Study: Reduce Smoking, Boost Heart Health

Suzanne Rostler
Reuters Health

NEW YORK - Smokers who quit or even just cut down on cigarettes can begin to reap the health benefits within a few months, new study findings suggest.

In the study, individuals who gradually quit smoking saw improvements in risk factors for heart disease, including lower cholesterol and carbon monoxide levels. The findings may encourage some of the millions of smokers worldwide to cut back on tobacco, which will cause an estimated 10 million deaths a year by 2030, report researchers led by Dr. Bjorn Eliasson from Sahlgrenska University Hospital in Goteborg, Sweden.

"Smoking reduction results in improvements in established cardiovascular risk factors...which has the potential to benefit individual and public health," the authors write.

Over 4 months, 33 adults who had smoked 15 or more cigarettes a day for at least 3 years reduced and tried to quit smoking. To help curb their cravings, they used a nicotine-containing nasal spray manufactured by Pharmacia Consumer Healthcare, which funded the study.

After 9 weeks, participants had cut their smoking in half, on average. Levels of carbon monoxide declined by about 17%, while total cholesterol and LDL ("bad") cholesterol levels also fell. Meanwhile, HDL ("good") cholesterol rose, and the blood's capacity to transport oxygen also improved, Eliasson's team reports in the August issue of Nicotine & Tobacco Research.

Carbon monoxide is a byproduct of tobacco smoke that has been found to boost cholesterol, levels of white blood cells and other risk factors for heart disease. The gas can also impair the blood's ability to transport oxygen throughout the body, which may raise the risk of heart attack.

According to previous research cited in the report, reducing total cholesterol by up to 9% and reducing LDL cholesterol by just 1% can lower a person's risk of heart disease.

"Reduction (of smoking) is a step in the right direction, especially for those that are not quite ready to stop yet," Eliasson told Reuters Health, although he added that it could be difficult for some people to maintain a lower level for a long period of time.

SOURCE: Nicotine & Tobacco Research 2001 August.

Smoking - Heart Circulation

Smokers are more than 5 times as likely as nonsmokers to develop abdominal aortic aneurysms. (Reuters March 2004)

Nicotine can trigger palpitations. (Longevity, May 1991)

Among people over 65, smokers have four to eight times the risk of an aneurysm than the average person’s risk: those with high blood pressure have double the risk. (“Deceptive Pain,” Discover magazine, Jan. 2001)

Smoking and exposure to secondhand smoke both significantly hasten hardening of the arteries, and the damage may be permanent, says a study at Wake Forest University. (“Smoking linked to hardening of the arteries,” AP, The Daily Progress, Charlottesville, Virginia, Jan. 14, 1998)

Smoking may account for a 50% increase in the development of arteriosclerosis (the buildup of plaque along arterial walls) for current smokers, and 25% for past smokers. (Delicious! magazine, May 1998)

In the winter, smokers may be at an increased risk of heart disease due to higher blood pressure and heart rate, say researchers in Israel. Although winter blood pressure readings are typically higher for most people, in smokers the average increase in systolic blood pressure was twice the increase in non-smokers. (“Cold Weather Raises Heart Risk for Smokers,” heartinfo.org - June 2001)

Smoking damages the arteries to the heart and brain, thereby increasing the risk of heart attack and stroke. ( British Medical Journal 1996, in Health Gazette newsletter, Feb. 1997)

Cigarette smoking harms the body by raising cholesterol levels and blood pressure. (“Addictive Substances: Nicotine,” Let’s Live magazine, Oct. 1996)

One cigarette can impair circulation for up to 45 minutes by constricting the small blood vessels. (The narrow vessels in the feet are particularly vulnerable to the damaging effects). (Hara Podiatrist Group, Covina, Ca., Prevention magazine, Dec. 1987)

Facts About Heart Disease and Women: Kicking The Smoking Habit

CORONARY HEART DISEASE is a woman's concern. Every woman's concern. One in ten American women 45 to 64 years of age has some form of heart disease, and this increases to one in five women over 65. Another 1.6 million women have had a stroke. Both heart disease and stroke are known as cardiovascular diseases, which are serious disorders of the heart and blood vessel system.

Cigarette smoking is a habit that greatly increases your chances of developing cardiovascular diseases. Surprising as it may seem, smoking by women in this country causes almost as many deaths from heart disease as from lung cancer. If you smoke, you are two to six times more likely to suffer a heart attack than a nonsmoking woman, and the risk increases with the number of cigarettes you smoke each day. Smoking also boosts the risk of stroke.

The Effects of Smoking on the Heart

Introduction

Each year, tobacco smoking accounts for around approximately 20% of all heart disease deaths.

What is Coronary Heart Disease (CHD)?

CHD has two principal forms - angina and heart attacks. Both occur because the arteries carrying blood to the heart muscle become blocked or narrowed, usually by a deposit of fatty substances, a process known as atherosclerosis. Angina is a severe pain in the chest brought on by exertion and relieved by rest. A heart attack is due to obstruction of a coronary artery either as a result of atherosclerosis or a blood clot: part of the heart muscle is deprived of oxygen and dies.

Risk factors for Coronary Heart Disease

Cigarette smoking, raised blood cholesterol and high blood pressure are the most firmly established, non-hereditary risk factors leading to CHD with cigarette smoking being the "most important of the known modifiable risk factors for CHD", according to the US Surgeon General. A cigarette smoker has two to three times the risk of having a heart attack than a non-smoker. If both of the other main risk factors are present then the chances of having a heart attack can be increased eight times. At least 80% of heart attacks in men under 45 are thought to be due to cigarette smoking. At this age, heavy smokers have 10 to 15 times the rate of fatal heart attacks of non-smokers. Even light smokers are at increased risk of CHD: a US study found that women who smoked 1-4 cigarettes a day had a 2.5-fold increased risk of fatal coronary heart disease.

The role of smoking in Coronary Heart Disease

Inhaling tobacco smoke causes several immediate responses within the heart and its blood vessels. Within one minute of starting to smoke, the heart rate begins to rise: it may increase by as much as 30 percent during the first 10 minutes of smoking. Smoking also raises blood pressure: blood vessels constrict which forces the heart to work harder to deliver oxygen to the rest of the body. Meanwhile, carbon monoxide in tobacco smoke exerts a negative effect on the heart by reducing the blood's ability to carry oxygen.

Smoking and arterial disease

Smoking tends to increase blood cholesterol levels. Cigarette smokers also have raised fibrinogen levels and platelet counts which make the blood more sticky. Carbon monoxide attaches itself to haemoglobin much more easily than oxygen does. This reduces the amount of oxygen available to the tissues. All these factors make smokers more at risk of developing various forms of atherosclerotic disease. As the atherosclerotic process progresses, blood flows less easily through rigid and narrowed arteries and the blood is more likely to form a thrombosis (clot). This sudden blockage of an artery may lead to a fatal heart attack, a stroke or gangrene of the leg.

Aneurysm

Is a ballooning of the wall of an artery which leads to risk of bursting or clotting, which may lead to catastrophic results. Smokers are very much more likely to die from a ruptured aneurysm of the abdominal aorta than non-smokers.

Peripheral vascular disease (PVD)

Smokers have a 16 times greater risk of developing peripheral vascular disease (blocked blood vessels in the legs or feet) than people who have never smoked. Smokers who ignore the warning of early symptoms and continue to smoke are more likely to develop gangrene of a leg.

Cigarette smoking combines with other factors to multiply the risks of atherosclerosis. Patients who continue to smoke after surgery for PVD are more likely to relapse, leading to amputation, and are more likely to die earlier.10

Thromboangiitis Obliterans (Buerger's Disease)

This is a rare form of PVD, and is virtually always due to heavy cigarette smoking. It consists of an inflammatory condition of small vessels that leads to blocking of the arteries and gangrene. Few sufferers are able to stop and many of them end up with multiple amputations.

Stroke

Smokers are more likely to develop a cerebral thrombosis (stroke) than non-smokers. A form of cerebral haemorrhage (subarachnoid) is more common in smokers, especially among women who also take the contraceptive pill.