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Exposure to secondhand smoke is associated with increased left ventricular mass

Publication ,  Journal Article
Skipina, TM; Upadhya, B; Soliman, EZ
Published in: Tobacco Induced Diseases
June 1, 2021

INTRODUCTION Chronic hypertension is associated with left ventricular hypertrophy. Recent evidence suggests that secondhand smoke (SHS) exposure is associated with chronic hypertension, so we sought to examine the relationship between secondhand smoke exposure and electrocardiographic left ventricular (LV) mass among non-smokers. METHODS This analysis included 4982 non-smoker participants from the Third National Health and Nutrition Examination (NHANES-III). Non-smoking was defined by self-report and serum cotinine =10 ng/mL, a biomarker for tobacco exposure. SHS exposure was defined as serum cotinine level =1 ng/mL. LV mass was estimated using an electrocardiographic model developed and applied in NHANES-III then validated in the Cardiovascular Health Study. Multivariable linear regression was used to examine the cross-sectional association between SHS exposure (vs no exposure) with estimated LV mass index. In similar models, we also examined the associations of LV mass index across quartiles of serum cotinine (reference group, 1st quartile) and in subgroups stratified by age, race, sex, hypertension, and obesity. RESULTS About 9.8% (n=489) of the participants were exposed to SHS. Exposure to SHS was associated with an estimated 2.9 g/m2 increase in LV mass index, with a dose-response relationship between higher serum cotinine and LV mass index. These results were consistent in men and women, Whites and non-Whites, elderly and non-elderly, and those with and without hypertension. Significant effect modification was present among obese individuals with an estimated 4.8 g/m2 increase in LV mass index (interaction p=0.01). CONCLUSIONS In a racially diverse sample of non-smokers, SHS is associated with increased LV mass with a dose-response relationship between level of exposure and LV mass. Effect modification was present among obese individuals. These findings underscore the harmful effect of passive smoking on the cardiovascular system and highlight the need for more restrictions on smoking in public areas, especially in countries or regions with less-stringent public health policies.

Duke Scholars

Published In

Tobacco Induced Diseases

DOI

EISSN

1617-9625

Publication Date

June 1, 2021

Volume

19

Issue

June

Related Subject Headings

  • 4206 Public health
  • 1103 Clinical Sciences
 

Citation

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Skipina, T. M., Upadhya, B., & Soliman, E. Z. (2021). Exposure to secondhand smoke is associated with increased left ventricular mass. Tobacco Induced Diseases, 19(June). https://doi.org/10.18332/TID/136415
Skipina, T. M., B. Upadhya, and E. Z. Soliman. “Exposure to secondhand smoke is associated with increased left ventricular mass.” Tobacco Induced Diseases 19, no. June (June 1, 2021). https://doi.org/10.18332/TID/136415.
Skipina TM, Upadhya B, Soliman EZ. Exposure to secondhand smoke is associated with increased left ventricular mass. Tobacco Induced Diseases. 2021 Jun 1;19(June).
Skipina, T. M., et al. “Exposure to secondhand smoke is associated with increased left ventricular mass.” Tobacco Induced Diseases, vol. 19, no. June, June 2021. Scopus, doi:10.18332/TID/136415.
Skipina TM, Upadhya B, Soliman EZ. Exposure to secondhand smoke is associated with increased left ventricular mass. Tobacco Induced Diseases. 2021 Jun 1;19(June).
Journal cover image

Published In

Tobacco Induced Diseases

DOI

EISSN

1617-9625

Publication Date

June 1, 2021

Volume

19

Issue

June

Related Subject Headings

  • 4206 Public health
  • 1103 Clinical Sciences