Smokers who quit remain at risk of heart failure for decades

Cigarette smokers have an excess risk of heart failure (HF) with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), confirms a recent study. Additionally, those who quit smoking show a reduction in HF risk, but the risk persists for a few decades.

A team of investigators conducted this study to assess the association of cigarette smoking and smoking cessation with the incidence of HFpEF and HFrEF in 9,345 Atherosclerosis Risk In Communities (ARIC) study participants (age range 61‒81 years) with no HF history at baseline in 2005.

The investigators analysed the relations of several cigarette smoking parameters (ie, smoking status, pack-years, intensity, duration, and years since cessation) with physician-adjudicated incident acute decompensated HF using multivariable Cox models.

Incident HF cases totaled 1,215 over a median follow-up of 13.0 years. Current cigarette smoking correlated with both HFpEF and HFrEF compared with never smoking, with adjusted hazard ratios of ∼2. A dose-response association was observed for pack-years of smoking and HF.

On the other hand, a more extended duration of smoking cessation resulted in a reduced HF risk, but a significantly elevated risk continued up to a few decades for HFpEF and HFrEF.

“Our results strengthened the evidence that smoking is an important modifiable risk factor for HF and highlighted the importance of smoking prevention and cessation for the prevention of HF, including HFpEF,” the investigators said.