Smoking ‘important’ modifiable risk factor for HF
Current smoking was associated with elevated risk for HF in a dose-response manner, according to a new analysis of the ARIC cohort.

Researchers analyzed 9,345 participants from the ARIC cohort (mean age, 70 years; age range, 61 to 81 years; 57% women; 21% Black) who were free from HF at baseline in 2005 to quantify the association between cigarette smoking and smoking cessation and development of HFpEF or HF with reduced ejection fraction.

In a median follow-up of 13 years, 1,215 patients developed HF. Compared with never smokers, current smokers were more likely to have a HF event (adjusted HR = 2.36; 95% CI, 1.92-2.9), a HFpEF event (aHR = 2.28; 95% CI, 1.67-3.1) or a HFrEF event (aHR = 2.16; 95% CI, 1.55-3), according to the researchers.Former smokers were also more likely than never smokers to develop HF, but not to the same extent as current smokers (aHR for HF = 1.36; 95% CI, 1.19-1.55; aHR for HFpEF = 1.31; 95% CI, 1.08-1.59; aHR for HFrEF = 1.36; 95% CI, 1.1-1.68).

The 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 HF [with preserved ejection fraction].