World No Tobacco Day 2015Tobacco And Cardiovascular Disease

Dr Rishi Sethi
DM FACC FESC FSACI FAPSIC MAMS

Professor
Department of Cardiology
King Georges Medical University
Lucknow.India

TOBACCO USE IN INDIA

PRACTICES, PATTERNS AND PREVALENCE

HEALTH CONSEQUENCES
OF
TOBACCO USE

Tobacco and Cardiovascular diseases

Prominent Risk Factors for CV Diseases

Smoking
Hypertension
Dyslipidemia
Metabolic Syndrome
Mental Stress

HOW SMOKING HARMS THE

CARDIOVASCULAR SYSTEM
Chemicals in cigarette smoke cause the cells that line
blood vessels to become swollen and inflamed.
This can narrow the blood vessels and can lead to
many cardiovascular conditions
Atherosclerosis
Coronary Heart Disease
Stroke
Peripheral Arterial Disease (PAD)
Abdominal Aortic Aneurysm

"Poor man's risk factor": correlation between high sensitivity C-reactive

protein and socio-economic class in patients of acute coronary syndrome.
Sethi R1, Puri A, Makhija A, Singhal A, Ahuja A, Mukerjee S, Dwivedi SK, Narain
VS, Saran RK, Puri VK.
Indian heart Journal 01/2008;60(3):205-9

Abstract
OBJECTIVE:
Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high
sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation. We did a study to assess the correlation of hsCRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS).
METHODS:
Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay. Patients were stratified by levels of hs-CRP into
low (<1 mg/L); intermediate (1-3 mg/L) or high (>3 mg/L) groups and in tertiles of 0-0.39 mg/L, 0.4-1.1 mg/L and >1.1 mg/L,
respectively. Classification of patient into upper (21.4%), middle (45.37 percent) and lower (33.3%) SES was based on Kuppuswami
Index which includes education, income and profession. Presence or absence of traditional risk factors for CAD diabetes, hypertension,
dyslipidemia and smoking was recorded in each patient.
RESULTS:
Mean levels of hs-CRP in lower, middle and upper SES were 2.3 +/- 2.1 mg/L, 0.8 +/- 1.7 mg/L and 1.2 +/- 1.5 mg/L, respectively. hs-CRP
levels were significantly higher in low SES compared with both upper SES (p = 0.033) and middle SES (p = 0.001). Prevalence of more
than one traditional CAD risk factors was seen in 13.5%, 37.5% and 67.67 percent; in patient of lower, middle and upper SES. It was
observed that multiple risk factors had a linear correlation with increasing SES. Of the four traditional risk factors of CAD, smoking was
the only factor which was significantly higher in lower SES (73%) as compared to middle (51.67 percent;) and upper (39.4%) SES. We
found that 62.3%, 20.8% and 26.5% patients of low, middle and upper SES had hs-CRP values in the highest tertile. Median value of the
Framingham risk score in low, middle and upper SES as 11, 14 and 18, respectively. We observed that at each category of Framingham
risk, low SES had higher hs-CRP.
CONCLUSION:
We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser
traditional risk factors and lower Framingham risk. These findings add credit to our belief that inflammation may be an important link in
the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors.

QUITTING SMOKING CUTS CVD RISKS

Even though we dont know exactly which smokers will
develop CVD from smoking, the best thing all smokers can
do for their hearts is to quit.
Smokers who quit start to improve their heart health and
reduce their risk for CVD immediately.
Within a year, the risk of heart attack drops dramatically,
and even people who have already had a heart attack can
cut their risk of having another if they quit smoking.
Within five years of quitting, smokers lower their risk of
stroke to about that of a person who has never smoked.

THANK YOU