Cigarette Smoking, Quitting, and the Risk of Heart Failure With Preserved and Reduced Ejection Fraction

For a study, researchers sought to measure the relationship between cigarette smoking and smoking cessation and the prevalence of HFpEF and HFrEF.

They used multivariable Cox models to assess the associations of several established cigarette smoking parameters (smoking status, pack-years, intensity, duration, and years since cessation) with physician-adjudicated incident acute decompensated HF in 9,345 ARIC (Atherosclerosis Risk In Communities) study White and Black participants without a history of HF at baseline in 2005 (age range 61-81 years).

There were 1,215 incident HF patients with a median follow-up of 13.0 years. Current cigarette smoking was related to HFpEF and HFrEF in the same way as never smoking, with adjusted HRs∼2. For pack-years of smoking and HF, there was a dose-response connection. A long time of smoking cessation was linked with a decreased risk of HF, although a considerably higher risk persisted for HFpEF and HFrEF for several decades.

All cigarette smoking factors were consistently associated with HFpEF and HFrEF. Smoking cessation lowered the risk of HF considerably, although the extra risk lingered for several decades. The findings added to the evidence that smoking is a modifiable risk factor for HF and emphasized the importance of smoking prevention and cessation in preventing HF, particularly HFpEF.

Reference: jacc.org/doi/10.1016/j.jacc.2022.03.377