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Abrupt smoking cessation may confer short-term CVD risks in metabolic syndrome
Recent findings show that sudden smoking cessation appears to increase some of the cardiovascular risk factors linked to metabolic syndrome, particularly elevated triglycerides.
These risk factors decrease over time, however, and the benefits of smoking cessation ultimately exceed weight gain and its attendant risk, the researchers wrote.
In the study, Guadalupe Ponciano-Rodriguez, MSc, and colleagues identified for evaluation 48 heavy smokers (24 men, 24 women) seen at a tobacco cessation clinic in Mexico. The participants (mean age, 49.4 years) smoked a mean of 19.92 cigarettes per day and 33.23 packs per year during 33.4 years. They began a group therapy treatment based on cognitive-behavior therapy (CBT), and this treatment was supplemented with varenicline (Chantix, Pfizer) in 16 participants and nicotine replacement therapy (NRT) in 16 participants. A third group of 16 participants underwent treatment with CBT alone. The quit-date goal was slated for week 3 and consisted of abrupt cessation. The investigators confirmed smoking abstinence through exhaled levels of carbon monoxide and also measured blood pressure, BMI and waist circumference on a weekly basis. Blood levels of glucose, triglycerides, HDL cholesterol and insulin were tested at weeks 1, 4 and 10 to establish the homeostasis model assessment (HOMA) index. A control group of 96 healthy nonsmokers also was evaluated.
Guadalupe Ponciano-Rodriguez
The researchers found that smokers had a mean BMI of 26.94, and the nonsmokers had a BMI of 26.23. The smokers exhibited a higher prevalence of hypertension, high triglycerides and lower HDL cholesterol than nonsmokers. At week 3, treatment with NRT yielded an 81% cessation rate, and treatment with CBT and varenicline produced a 93% quit rate. The mean weight gain at end of treatment was 1.09 kg in the CBT-only group, 1.06 in the NRT group and 1.17 kg in the varenicline group. Although the rate of metabolic syndrome was 31.25% at week 1, it decreased to 29.16% at the study’s end. The number of participants with hypertension, glucose changes, hypertriglyceridemia and low HDL also was decreased at the conclusion of the study.
According to the researchers, longtime smokers appear to develop a sort of homeostasis that is disrupted upon cessation, especially in older men and heavy smokers. They added, however, that the lasting effects of quitting are more significant than its short-term risks.
“In this study, we showed that even when there is an increase in weight after cessation, quitting smoking reduces, in an important way, variables such as high [triglycerides] and glucose, as well as low HDL cholesterol, which have been involved in diabetes mellitus, CVD and stroke.”
Disclosure: The researchers report no relevant financial disclosures.