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Influence of smoking and hypertension on left ventricular mass
1Upgraded Department of Medicine, SMS Medical College, Jaipur, Rajasthan.
Insights
Smoking and hypertension significantly increase left ventricular mass (LVM). The combined effect of both smoking and hypertension on LVM is greater than their individual impacts, with hypertension showing a more pronounced effect.
Area of Science:
- Cardiology
- Public Health
Background:
- Left ventricular mass (LVM) is a critical indicator of cardiac health.
- Smoking and hypertension are prevalent risk factors for cardiovascular disease.
- Understanding their individual and combined effects on LVM is crucial for risk stratification.
Purpose of the Study:
- To investigate the independent and combined effects of smoking and hypertension on left ventricular mass (LVM).
Main Methods:
- A study involving 100 patients aged 31-65, categorized into four groups: non-smoker normotensives, non-smoker hypertensives, smoker normotensives, and smoker hypertensives.
- Exclusion criteria included secondary hypertension, diabetes mellitus, dyslipidemia, cardiomyopathies, and valvular heart disease.
- M-mode echocardiography was utilized to calculate LVM using the Devereux formula.
Main Results:
- Mean LVM was significantly higher in smokers (191.66 gms) compared to non-smokers (136.04 gms) (P < 0.001).
- Mean LVM was significantly higher in hypertensives (197.25 gms) compared to normotensives (126.29 gms) (P < 0.001).
- The combined effect in smoker hypertensives (228.78 gms) was substantially greater than in non-smoker normotensives (106.77 gms) (P < 0.001).
Conclusions:
- Both smoking and hypertension independently increase LVM, with hypertension having a more significant impact.
- The synergistic effect of smoking and hypertension leads to a greater increase in LVM than either factor alone.
- Smoking contributes to increased LVM even in the absence of hypertension.
Objective:
The present study was designed to observe the influence of smoking and hypertension on left ventricular mass (LVM), both individual and the combined effect.
Methods:
This study was conducted in the Department of Medicine, SMS Medical College Hospital, Jaipur. Hundred patients were included in the study. They were divided into four groups--non smoker normotensives, non-smoker hypertensives, smoker normotensives and smoker hypertensives. They were also divided into smokers and nonsmokers and hypertensives and normotensive. Patients of age group 31-65 years of both sexes were chosen. Patients with secondary hypertension, diabetes mellitus, dyslipidemia, cardiomyopathies, valvular heart disease women on oral contraceptives were excluded from the study on the basis of history and relevant laboratory tests. An M-mode echocardiography was done and the LV mass was calculated by the formula proposed by Devereux et al. LV mass = 0.8 [1.04 (IVSd + LVIDd + LVPWd)3 - (LVIDd)3] + 0.6 gms
Results:
The mean LV mass (in gms) in the four groups of nonsmoker normotensives, nonsmoker hypertensives, smoker normotensives and smoker hypertensives are 106.77 +/- 25.78, 165.3 +/- 42.55, 154.53 +/- 24.6 and 228.78 +/- 56.88 respectively. The comparison of mean LV mass (in gms) of smokers and nonsmokers were 191.66 +/- 40.74 and 136.04 +/- 36.16 (P < 0.001) respectively. The comparison of the mean LV mass (in gms) of hypertensives and nonhypertensives were 197.25 +/- 49.72 and 126.29 +/- 25.19 (P < 0.001) respectively. Comparison of the mean LV mass (in gms) of patient with two risk factors i.e., smokers hypertensives with patients without any risk factor i.e., nonsmoker normotensive were 228.78 +/- 56.88 and 106.77 +/- 25.78 (P < 0.001) respectively. While comparison of the mean LV mass (in gms) of patients with one risk factor each i.e., smoker normotensives and nonsmoker hypertensives were 165.3 +/- 42.55 and 154.53 +/- 24.6 (P < 0.05) respectively.
Conclusion:
Both smoking and hypertension cause an increase in LV mass, hypertension causing a more increase, than smoking, individually. Both smoking and hypertension combine together to increase the LV mass, more than either of them individually. Smoking by itself can cause an increase in LV mass independent of hypertension.