The Effect of Smoking on Heart Rate and Breath Rate - Research Paper Example

Smokers versus Nonsmokers Introduction Tobacco use is one of the major preventable causes of premature death and disease in the world A disproportionate share of the global tobacco burden falls on developing countries, where 84% of 1.3 billion current smokers reside (1). The World Health Organization (WHO) attributes approximately 5 million deaths a year to tobacco. The number is expected to exceed 10 million deaths by 2020, with approximately 70% of these deaths occurring in developing countries (CDC, 2007). Dietrich et al (2007) performed a cross-sectional study-SAPALDIA (Swiss Cohort Study on Air Pollution and Lung Diseases in Adults) between 2001-2003. They observed ETS-associated increases in heart rate and, more weakly, in DBP, consistent with increases in sympathetic stimulation. Ultrafine particles are associated with oxidative stress, as well as with reduced HRV. In conclusion, the study contributed to the evidence that exposure to second-hand smoke increases cardiac risk through cardiac autonomic dysfunction. Protection from passive smoking can benefit health. Pope et al., (2001) evaluated the potential effects of short-term ETS exposure on changes in cardiac autonomic function, specifically, in a commercial airport as measured by HR and HRV in a panel of adult nonsmokers. The authors suggested that altered cardiac autonomic function, as reflected by decrements in HRV, may be part of the pathophysiologic mechanisms by which exposure to ETS leads to increased risk of cardiovascular mortality. Maziak et al (2005) mentioned that the exposure to ETS causes deleterious effects in the respiratory system of adults and children in Syria. Exposure to ETS was assessed from multiple self-reported indices combined into a composite score (maximum 22), while outcomes included both self-report (symptoms/ diagnosis of asthma, bronchitis, and hay fever), and objective indices (spirometric assessment of FEV1 and FVC). They evaluated the relation between ETS score and studied outcomes as well as the association between ETS exposure and respiratory health. The results indicated that there was a significant dose-response pattern in the relationship of ETS score with symptoms of asthma, hay fever, and bronchitis, but not with diagnoses of these outcomes. This study provided an evidence for the extensive exposure to ETS among adult nonsmokers in Syria, and its dose-response relationship with respiratory symptoms of infectious and noninfectious nature. It also called for an elaborate effort to increase awareness of this public health problem and to enforce regulations aimed at protecting non-smokers. Oncken et al (2002) evaluated the effect of repeated cigarette smoking on fetal heart rate (FHR) characteristics. Their observation in this study indicated that cigarette smoking has a significant impact on FHR characteristics. Isabel et al (2005) assessed the independent association of smoking with respiratory symptoms and lung function in young adults who took part in the European Community Respiratory Health Survey (ECRHS–I). Their results showed that the prevalence of respiratory symptoms was higher among smokers and smoking conferred a high risk of developing a number of respiratory symptoms and the deterioration of the ventilatory function among young adults. Ali-Safi (2005) explored the correlation of smoking habit with blood pressure and heart rate values through a randomized cross-sectional epidemiological study in Jordan. Smoker males and females were found to have significantly higher SBP, DBP, ABP values than non-smokers. Smoking had statistically non-significant effects on heart rate in females while heart rate values were significantly higher in male smokers than in non-smokers. Smoker or non-smoker adults with a positive family history of hypertension had significantly higher blood pressure and heart rate values than those with a negative family history of hypertension. The authors concluded that smokers have higher blood pressure than non-smokers. Since there is only limited research on effect of smoking on heart rate and breath rate, this particular study was undertaken. It was hypothesized that there would be significant difference between smokers and non-smokers in the heart rate as well as respiration rate after a run time of 20 minutes. Objectives The study was conducted to find out the difference in the breath rate and respiration rate in smokers and non-smokers after running for 20 minutes and thereby to explore the effect of smoking on heart rate and breath rate. Method A prospective parallel group repeated measures study was conducted in 20 patients. Two methods were used to identify potentially eligible patients. First, the study co-ordinator discussed with the young adult subjects about the study. Some of the subjects were also contacted through telephone by the study-coordinating center initially. Fifty patients were interviewed initially of which, 39 participants met with the inclusion criteria. From these, twenty patients were selected and were enrolled in the study. Subjects who smoked for more than 6 months and who gave informed consent were enrolled into the smoker group. Subjects were excluded if they were unwilling to give informed consent or had a concurrent disease. Initial meeting with the patient ran 20-25 minutes in length. The patients were enrolled into the study after obtaining their written informed consent. Ten study participants were smokers and 10 were non-smokers. Smokers were asked to report the number of cigarettes they smoked per day. Their demographic details were collected in customized data entry formats. All the participants were asked to run for 20 minutes. In the beginning of the experiment as well as at the end of 20 minutes, their heart rate and respiration rate were measured. The respiration rate was measured when the subject was at rest and involved counting the number of breaths for one minute by counting how many times the chest rises. The data obtained from the two groups were then compared. Statistical Analysis Paired t-test was performed in order to find out the statistical difference between the two groups. A p value less than 0.05 indicated a statistically significant difference. Results The study participants were divided into a smoker and non-smoker group, of which the smoker group consisted of ten males and ten females while the non-smoker group consisted of eight males and eleven females. The age range of patients in the smoker and non-smoker groups were 18 to 35 years and 17 to 36 years respectively. The smoker group had mean age of 34.05  12.06 years and the non-smoker group 32.47  9.99 years. The average blood pressure for the smoker group was group 126/82 and for the nonsmoker group was 130/80 mmHg. Their average body mass index was 25.81 and 25.09 kg/m2 respectively. The average number of cigarettes smoked per day by the smoker group patients was 13. The duration of smoking in the smoker group ranged between 1 to 14 years. The demographic details of the patients in the two groups are shown in Table 1. All the patients completed 20 minutes run. The heart rate and breathe rate of the two groups before and after the run is given in Table 2. The initial mean heart rate value in smoker group was 74.3 bpm and non-smoker group was 72 bpm. At the end of 20 minutes, the values changed to 181.7 and 159.10 bpm respectively. The breathe rate in the beginning of the experiment was 15 and 14 in the smoker and non-smoker group respectively. After 20 minutes run, the mean values changed to 44 and 52 in these two groups. Table 1:Demographic details of smoker group (n=20) and non-smoker group patients (n=20) S.No Characteristic Smoker group (n=20) Non-smoker group (n=20) P* Mean SD Mean SD 1. 2. 3. 4. Age (years) Duration of smoking (years) Body mass index (kg/m2) Blood Pressure (mm Hg) 34.05 5.80 25.81 126/82 ± 12.05 ± 5.34 ± 5.83 ± 40.82 32.47 - 25.09 130/80 ± 9.99 - ± 2.49 ± 27.55 0.073 - 0.100 0.102 P* Paired t test Table 2 Outcome measures before and after 20 min run for the smoker group (n=20) and non-smoker group (n=20) S. No. Parameter Before run After run P* 1. Heart rate: a. Smoker group b. Non-smoker group 74.3±40.82 72±27.55 181.7±42.16 159.10±12.53 0.0001 2. Breathe rate: a.Smoker group b.Non-smoker group 15±0.68 14±0.99 44±0.60 52±0.45 0.058 * Paired t – test Discussion The study demonstrated the effect of smoking on heart rate and breathe rate. The study included healthy adult males and females. Patients with hypertension or cardiovascular disorders or any other illness were excluded from the study. Initially, they were asked if they had hypertension or other cardiovascular disorders or any other illness, and if the answer was negative, they were explained about the study. The study revealed that smoking had a significant effect on both heart rate (p Read More