How smoking can affect your Heart Health | Aakash Healthcare

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How smoking can affect your Heart Health

It is a well-known fact by now that smoking is harmful for health. Tobacco use is the most preventable cause of death across the globe. Most of tobacco consumption has shifted from developed nations to developing nations in last few decades. India is home to about 12% of the world’s smokers and around 35% of adults in India smoke tobacco. Smoking claims roughly close to a million lives per year in India and is the fourth largest cause of death among non communicable diseases. Tobacco use is responsible for roughly 25% of all deaths among men and 10% of all deaths among women.  Cigarettes contain thousands of chemicals like carbon monoxide and even cyanide (hydrogen cyanide). This article will focus on the severe effects smoking has on the heart.

Smoking harms and destroys blood cells because of the various chemicals it contains; along with blood cells tobacco can alter (structurally and functionally) blood vessels. Cigarettes contain chemicals like carbon monoxide and tar, when inhaled this leads to an increased risk of Atherosclerosis (wherein plaque deposits form on artery walls) or Ischemic Heart Disease (when plaque deposits are formed on the coronary arteries, arteries of heart). These atherosclerotic plaques harden over time and lessens the space available within the arteries, leading to narrower arteries. Narrower arteries mean lesser healthy oxygen rich blood reaches the heart and other viral organs and parts of the body. If left unchecked and uncorrected, atherosclerosis can eventually lead to a heart attacks, brain strokes, weaker heart with higher risk of heart failure. Not only does smoking reduce and slow down blood flow; it also increases blood pressure. Higher blood pressure (which has no discernible symptoms) also increases chance of developing brain stroke or heart attack. Smoking can also lead to Peripheral Artery Disease (P.A.D) wherein plaque deposits form on arteries that carry blood to the limbs, mainly legs and patient start getting symptoms of leg pain while walking. In severe cases these can cause ulcers in leg, which are difficult to heal due to decreased blood supply because of blockages. A disrupted irregular heart rhythm, higher LDL or bad cholesterol, increased triglycerides (which are a form of fat in the blood), thickened blood that cannot carry sufficient oxygen are other heart related issues smoking can cause over a period of time. Smoking, when combined with other common poor lifestyle indicators like high cholesterol, high blood pressure or obesity can be lethal.

It is not smoking air per se that is harmful, it is the chemicals that cause the real damage. The three chief ingredients in cigarettes are Nicotine, Carbon Monoxide and Tar. Nicotine is a highly addicted chemical found in all tobacco products; nicotine creates addiction. It raises the heart rate and increases blood pressure, and untreated high blood pressure can permanently damage the arteries and heart. Tar is the chemical that is mostly associated with lung cancer, 70% remains within the lungs and reduces their ability to pump clean oxygenated blood; which eventually means lesser oxygen available for the heart. Carbon Monoxide is a poisonous gas and a well-known air pollutant; it directly reduces the blood cells’ capacity to carry oxygen to all the parts of the body.

Not just smokers, even second-hand smokers or those who happen to be around smokers are at risk. Breathing in secondhand tobacco smoke can cause the same primary damage smoking causes to smokers. Children are particularly vulnerable when exposed to secondhand smoke as their lungs are developing and it can lay the foundations for developing Ischemi heart diseases in the future as it lowers the “good cholesterol” or HDL and damages heart tissue. Secondhand smoke is most dangerous for prematurely born children with respiratory problems or children with respiratory diseases like asthma. There is increased risk of low birth weight babies born to pregnant ladies who smokes.

Often misleading adjectives behind cigarette boxes read “mild tobacco” or “less tar”: these are fallacious to say the least and there is nothing known as a “safe” or “safer” cigarette. There is no safe amount of smoking; smoke less or more, the damage is done with every stick. Bidis, cigars, pipes; none of these are safe as they all contain tobacco which will eventually need to be burned for consumption and the resulting smoke will contain all the same chemicals stated earlier. Heart disease risk is prominently found in cigar smokers according to some studies. Shisha or Hukka is no safer, it contains the same array of chemicals and one hour of smoking a shisha generates the same amount of smoke a hundred cigarettes would. E-Cigarettes seem to be trending these days but these cigarettes are also harmful to health, including risk of serious lung damage and cancers.

There is good news for those who are considering or have already quit smoking. Within the first 20 minutes of quitting, blood pressure and heart rate can stabilise and return to normal, at 6 weeks, lung function improves and within one year of quitting; the risk of heart disease is halved. Quitting smoking after a heart attack reduces risk of second heart attack by 50%. Quitting smoking between 30 to 39 years adds roughly 10 years to life and quitting between 60 to 65 years increase lifespan by upto 4years. So, there is a benefit of quitting smoking at any age but earlier the better.

Dr. Rupesh Kaushik
Senior Consultant
Cardiology & Cardiac Surgery

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