioration in the structure and function of left heart chamber — the most important part of the heart”, says Dr. Holt. “Furthermore, we found that over a 10-year period, those who continued to smoke developed thicker, heavier and weaker hearts that were less able to pump blood compared to those who had not. never smoked and those who quit smoking during that time.”

MNT spoke with Dr. Rigved Tadwalkar, a board-certified cardiologist at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in this study.

“What’s interesting about this study is that it’s looking at changes in the heart’s main pumping chamber, the left ventricle, from tobacco use, which until now has been less well explained,” he commented.

“We always talk about the link between tobacco use and diseases of the blood vessels, including the arteries of the heart, but we haven’t gone into the details of how it affects the structure and function of the heart itself,” he noted.

According to Dr. Tadwalkar, cigarettes increase the tendency to develop plaques on the inner walls of arteries, known clinically as atherosclerosis. This can lead to heart damage both directly and indirectly, he said.

“Smoking directly damages the vascular wall, the wall of blood vessels, leading to tightening and reduced elasticity, as well as impaired function of the endothelium, which is the inner layer of blood vessels,” he explained.

“Indirectly, it has multiple effects. Smoking may increase [the] inflammatory burden and this is demonstrated in various ways, including increased platelet activity [and] increased homocysteine ​​levels. It can grow thrombosis – which is clotting – cholesterol levels, and can lead to activation of the sympathetic nervous system, which is the part of the nervous system responsible for raising blood pressure and heart rate. So chronically elevated heart rate and blood pressure can lead to this dysfunction.”

– Dr. Rigved Tadwalkar

According to the new study, Dr. Holt and her team found evidence that quitting smoking can help the heart recover to some extent.

“The finding that the heart seems to regain its former structure and function after smoking cessation may be a valid motivation to give the patient to stop smoking,” she added.

Dr. Tadwalkar agreed. “We certainly have data that there is, and this study follows a line of other previous studies that show that in different ways, and not just from the heart, quitting smoking will improve overall health,” he explained.

“Quitting smoking immediately will reduce heart rate and blood pressure, as well as [the] sympathetic nervous system response,” continued Dr. Tadwalkar.

“So the good news is that even immediately, there are physiological benefits to this,” he noted. “And then the decrease over time in that inflammatory burden and these other destructive pathophysiological processes, from the lack of chronic exposure, is part of the reason for this improvement.”

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