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IJCRR - 4(22), November, 2012

Pages: 59-62

Date of Publication: 24-Nov-2012

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A COMPARATIVE STUDY OF RESTING HEART RATE IN SMOKERS AND NONSMOKERS

Author: Motilal C. Tayade, Nandkumar .B.Kulkarni

Category: Healthcare

Abstract:Introduction: Smoking affects cardiovascularsystem by several mechanisms.Nicotine increases cardiac output byincreasing both heart rate and myocardialcontractility.The present study was planned to compare and assess resting heart rate in smokers as compared to non smokers. Aim and objectives: Our aim was to assess and compare resting heart rate in smokers and nonsmokers. Our objectives were to study the effects of smoking on resting heart rate. Material and methods:200 male subjects in the age group 25 to 40 years comprising of 100 smokers and 100 nonsmokers as control group were considered for present study .Participant subjects were from staff members, residents and patients from routine OPD. Immediately after waking up and before subject get out of bed asked him to count his own Pulse rate by palpating radial artey for full one minute.( As per ACSM ) Observation and Result: Data was tabulated and analyzed. Standard error of difference between two means was taken. Z test was appliedand by using the test P Value was found < 0.05 (significant) Conclusion: Resting heart rate is a simple measurement with prognostic implications. High resting heart rate was noted in smokers as compared to nonsmokers.

Keywords: Resting heart rate , Smoking , ACSM criteria , Radial pulse.

Full Text:

INTRODUCTION
Cigarette smoking is a major single cause of preventable cancer deaths in the world today.1 Smoking related diseases are some of the biggest killers in the world today and are cited as one of the biggest causes of premature death in industrialized countries. The World Health Organization (WHO) estimates that tobacco caused 100 million deaths over the course of the 20th century .2 Smoking affects cardiovascular system by several mechanisms. Nicotine increases cardiac output byincreasing both heart rate and myocardialcontractility.3 Autonomic alterations may contribute to the increased cardiovascular risk present in smokers.4 The pressor and tachycardial effects ofCigarette smoking are associated with increase in plasma catecholamines.4 Resting heart rate is considered as one of ideal parameter for assessment of cardiovascular functions. The present study was planned to compare and assess resting heart rate in smokers as compared to non smokers.

Aim and Objectives
Our aim was to assess and compare resting heart rate in Smokers and Nonsmokers. Our objectives were to study the effects of smoking on resting heart rate.

RESEARCH METHODOLOGY
200 male subjects in the age group 25 to 40 Years comprising of 100 smokers and 100 nonsmokers as control group were considered for present study .Participant subjects were from staff members, residents and patients from routine OPD. The informed written consent was obtained Case Group was selected the Smokers with history of smoking for more than 5 years with no history of major illness like Hypertension, Diabetes Mellitus, Peripheral Neuropathy in past or present. While Control Group was selected subjects who have never smoked in life and not having any other addiction related to tobacco and with no history of major illness like Hypertension, Diabetes Mellitus, Peripheral Neuropathy in past and present.The both groups were selected after proper counseling and written consent. The study was approved by Institutional Ethical Committee, Pravra Institute of Medical Sciences, Loni from our university. Immediately after waking up and before subject get out of bed asked him to count his own Pulse rate by palpating radial artery for full one minute. The necessary training was provided to them as per ACSM guidelines.5 Asked him to take readings only on those days when he wake up after good sound sleep with he do not have any form of stressand his bladder was not excessively distended during reading.Asked him to take such 5 readings and fill in the chart. This method of counting resting heart rate was as per ACSM guidelines.

Smoking Index:
6 It is criteria considered for present study to classify the smokers according to their severity. Here smoking index is calculated by multiplying numbers of cigarette smoked per day and duration of smoking in years. According to this index smokers were classified in three groups. (Table no.2)

RESULTS
In this present study we noted higher resting heart rate in smokers as compare to nonsmokers. (Table no.1) High resting heart rate was noted in subjects with higher smoking index. This clears there is direct relationship with resting heart rate and smoking severity. (Table no. 2) Data was analyzed. Standard error of difference between two means was taken. Z test was applied and by using test P Value was found < 0.05 (significant)

DISCUSSION
There are different forms of smoking in India like Biddis, Cigarrete, Hukkas, Cigar, Chilim etc. However in urban area filtered cigattre smoking is the major form of smoking while in rural India Biddis are the major form .Tobacco smoking in India kills 9,00,000 people a year, a figure that is expected to rise to one million by 2010.7 In present study we selected the subjects who smoke filtered cigarettes only. Smoke contains several carcinogenic pyrolytic products that bind to DNA and cause many genetic mutations. There are over 19 known chemical carcinogensin cigarette smoke. Polynuclear aromatic hydrocarbonsare tarcomponents produced by pyrolysisin smoking.

Many of them are highly carcinogenic and mutagenic. 8 Acrolein is a pyrolysis product that is abundant in cigarette smoke. It gives smoke an acrid smell and an irritating, lachromatory effect and is a major contributor to its carcinogenity.Nicotineis a highly addictive psychoactive chemical.9 Resting heart rate is an easy counting measurable parameter with high prognostic implications. Heart rate is measured by finding the pulse of body. Jean-Claude Tardif noted Resting heart rate is indeed a strong predictor of mortality in patients with coronary artery disease. 10 Experimental data have demonstrated that a reduction in heart rate can delay the progression of atherosclerosis in animal models.11 A study done by KA Perkins et.al.regarding the acute effects of nicotine on resting metabolic rate (RMR), these results confirm that intake of nicotine, isolated from tobacco smoke, significantly increases RMR in humans.12

CONCLUSION
Smoking is by far the hardest on the heart, increasing persons resting heart rate. Resting heart rate is easy measurable parameter with prognostic implications.

ACKNOWLEDGEMENT
Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

RECOMMENDATIONS
The government should make strict laws related to smoking and cigarette industries. Make awareness among society about hazards of smoking.

ACKNOWLEDGEMENTS
We are very thankful to the participants including staff members, nonteaching staff from our college as well patients visiting to routine OPD, who voluntarily participated in present study.

References:

1. Satyavan Sharma. New approaches in smoking Cessation. Indian Heart Journal , March- April 2008, Volume- 60, No.2, B34-372.

2. Rajeev Gupta, Anoop Misra, Prem Pais, Priyanka Rastogi, V.P. Gupta. Correlation of regional cardiovascular disease mortality in India with lifestyle and nutritional factors. International Journal of Cardiology Volume 108, Issue 3, Pages 291-300, 14 April 2006.

3. Vendhan Gajalakshmi, Richard Peto, Thanjavur Santhanakrishna Kanaka, Prabhat Jha. Smoking and mortality from tuberculosis and other diseases in India: retrospective study of 43 000 adult male deaths and 35000 controls. THE LANCET Vol 362 August 16, 2003.(507-515)

4. G. Grassi, G Seravalle,DA Calhoun,G Mancia.Mechanisms responsible for sympathetic activation by cigarette smoking in humans. Cattedra Medicina Interna: 1999, vol. 2, 32-37.

5. Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: an update. Journal of American college of cardiology, 2003. PIMD:15145091.

6. ACSM guidelines references .cardioguidelines. http://www.straightforwardfitness.com/acsmcardio-guidelines.html

7. S.K.Gupta. Respiratory disorders among workers in a railway workshop. Ind.Journal of Tuberculosis.1995,42,161.

8. India smoking: BBC Report. http://news.bbc.co.uk/2/hi/3758707.stm

9. Dr. C. Everett Koop. "Smoking and smokeless tobacco". http://www.drkoop.com/ency/93/002032.htm l. Retrieved July 15, 2006.

10. Philip J. Hilts. Relative addictiveness of drugs. New York Times.Aug.2, 1994.

11. Health effects of Tobacco. www.wikipedia.org/wiki/effects of tobacco.

12. Ariel Diaz, Martial G. Bourassa1, MarieClaude Guertin andJean-Claude Tardif1 Long-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease. European heart journal: Volume -26, Issue -10,967-974. (2005)

13. Jian-Feng Huang, Xiangfeng Lu, Xigui Wu, Jichun Chen, Jie Cao,Jianxin Li and Dongfeng Gu. Heart rate influence on incidence of cardiovascular disease among adults in China. International journal of Epidemiology:Volume -39,Issue-6,1638- 1646(2010 )

14. Jean-claudeTardif. The pivotal role of heart rate in clinical practice. European heart journal.(2008) Volume-10,issue –F,Page -11- 16.

15. Philip Greenland ,Martha L.D. ,Cheng, Jeffrey,Jeremian stamler.Cardiovascular and noncardiovascular mortality.American journal of epidemiology.Issue-9, Vol.149: 853-862(1999)

16. S.G. Sarvotham, J.N.Berry, Prevalence of coronary heart disease in an urban population in northern india.circulation.1968;37;939.

17. Fox K., Ford I., Steg PG et. al. Heart rate as a prognostic risk factor in patients with coronary artery disease and left ventricular systolic dysfunction : An analysis of RCT. The Lancet.Volume -372, Number-9641,779- 780 (1. Sep. 2008).

Abbreviations:
WHO : World health organization
ACSM : American college of sports medicine
CAD : coronary artery disease
RHR : Resting heart rate

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