Quitting smoking may lower risk for heart failure
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Compared with sustained levels of smoking, people who increased their levels had elevated risk for heart failure and those who quit had reduced risk for HF, researchers reported.
In addition, people who reduced their levels of smoking but did not quit outright did not have reduced risk for HF compared with people who sustained their levels of smoking.
“Current evidence on the relationship between smoking and HF suggests that smoking is a risk factor for HF independent of traditional risk factors. Smoking increases the risk of coronary artery disease, a major cause of HF, and there are also other effects of smoking that result in cardiac dysfunction and HF,” Jung Eun Yoo, MD, PhD, from the department of family medicine, Healthcare System Gangnam Center, Seoul National University Hospital, South Korea, and colleagues wrote in JACC: Heart Failure.
In a retrospective, population-based study, Yoo and colleagues used information from the Korean National Health Insurance System database and included 778,608 current smokers. The program investigated the effects of smoking behavior change on HF development in participants who underwent screenings in 2009 and 2011.
Study participants were categorized as quitters, those who stopped between the two screenings; reducers, those who decreased daily cigarette use by 20% or more but did not fully quit; sustainers, those who continued the same cigarette use or increased or decreased by less than 20%; and increasers, those who increased daily cigarette use by 20% or more. Participants were also divided into light smokers, fewer than 10 cigarettes per day; moderate smokers, 10 to 19 cigarettes per day; and heavy smokers, 20 cigarettes or more per day.
From 2009 to 2011, 47.7% of the participants sustained their smoking level, 21.9% became reducers, 14.5% became quitters and 15.9% became increasers. Compared with sustainers, increasers had elevated risk for HF (adjusted HR = 1.06; 95% CI, 1.02-1.1) and quitters had reduced risk for HF (aHR = 0.86; 95% CI, 0.83-0.9). Heavy smokers who quit smoking had lower risk for HF than heavy smokers who sustained (aHR = 0.9; 95% CI, 0.85-0.95). The risk for HF increased slightly in reducers compared with sustainers (aHR for people who reduced at least 50% = 1.06; 95% CI, 1.01-1.11; aHR for people who reduced less than 50% = 1.04; 95% CI, 1-1.08).
The association between incident HF and smoking behavior change was found to be more prominent in men and younger people aged 40 to 64 years. Regardless of baseline smoking levels, smoking cessation was associated with a decreased risk for HF.
“In the present study, the beneficial effect of self-reported smoking cessation on HF risk reduction was more prominent in younger participants than in the older age group. Although smoking cessation is beneficial at all ages, the greatest benefit was seen in those who quit earliest in life,” Yoo and colleagues wrote.
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