Tobacco and heart disease

Dr Ksh. Kala Singh *

"Tobacco In Any Form” “other Than Advanced Age, Smoking Remains The Single Most Important Risk Factor For Coronary Artery Disease

Smoking is a major cause of cardiovascular Disease and causes one of every three deaths from cardiovascular Disease. Every 8 seconds an Indian dies due to tobacco related diseases. India is the second largest consumer of tobacco products in the world. Types of Tobacco products use in India are:

(A)Smokeless forms: Khaini, Gutkhas, Betel quid with tobacco (paan), Zarda, Paan masala with tobacco, Mawa, Mishri, Gul, Bajjar, Snus, Snuff. Toothpowder with tobacco, Tuibur (tobacco water in use in Mizoram and Manipur).

Smoking forms: Bidis, Cigarettes, Hukka, Cigars, Cheroot, Chutta, Hukli Dhumti& Pipes. Tobacco is derived from the plant NICOTINA TOBACCUM. The leaves of this plant are use to make smoking and smokeless tobacco products. Processed tobacco contains atleast 2550 chemicals. There are more than 7000 chemicals in tobacco smokes. At least 69 of these chemicals are known carcinogens or chemicals that cause Cancer.


Some of the important harmfull contains of tobacco are
Nicotine, Tar, Benzopyrene, Carbone Monoxide, Arsenic, Cadmium, Ammonia, Turpentine, Methoprene Acetone, Lead, Propylene Glycol etc.

NICOTINE: The most important is that Nicotine which is highly toxic, addictive and lethal substance. Also Nicotine is a drug more addictive than marijuana, cocaine, heroin, morphine and bhang. Within seconds of inhalling smoke from a cigarette, the nicotine reaches to the brain, stimulating the nervous system, thereby increasing heart rate, raising blood pressure and constricting small blood vessels under the skin.

CARBON MONOXIDE: Carbon monoxide is a chemical contained in tobacco smoke which is produced as a result of the burning of tobacco. It reduces the ability of red blood cells to deliver oxygen to tissues causing the greatest potential damage to the heart, brain and skeletal muscles (tissues that have the highest demand for oxygen). There are many harmful effects of chronic tobacco use on the cardiovascular system.

(A) Harmful effects of tobacco use on the newborn babiesheart are:
Congenital Defects of the Heart. Pregnant women with smokers will cause defect in developing heart of the Foetus, particularly in the formation of the septum of the heart thereby causing holes of the Septum (Atrial Septum Defect, Venticular Septum defect (Tetralogy of Fallot) & PDA (Patent DuctusArteriosus) are found in those pregnant women of chronic smokers.

(ii) Dead foetus: It may be due to the side effect of the carbon monoxide & Nicotine to the cardiovascular system of the foetus through the placental circulation.

(iii) Pre-term baby: Delivery before the full term may occur in those mothers who are chronic smokers and tobacco users due to delayed development in different organs of the foetus.

(iv) Low birth weight baby: Due to improper Development of Lung & Cardiovascular system.


Chronic use of Tobacco Causes:
Raise triglycerides (a type of fat in blood) & decreases high density lipoprotein cholesterol (HDLC-C) levels.
(ii) Make blood sticky and more likely to clot, which can block blood blow to the heart and brain.
(iii) Damage cells that line the blood Vessels and initiated endothelial dysfunction.
(iv) Increased the buildup of plaque (fat,cholesterol, Calcium and other substances) in blood vessels& increased thrombgenesis.
(v) Cause thickening and narrowing of blood Vessels.

As aresult of these effects Atheroscclerosis (Thickening & Stiffness of Vessels), Hypertension (High Blood pressure), Heart attack (coronary artery disease), Stroke (bleeding in the brain), Aneurysm (weakening, dilatation & enlargement of blood-vessels), Peripheral Vascular disease (Buerger’s disease), Heart failure (when the Heart cannot pump enough blood & oxygen to support other organs), Arrhythmia (when the heart beats too fast,too slow or irregular) and other disorders of the cardiovascular systemetc. will occur to the chronic tobacco users causing heart disease actually result in more death per year than smoking caused lung cancer.

Thirty percent of heart disease deaths are caused by cigarette smoking. Also smoking is the single largest preventable cause of heart disease in the United States.


Usually occurs in large vessels but it may occur in the Blood Vessels of the Heart, and other parts of the body. The plaque formed by fat, cholesterol, calcium and other Substances in the blood vessel will decrease or block the blood flow to the organs and extremities of the body. Smoking also causes damaging blood vessels, so Atherosclerosis is accelerated and threatens life.


It is also known as silent killer because without any symptom patient may die. Average blood pressure is 120/ 80 mmHg. When our age is above 40yrs, better to keep below140/90mmHg. Uncontrolled Hypertension may cause stroke (Cerebral Haemorrhage), Retinal Haemorrhage, Heart attack, Kidney failure etc. It is difficult to control Blood Pressure in chronic smokers.


Decreased blood flow in the coronary arteries due to the above reasons will cause Heart attack causing severe chest pain, low blood pressure, shock & death. Usually occurs after early morning activity

STROKE : cked or when a blood vessel in the brain bursts, causing brain tissue to die. Cigarette smoking is a major cause of stroke by increasing clotting factors in the blood, decreasing HDL cholesterol levels, increasing triglyceride levels and damaging the lining of blood vessels. The risk for stroke increases as the number of cigarettes smoked increases. Stroke can cause disability (Such as paralysis, muscle weakness, trouble speaking, memory loss) or death.


Usually occurs particularly in the Abdominal Vessels, Cerebral Vessels & Renal Vessels. These vesselsare dilated with thinning of the walls, may cause tear and rupture of the vessels at my time. Blood vessels of the Heart may have the same problem in chronic smokers.


Particularly of the lower limbs, upper limbs etc. Due to chronic decrease of blood flow to the distal parts will develop gangre and amputation of the limb to be done to save life. Buerger’sdisease of the lower limb are very common in male chronic smokers. Doctors ask the patient during the treatment, select any one either the cigarette or the limb not the both.


Smokers often have irregularity of heart rate, it may be too fast with palpitation, vertigo and chest pain or too slow causing difficulty in respiration and syncope. It may be associated with coronary artery disease. Women incur similar increases in the relative risk for coronary heart disease. Smoking acts synergistically with oral contraceptive agents, placing younger women taking these agents at even higher relative risk.

Because of adverse synergy with oral contraceptives, young female smokers who take oral contraceptives have particularly elevated risks for premature coronary artery disease and stroke. Smoking is especially hazardous for women with diabetes.

Secondhand smoke: It is a much greater problem than many people realize. Secondhand smoke is a combination of the smoke given off by the burning end of a cigarette, Pipe, or Cigar and the smoke exhaled from the lungs of smokers. It is estimated that 37,000 Coronary heart disease deaths per year are cause by exposure to secondhand smoke in the United States. Nonsmokers who breath secondhand smoke at home or at work increase their risk of developing heart disease by 25-30%.

Secondhand smoke increase the risk for stroke by 20-30%. Quit smoking Today people who quit smoking dramatically reduce their risk of dying from heart disease. The body begins to repair itself almost immediately. Quitting can help people who already have heart disease. People who quit smoking can cut their risk of having another hearth attack or dying of heart disease in half.

When a smoker quits the risk of heart disease death begins to fall almost immediately, but it takes ten years for the risk to approach that of a nonsmoker.


* Dr Ksh. Kala Singh, M Ch , wrote this article for The Sangai Express
The writer is president of Manipur Heart Care Society
This article was posted on June 07, 2018.

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