Document Detail


Long-term effects of smoking and smoking cessation on exercise stress testing: three-year outcomes from a randomized clinical trial.
MedLine Citation:
PMID:  22172440     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The long-term effects of smoking and smoking cessation on markers of cardiovascular disease (CVD) prognosis obtained during treadmill stress testing (TST) are unknown. The purpose of this study was to evaluate the long-term effects of smoking cessation and continued smoking on TST parameters that predict CVD risk.
METHODS: In a prospective, double-blind, randomized, placebo-controlled trial of 5 smoking cessation pharmacotherapies, symptom-limited TST was performed to determine peak METs, rate-pressure product (RPP), heart rate (HR) increase, HR reserve, and 60-second HR recovery, before and 3 years after the target smoking cessation date. Relationships between TST parameters and treatments among successful abstainers and continuing smokers were evaluated using multivariable analyses.
RESULTS: At baseline, the 600 current smokers (61% women) had a mean age of 43.4 (SD 11.5) years and smoked 20.7 (8.4) cigarettes per day. Their exercise capacity was 8.7 (2.3) METs, HR reserve was 86.6 (9.6)%, HR increase was 81.1 (20.9) beats/min, and HR recovery was 22.3 (11.3) beats. Cigarettes per day and pack-years were independently and inversely associated with baseline peak METs (P < .001), RPP (P < .01, pack-years only), HR increase (P < .05), and HR reserve (P < .01). After 3 years, 168 (28%) had quit smoking. Abstainers had greater improvements than continuing smokers (all P < .001) in RPP (2,055 mm Hg beats/min), HR increase (5.9 beats/min), and HR reserve (3.7%), even after statistical adjustment (all P < .001).
CONCLUSIONS: Smokers with a higher smoking burden have lower exercise capacity, lower HR reserve, and a blunted exercise HR response. After 3 years, TST improvements suggestive of improved CVD prognosis were observed among successful abstainers.
Authors:
Asha Asthana; Megan E Piper; Patrick E McBride; Ann Ward; Michael C Fiore; Timothy B Baker; James H Stein
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2011-11-14
Journal Detail:
Title:  American heart journal     Volume:  163     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-16     Completed Date:  2012-02-10     Revised Date:  2014-09-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-87.e1     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00332644
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiovascular Diseases / etiology,  physiopathology*
Double-Blind Method
Exercise Test
Female
Humans
Male
Middle Aged
Prospective Studies
Smoking / adverse effects*
Smoking Cessation*
Time
Grant Support
ID/Acronym/Agency:
P50 DA019706/DA/NIDA NIH HHS; P50 DA019706-06/DA/NIDA NIH HHS; UL1 RR025011/RR/NCRR NIH HHS; UL1 RR025011-05/RR/NCRR NIH HHS
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