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Smoking Status, Intensity of Smoking, and Their Relation to Left Ventricular Hypertrophy in Working Aged Korean Men
Sung Keun Park1, Jae-Hong Ryoo2, Jeong Gyu Kang3
1Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Insights
Smoking, including former and current use, is linked to left ventricular hypertrophy (LVH). Higher smoking intensity, measured by pack-years and cotinine levels, correlates with increased LVH risk in working-aged men.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Smoking is a known risk factor for atherosclerotic cardiovascular disease.
- The impact of smoking on left ventricular (LV) structure, specifically left ventricular hypertrophy (LVH), is less understood.
- Understanding this relationship is crucial for cardiovascular disease prevention strategies.
Purpose of the Study:
- To investigate the association between smoking status and smoking intensity with LVH.
- To determine if smoking affects LV structure in a working-aged population.
- To quantify the dose-dependent relationship between smoking and LVH.
Main Methods:
- A large cohort of 53,666 working-aged Korean men undergoing health check-ups were analyzed.
- Participants were categorized by smoking status (never, former, current), smoking intensity (pack-years), and urine cotinine levels.
- Multivariate logistic regression was employed to calculate adjusted odds ratios (ORs) for LVH.
Main Results:
- Former and current smokers exhibited higher LV mass index, relative wall thickness, and prevalence of LVH compared to never smokers.
- A dose-dependent relationship was observed between smoking intensity (pack-years, cotinine levels) and LVH.
- The odds of LVH increased significantly with higher smoking pack-years and cotinine excretion levels.
Conclusions:
- Smoking exposure and its intensity are significantly associated with LVH in a working-aged population.
- These findings highlight the adverse effects of smoking on LV structure, even in younger individuals.
- The study underscores the importance of smoking cessation for cardiovascular health.
Introduction:
Smoking is an established risk factor for atherosclerotic cardiovascular disease. However, the effect of smoking on left ventricular (LV) structure has been less studied. This study was designed to assess the association of smoking status and smoking intensity with left ventricular hypertrophy (LVH).
Methods:
Study subjects were 53,666 working aged Korean men who received echocardiography as an item of health check up. They were grouped by smoking status (never, former, and current smokers), pack-year of smoking (never, <10, 10-19.9, and ≥20 pack-year), and urine cotinine excretion (<100, 100-999, ≥1000 ng/mL). Multivariate logistic regression analysis was used in calculating adjusted odds ratios (ORs) and 95% confidence interval for LVH (adjusted odds ratios [95% confidence interval]). The proportions of abnormal LV geometry patterns were compared among groups.
Results:
Former and current smokers had the higher levels in LV mass index, relative wall thickness, and the prevalence of LVH than never smoker. The association with LVH increased in order of never (reference), former (1.44 [1.01-2.04]), and current smokers (2.10 [1.44-3.05]). LVH showed the proportional relationship with pack-year of smoking (never smoker: reference, <10: 1.45 [1.01-2.08], 10-19.9: 1.73 [1.17-2.57], ≥20: 2.43 [1.58-3.74]) and urine cotinine excretion (never smoker: reference, 100-999: 1.70 [1.21-2.37], >1000: 1.97 [1.43-2.72]). The proportions of abnormal LV geometry patterns were higher in smoking groups than never smoking group.
Conclusion:
Exposure to tobacco use and intensity of smoking was associated with LVH in working aged population.
Implications:
In working aged Koreans with mean age of 39.9 ± 7.0 years, former and current smokers are more likely to have LVH than never smoker. Dose-dependent relationship was found between the smoking status (never, former, and current smokers), pack-year of smoking, urine cotinine excretion, and LVH. These findings indicate that smoking has an adverse influence on LV structure even in relatively young age group.
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