Stroke could be the initial sign of cardiovascular disease in some smokers

November 20, 2021 11:17 PM STI

Washington [US], November 20 (ANI): Death from heart attack or stroke may be the first event of cardiovascular disease (CVD) in some people who smoke cigarettes and CVD is the main adverse health effect of smokers, according to a new study.
The results of the study were published in the Journal of the American Heart Association, an open access journal of the American Heart Association.
Decades of research link smoking to premature death from cardiovascular disease and other illnesses such as lung cancer. According to the American Heart Association’s Heart and Stroke Statistical Update 2021, more than 480,000 American adults die from smoking each year.
Despite growing awareness of the health benefits of quitting smoking, more than 34 million adults in the United States still smoke cigarettes.
“There is often more awareness and concern about cancer resulting from smoking than from heart disease, so we wanted to better define the risks of smoking related to different types of cardiovascular disease and, most importantly, cardiovascular death”, the main study said. author Sadiya S. Kahn, MD, M Sc, assistant professor of medicine in the division of cardiology at the Feinberg School of Medicine at Northwestern University in Chicago.
Khan added, “In our analysis, even after adjusting for non-heart related deaths, such as those from lung cancer, we found that fatal or non-fatal events related to cardiovascular disease are more likely to occur in smokers. “
The researchers pooled data from nine long-term cohort studies in the United States to assess several lifestyle factors as well as cardiovascular and other health outcomes. The analysis included data from 106,165 adults (50.4% female; 16.2% black adults; 50.1% cigarette smokers) aged 20 to 79, who had no cardiovascular disease at the start of studies.
The new analysis classified participants by smoking status (either yes or no, self-reported when enrolling in the study); age (young: 20 to 39; middle age: 40 to 59; and over: 60 to 79); and sex.
Using the combined data, the researchers estimated the number of years lived with and without cardiovascular disease based on smoking status, then examined the association between smoking and cardiovascular events after accounting for deaths from to other diseases such as lung cancer. Adjustments were made for age, race, body mass index (BMI), blood pressure, and cholesterol levels.
The duration of follow-up for study participants ranged from 10 to 25 years.
The greatest differences in risk and death between participants who smoked and those who did not occur occurred in middle age. The analysis found:
1. Middle-aged women who smoked were almost twice as likely as non-smoker women to have fatal cardiovascular disease as the first sign of cardiovascular disease.
2. Middle-aged men who smoked had a 79% chance of having fatal cardiovascular disease as the first sign of cardiovascular disease – about 1.5 times more than middle-aged men who did not smoke.
3. For middle-aged women, long-term CVD risk rates were nearly 10% higher among those who smoked than those who did not (34.7% for smokers; 24.8% for those who did not smoke. non-smokers).
4. Middle-aged men who smoked had a more than 10% higher long-term risk of cardiovascular disease than men who did not smoke (46% for smokers; 35.8% for non-smokers) .

Smoking was associated with the development of cardiovascular disease at an earlier age, five years in middle-aged men and almost four years in middle-aged women. Similar results were seen in younger and older adults, so that more years lived without CVD were seen in all non-smoking participants of all age and sex groups.
“Our results indicate that preventing heart attack, stroke or heart failure is vital, but preventing sudden unexpected death as the first manifestation of cardiovascular disease is clearly a priority. People who smoke may not realize the damage cigarettes do to their body until it is too much. late, ”Khan said.
“Another notable finding in smokers was the early onset of CVD, and among those who developed CVD, how much younger they were. There isn’t a lot of research on young adults who smoke, especially young men. Our study adds an important perspective. Khan added.
In young adults aged 20 to 39, the analysis revealed:
The risk of CVD began to increase significantly in young men who smoked near the 10-year follow-up mark, while in young women the increased risk of CVD in smokers became more evident near the mark. 20-year follow-up.
Regarding CVD subtypes, young men who smoked had the highest long-term risk of heart attack (24%), while young women had the highest long-term risk (11, 3%) from other causes of CVD death, such as stroke or heart failure.
In all age groups, the majority of early cardiovascular events were fatal or non-fatal heart attacks. Fatal and non-fatal stroke was the second leading cause of the first cardiovascular event in people in the young age group. Heart failure was the second leading cause among the middle age and older groups.
Khan said these findings highlight the contribution of smoking to the earlier onset of cardiovascular disease overall, and also affected excessive cardiovascular risk up to the eighth decade of life in men and women, even after adjusting for the concurrent risk of non-cardiovascular death.
Based on these results, the researchers suggest that all people who smoke should discuss steps they can take to quit smoking and improve their cardiovascular health with their doctor or other healthcare professionals.
“Smoking cessation is very difficult and it is important to seek support and resources from your doctor or other healthcare professionals – the sooner the better,” said Khan. “This earlier onset of heart disease and stroke is very important to consider with aging and the already known complications of aging.”
There were some limitations to the study. Smoking status was based on participants’ report at the start of the study, so some might have quit or started smoking during follow-up, which would not have been included. Khan also noted that they were unable to provide more details on who smoked, such as how many years participants smoked, how many cigarettes smoked per day, or whether people who had already smoked. smoked were included in the studies.
“Despite these limitations, the results are quite significant,” Khan said.
“These results offer a very compelling message that people who smoke need to hear – smoking can kill you before you even know you have cardiovascular disease. It can, indeed, be a silent killer,” said Esa M. Davis, MD, member. of the American Heart Association’s Council on Lifestyle and Cardiometabolic Health, Associate Professor of Medicine and Medical Director of Clinical and Translational Sciences of the Tobacco Treatment Department of the University of Pittsburgh Medical Center, who did not participated in the study.
Esa added, “Heart attacks, strokes, and other types of cardiovascular disease don’t always show early symptoms. Therefore, if you don’t know you have CVD, you can’t treat it. You can help prevent CVD by never smoking or quitting. smoke as soon as possible. “
The American Heart Association supports an end to the use of all combustible tobacco products while ensuring that other tobacco products such as e-cigarettes do not addiction to the next generation of young people and adolescents. In 2019, the Association announced $ 20 million in research funding to drive scientific discoveries that will help end teenage smoking and nicotine addiction in the United States.
Additionally, the Association’s Tobacco Center of Regulatory Science is now in its second round of funding from the United States Food and Drug Administration (FDA) and National Institutes of Health (NIH) to study the cardiovascular effects of tobacco and nicotine products, including e-cigarettes and other non-traditional devices.
The basic and population-based research supported by the Center will help develop a better understanding of the potential regulation of current, new and emerging tobacco and nicotine products. (ANI)

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