Smoking as a Heart Disease Factor - Essay Example

Introduction The heart is the central organ of the cardiovascular system which is an elaborate network that performs two major tasks. The heart delivers oxygen and nutrients to body organs and removes waste products of metabolism from tissue cells (Cabin 1992). The heart itself is a muscular organ with elastic vessels to transport blood around the body. There are a variety of factors that can affect the heart and how it works. One of these factors is smoking. Smoking involves inhaling the fumes from burning tobacco, usually in the form of cigarettes. This is dangerous as the smoker is putting themselves at risk of inhaling other poisonous substances such as carbon monoxide, which is a by-product of the smoking process. A direct link has been identified between lung cancer and tobacco smoking, as well as other links to respiratory conditions such as bronchitis and emphysema, and to coronary heart diseases (Pocket Dictionary of Biology 1999.) Several clinical trials support these findings as well (Kunz1, Pechlaner, Ho, & Pfister 2005). Smoking increases the risk of developing heart disease and is the leading cause of premature and preventable deaths in the United States alone (Cohen 1999). Smoking is a major risk factor for developing heart disease as it indirectly affects how the heart works and creates an imbalance in the cardiovascular system. For example, smoking causes emphysema, where the lungs lose their elasticity and the individual is often left short of breath. One of the heart's functions is to deliver oxygen, so the reduced surface area in the lungs results in an increased demand for oxygen by the lungs and other muscular organs and tissue. As a result of this increased demand, the heart has to work harder to compensate for this imbalance. If this happens over a long period of time, the heart muscles will weaken and/or change (e.g. heart enlargement, hardening of arteries, fatty deposits) and combined with other risk factors, will lead to heart disease. The following points summarise the ways in which smoking affects the cardiovascular system. Smoking increases the levels of carbon monoxide which is a poisonous gas. In the long term this gas contributes to the damaged lining of blood vessels and artery hardening (Black 1992). Smoking raises blood levels of fibrinogen which is a clotting agent that causes blood platelets to stick together, increasing the risk of blood clots and blockages in the vascular system (Black 1992). Nicotine raises blood pressure and the heart rate which results in the heart working harder. It also constricts the coronary arteries which results in less supply of blood and oxygen to the heart (Black 1992). However, it is important to be aware of the nature of the various forms of heart disease, as this will increase our understanding of how smoking directly affects the working of the heart and the cardiovascular system. Heart Disease Heart disease consists of a variety of diseases that directly affect the workings of the heart. Arteriosclerotic disease is a result of the occurrence of fatty deposits inside the coronary arteries and blood vessels that supply blood to the heart muscle. When the blood supply from these vessels is slowed down or ceases, the individual will most probably experience angina or a heart attack. High blood pressure occurs when the heart encounters a higher resistance in the blood vessels outside the heart. This results in the enlargement of the heart and thickening of the heart muscle. (Cohen 1992) These factors contribute to reduced efficiency in the cardiovascular system as the heart now requires more oxygen to function and strains its muscle. It also speeds up the process of atherosclerosis by driving blood fat and cholesterol into the blood vessel walls increasing the risk of a heart attack or stroke. Heart failure occurs when the heart becomes excessively stiff or fatigued from working too hard, either because it must pump against too strong a resistance or because there has been a loss of heart muscle strength (Cohen 1992). Valvular heart disease occurs when one or more of the heart's valves malfunction because it has narrowed or fails to close properly. Heart failure is often the end result of valvular disease. Generally, anything that affects the heart muscle and its tone will weaken the heart and result in an individual suffering from heart disease (Cohen 1992). Narrowing in one or more of the coronary arteries decreases the supply of oxygen and smokers find it difficult to exercise for long periods of time, and often run out of breath from standard activities such as walking or going up some stairs. Smoking and the heart, the development of heart disease and the vascular system Smoking is obviously a major risk factor for heart disease, however, the presence of other risk factors such as obesity; in addition to smoking, will greatly magnify the risk and almost guarantee the development of heart disease. Research has shown conclusively that smoking accelerates arteriosclerosis (hardening of the arteries) and atherosclerosis (a type of arteriosclerosis characterized by fatty deposits in the artery walls), increasing the risk of heart disease, stroke, and peripheral vascular disease (Zahler and Piselli 1992). Smoking increases the levels of carbon monoxide which in the long term, contributes to damaging the lining of the blood vessels and accelerates the process of atherosclerosis. Smokers tend to have decreased levels of high-density lipoproteins (HDL-the "good cholesterol) and increased levels of low-density lipoproteins (LDL-the "bad' cholesterol) and triglycerides (a blood fat), thereby raising the risk and severity of atherosclerosis (Zahler and Piselli 1992). Blood levels of fibrinogen, a clotting agent, are also raised by smoking. This may increase the likelihood of blood clots forming and blocking the coronary arteries, leading to a heart attack or stroke. These clots are likely to form in the inner lining of blood vessel walls that are clogged by atherosclerotic plaque and have been roughened by prior damage, rather than on those that remain smooth and intact (Zahler and Piselli 1992). Smoking may also cause blood platelets to clump abnormally, adding to the risk of clotting. Nicotine raises blood pressure and heart rate, requiring the heart to work harder. It also constricts the coronary arteries, lessening the supply of blood and oxygen to the heart muscle. Smoking also has an effect on the vascular system as weakened and blocked blood vessels will not be able to maintain their core functions of transporting blood, oxygen and other metabolic material. Risk Factors A cardiovascular risk factor is a condition that is associated with an increased risk of developing cardiovascular disease (Black 1992). The risk of cardiovascular events increases as we get older. In many epidemiologic surveys, age remains one of the strongest predictors of disease. More than half of those who have heart attacks are 65 or older, and about four out of five who die of such attacks are over age 65 (Black 1992). Nothing can be done to reduce age, however, careful attention to diet and maintaining fitness may delay the degenerative changes associated with aging. Men are more likely than women to develop heart disease and other cardiovascular diseases that are manifestations of atherosclerosis. It is likely that the protective role of estrogens is the predominant factor. This seems to be supported by the fact that heart disease risk for women rises dramatically after menopause, when their bodies stop producing oestrogen (Black 1992). This is a key reason as to why most post-menopausal women are prescribed oestrogen hormone treatment, as their chances of getting heart disease more than triple. This hormone also increases the levels of HDL. Some people have a significantly greater likelihood of having a heart attack or stroke because they have inherited a tendency from their parents. Hypertension is a special problem for African- Americans. Overall, the percentage of blacks in the United States with hypertension is 50 percent greater than that of whites or Asians (Black 1992). Elevated levels of serum lipids (cholesterol and triglycerides) are extremely common and are one of the most important of the heart disease risk factors that can be changed. Obesity can predispose the development of other risk factors, and the greater the degree of overweight, the greater the likelihood of developing other antecedents of atherosclerosis (such as high blood pressure and diabetes) that will increase the probability that heart disease will develop. Individuals with diabetes mellitus, especially those whose diabetes occurs in adult life, have an increased incidence of heart disease and stroke. Elevated levels of insulin can raise blood pressure and assist in the deposition of and reduce the removal of cholesterol from plaques in the arteries (Black 1992). Cocaine constricts the coronary arteries, decreasing blood flow to the arteries of the heart, and reduces the amount of oxygen available to the heart while increasing the heart rate and demand for oxygen. This combination of effects can precipitate a cardiac crisis and sometimes death, even upon the first use of the drug (Black 1992). Remedies Exercise seems to have a positive effect on a number of other risk factors. Whether its benefit lies in the fact that it helps control weight, improves the body's ability to use insulin, conditions the heart muscle, increases levels of protective HDL cholesterol, moderates stress, or lowers blood pressure- or a combination of these effects-is not clear. Whatever the reason, regular exercise can lower cardiovascular risk and it should be encouraged for everyone within the limits of each individual (Wackers 1992). Other remedies include the reduction in the consumption of alcohol, the cessation of smoking and the adoption of a healthy diet that is low in LDL fat. Some of these measures may need to be combined with cholesterol lowering drugs especially for those with risk factors that cannot be changed such as age and genetic inheritance. Conclusion Smoking is more commonly associated with lung cancer, due to clinical trials conducted, public awareness campaigns and the direct association between inhaling smoke and getting lung cancer. However, there is not enough awareness when it comes to the risks of smoking in terms of heart disease. Heart disease is often associated with other risk factors such as diet and obesity. The public are well aware of the effects of including high fat foods in their diets, and the effects excess body fat has on the heart, and therefore heart disease tends to be associated diet. This perception needs to be adjusted, as smoking clearly presents risks to the way the heart works and is a precipitator for heart disease. This change in perception and increased awareness is required as smoking has the potential to cause long-term damage as the smoker is not always aware of the effect smoking has on their heart. Other individuals may also be in the high risk population, in terms of gender and genetics, and failure to recognise the effects of the smoking will be detrimental to their long term health. The time has come for the general public to be educated on the effects smoking has on various organs of the human body, and not just the obvious ones i.e. lungs. Successful risk minimisation and lower incidences of heart disease will rely on a totally holistic approach to the problem and not an isolated approach. Works Cited Black H R. (1992). Yale University School of Medicine Heart Book, Hearst Books, New York, Chapter 1, pp. 23-35 Cabin H S. (1992). Yale University School of Medicine Heart Book, Hearst Books, New York, Chapter 1, pp. 1-7 Cohen L S. (1992). Yale University School of Medicine Heart Book, Hearst Books, New York, Chapter 2, pp.11-20 Kunz1 F, Pechlaner C, Ho H, & Pfister R. (2005). The smoker's paradox and the real risk of smoking, Department of Internal Medicine; Department of Sports and Cardiovascular Medicine, Innsbruck Medical University, Innsbruck, Austria, European Journal of Epidemiology 20: 161-167 The Hutchinson. (1999), Pocket Dictionary of Biology, Helicon, Denmark, p.196 Wackers F J TH. (1992). Yale University School of Medicine Heart Book, Hearst Books, New York, Chapter 1, pp. 85-94 Zahler R and Piselli C. (1992). Yale University School of Medicine Heart Book, Hearst Books, New York, Chapter 1, pp. 71-83 References Anonymous, (Feb 2005), Smoking kills millions each year, Australian Nursing Journal;; 12, 7; ProQuest Nursing Journals, pg. 27 Manley A F, (Aug 1997), Cardiovascular implications of smoking: The Surgeon General's point of view, Journal of Health Care for the Poor and Underserved;; 8, 3; ProQuest Medical Library pg. 303 Napoli M, (March 2005), Stop Smoking And Live Longer, Health Facts, ProQuest Nursing Journals, 30, 3; pg. 5 Wise J, (Jan 24, 1998), Heavy smoking may cause irreversible damage to arteries, British Medical Journal;; 316, 7127; ProQuest Medical Library, pg. 250 Read More