Association between cigarette smoking and heart failure in older adults

By Samar Mahmoud, MS
Published January 27, 2022


Key Takeaways

  • This community-based study found that cigarette smoking is correlated with blood and imaging biomarkers linked to incident heart failure (HF) in older adults.    

  • As smoking is a leading cause of preventable morbidity,  this work highlights the need for strategies to reduce smoking at the individual as well as population levels.

Previous studies have shown that cigarette smoking is associated with adverse cardiovascular outcomes, including incidence of HF.

Why This Study Matters

The underlying mechanisms that link smoking to HF have not been elucidated in older adults. To shed light on the potential pathways modified by smoking, this study examined cross-sectional associations of smoking with blood and imaging biomarkers previously linked to incident HF.

Study Design

Investigators assessed levels of inflammation (C-reactive protein and interleukin-6), markers of cardiomyocyte injury (cardiac troponin T), and markers of myocardial fibrosis (soluble suppression of tumorigenicity 2 and galectin 3). 

In terms of functional phenotypes, researchers evaluated left ventricle systolic and diastolic function.  A serial nested, multivariable Cox model was utilized to determine correlations between smoking and HF. 

Results and Conclusions

Compared to non-smokers, cigarette smokers had higher levels of inflammation, cardiomyocyte injury, and myocardial fibrosis. 

Smokers had worse left ventricle systolic and diastolic function when compared to non-smokers. 

In models adjusting for age, gender, and race, current and former smoking were associated with HF, with a hazard ratio of 1.41 and 1.14, respectively.  Smoking was also linked to HF with preserved and decreased ejection fraction. 

Related Research

Consider these findings from similar research studies:

  • Smoking cessation is associated with reduced risk of cardiovascular disease within 5 years in comparison to current smokers (Source)

  • A fatal event is often the first manifestation of clinical cardiovascular disease in current smokers (Source). 

Original Source 

Gottdiener JS, Buzkova P, Kahn PA, et al. Relation of cigarette smoking and heart failure in adults ≥ 65 years of age(From the cardiovascular health study). The American Journal of Cardiology. Published online January 2022:S0002914921012431.


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