Childhood smoke exposure reduces LV function
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Passive smoke exposure in childhood was associated with a reduction in global longitudinal strain, a marker of left ventricular dysfunction, in adulthood, researchers reported at the virtual American Heart Association Scientific Sessions.
“Children should be protected from passive smoking, as this has not only effects on children at the time of exposure, but also long into the future,” Chigozie Ezegbe, MBBS, MPH, PhD candidate, and Seana Gall, MD, National Heart Foundation of Australia Future Leader Fellow, both at Menzies Institute for Medical Research at the University of Tasmania, Australia, told Healio. “The major source of passive smoke for children is from parents. Policies and interventions to support families to be smoke free, particularly pregnant women and their partners, should be implemented. We have previously found that many women who quit smoking during pregnancy restart smoking months after during postpartum. Following them up with longer-term support could help with relapse to smoking and have long-term health benefits for children.”
Researchers evaluated data from 781 participants (mean age, 45 years; 53% women) from the Childhood Determinants of Adult Health study with 34-year follow-up. Passive smoking exposure measure responses were obtained from a validated questionnaire for severity of exposure index, cumulative years of exposure and total household smokers. Ultrasound imaging was used to measure the global longitudinal strain of the left ventricle.
More than half of participants (54.2%) were exposed to passive smoking during childhood. Researchers observed a decrease in global longitudinal strain (adjusted = –0.17%; 95% CI, –0.32 to –0.02) per standard deviation of severity of exposure index. Cumulative years of exposure was associated with a global longitudinal strain decrease per SD of exposure (adjusted = –0.18%; 95% CI, –0.33 to –0.05). For each total household smoker in a participant’s childhood, global longitudinal strain decreased (adjusted = –0.2%; 95% CI, –0.36 to –0.05).
Current examinations of other CV effects of secondhand smoke exposure, including alterations in BP and plaque buildup in arteries, are underway.
Ezegbe and Gall told Healio that further understanding is required to determine whether CV damage caused by exposure to passive smoke in early life can be modified or reversed through lifestyle changes or medications.
“We want clinicians to know the number of adverse effects due to exposure of children to tobacco smoke on the cardiovascular system. These findings may be important in terms of advocacy and implementation of interventions to help parents with children to stop smoking or protect their children from tobacco smoke,” Ezegbe and Gall said. “More broadly, recognizing that adult cardiovascular health is influenced by factors from across the life course, including childhood, is important for informing prevention programs.”
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Ezegbe C, et al. Social and behavioral risk factors for cardiovascular disease. Presented at: American Heart Association Scientific Sessions; Nov. 13-17, 2020 (virtual meeting).
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