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Children exposed to tobacco smoke have worse heart function as adults

Presented by
Dr Chigozie Ezegbe, University of Tasmania, Australia
AHA 2020
Childhood passive smoke exposure, independent of whether the individuals smoke themselves, was associated with a reduction in global longitudinal strain (GLS), a measure of subclinical cardiac dysfunction [1]. The more passive smoke exposure a child had, the higher the risk for reduced heart function.

Although it is generally assumed that prolonged childhood exposure to passive smoke may affect adult cardiovascular (CV) health, there are few studies of cardiac function decades after the exposure. Subclinical left ventricular dysfunction detected by GLS is predictive of the subsequent development of heart failure and was used as a surrogate for increased risk. The investigators addressed the association of passive smoke exposure during childhood with GLS in adulthood.

Dr Chigozie Ezegbe (University of Tasmania, Australia) presented the data, derived from the Childhood Determinants of Adult Health Study 34-year follow-up (2014–2019). From a validated questionnaire, results of 3 measures of passive smoke exposure were analysed: the severity of exposure index, the cumulative years of exposure, and the total number of household smokers. Linear regression analysis was adjusted for confounding factors (i.e. age, gender, childhood socioeconomic position, childhood smoking, adult smoking status, and parental education level). The mean age of participants was 45.2 years, and 55.4% were female. Of 781 participants, 54.2% had been exposed to passive smoking.

Per standard deviation (SD) of severity of exposure index, the GLS decreased (range 0–318; mean 24.2 ±35.8; β-adjusted -0.17%; 95% CI -0.32 to -0.02). Likewise, the cumulative years of exposure (range 0–106, mean 10.4 ±13.9) was associated with a decrease in GLS (β-adjusted -0.18%; -0.33 to -0.05) per SD of exposure. For each household smoker (range 0-5; mean 0.9 ±1.0), the GLS decreased as well (β-adjusted -0.20%; -0.36 to -0.05). Each 1% decrease in GLS was associated with a 12% higher risk of CV morbidity and mortality in a low-risk general population. Every effort should be made to prevent exposure of children to passive smoking during childhood due to potential long-term consequences to cardiac function.

    1. Ezegbe C, et al. Childhood Passive Smoke Exposure is Associated With Subclinical Left Ventricular Dysfunction in Adulthood – Childhood Determinants of Adult Health Study. P1917, AHA Scientific Sessions 2020, 13-17 Nov.


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