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Cardiac function in smokers and nonsmokers: the CARDIA study. The Coronary Artery Risk Development in Young Adults
1Department of Preventive Medicine, Northwestern University Medical School, Chicago, Illinois, USA.
Insights
Cigarette smoking in young adults is linked to higher resting heart rates and altered cardiac function, potentially increasing myocardial oxygen demand. These effects, including gender-specific variations, suggest long-term cardiovascular risks.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Public Health
Background:
- The long-term cardiovascular impacts of cigarette smoking in healthy young adults remain less understood than immediate effects.
- Key indicators like heart rate, left ventricular mass, and end-systolic stress are of interest due to their relation to myocardial oxygen consumption.
Purpose of the Study:
- To assess clinical and echocardiographic measures of cardiac function at rest in young adult smokers versus nonsmokers.
- To determine the association between cigarette smoking and left/right ventricular performance.
Main Methods:
- The Coronary Artery Risk Development in Young Adults (CARDIA) study involved 3,366 participants (ages 23-35), equally distributed by race and gender.
- Echocardiography was used to measure pulmonary artery acceleration time, left ventricular mass, end-systolic stress, and fractional shortening.
- Heart rate, anthropometrics, and blood pressure were also assessed, excluding ex-smokers.
Main Results:
- Smokers exhibited significantly higher resting heart rates (1.5-5 beats/min) across most race/gender groups.
- Smokers had lower pulmonary artery acceleration time (4-8 ms) in men and a trend toward increased left ventricular mass, significant in black women.
- Increased left ventricular end-systolic stress was observed in women who smoked; no differences in systolic blood pressure or fractional shortening were found.
Conclusions:
- Quantifiable differences in resting cardiovascular function exist between young adult smokers and nonsmokers.
- These differences, including gender-specific findings, suggest increased myocardial oxygen consumption in smokers.
- The study highlights potential long-term cardiovascular risks associated with smoking in young adults.
Objectives:
This study assessed clinical and echocardiographic measures of cardiac function at rest in smokers and nonsmokers to determine the associations of cigarette smoking with various measures of left and right ventricular performance.
Background:
Whereas the immediate cardiovascular effects of cigarette smoking have been well described, the long-term effects in an otherwise healthy cohort have not. Of particular interest were associations with heart rate, left ventricular end-systolic stress and left ventricular mass because higher levels of these measures would suggest increased myocardial oxygen consumption.
Methods:
In year 5 of the Coronary Artery Risk Development in Young Adults (CARDIA) study, 3,366 smokers and nonsmokers (ex-smokers were excluded) underwent echocardiography as well as assessment of heart rate, anthropometric measurements and blood pressure. Participants ranged in age from 23 to 35 years and were equally distributed by race and gender. Echocardiographic measures included pulsed Doppler pulmonary artery acceleration time (a decrease suggests increased pulmonary artery pressure), left ventricular mass, left ventricular end-systolic stress and left ventricular fractional shortening.
Results:
All comparisons were between smokers and nonsmokers. Heart rate at rest was significantly higher in smokers by 1.5 to 5 beats/min in all race/gender groups except black men. In men who smoked, pulmonary artery acceleration time was significantly lower by 4 to 8 ms. Except for black male smokers, there was a trend toward increased left ventricular mass (3 to 8 g) in all race/gender groups, significant in black women. Left ventricular end-systolic stress was significantly higher in women who smoked (4 to 6 dynes/cm2). There were no differences for systolic blood pressure or left ventricular fractional shortening.
Conclusion:
In an assessment of cardiovascular function at rest in young adults, quantifiable differences between smokers and nonsmokers that predict increased rest myocardial oxygen consumption in smokers were found. Some of these differences were gender specific.
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