Maheshwari V D, Pillai A
Upgraded Department of Medicine, SMS Medical College, Jaipur, Rajasthan.
J Assoc Physicians India. 2000 Apr;48(4):397-9.
The present study was designed to observe the influence of smoking and hypertension on left ventricular mass (LVM), both individual and the combined effect.
This study was conducted in the Department of Medicine, SMS Medical College Hospital, Jaipur. Hundred patients were included in the study. They were divided into four groups--non smoker normotensives, non-smoker hypertensives, smoker normotensives and smoker hypertensives. They were also divided into smokers and nonsmokers and hypertensives and normotensive. Patients of age group 31-65 years of both sexes were chosen. Patients with secondary hypertension, diabetes mellitus, dyslipidemia, cardiomyopathies, valvular heart disease women on oral contraceptives were excluded from the study on the basis of history and relevant laboratory tests. An M-mode echocardiography was done and the LV mass was calculated by the formula proposed by Devereux et al. LV mass = 0.8 [1.04 (IVSd + LVIDd + LVPWd)3 - (LVIDd)3] + 0.6 gms
The mean LV mass (in gms) in the four groups of nonsmoker normotensives, nonsmoker hypertensives, smoker normotensives and smoker hypertensives are 106.77 +/- 25.78, 165.3 +/- 42.55, 154.53 +/- 24.6 and 228.78 +/- 56.88 respectively. The comparison of mean LV mass (in gms) of smokers and nonsmokers were 191.66 +/- 40.74 and 136.04 +/- 36.16 (P < 0.001) respectively. The comparison of the mean LV mass (in gms) of hypertensives and nonhypertensives were 197.25 +/- 49.72 and 126.29 +/- 25.19 (P < 0.001) respectively. Comparison of the mean LV mass (in gms) of patient with two risk factors i.e., smokers hypertensives with patients without any risk factor i.e., nonsmoker normotensive were 228.78 +/- 56.88 and 106.77 +/- 25.78 (P < 0.001) respectively. While comparison of the mean LV mass (in gms) of patients with one risk factor each i.e., smoker normotensives and nonsmoker hypertensives were 165.3 +/- 42.55 and 154.53 +/- 24.6 (P < 0.05) respectively.
Both smoking and hypertension cause an increase in LV mass, hypertension causing a more increase, than smoking, individually. Both smoking and hypertension combine together to increase the LV mass, more than either of them individually. Smoking by itself can cause an increase in LV mass independent of hypertension.
本研究旨在观察吸烟和高血压对左心室质量（LVM）的影响，包括单独影响及联合影响。
本研究在斋浦尔SMS医学院医院内科进行。100名患者纳入研究。他们被分为四组——非吸烟正常血压者、非吸烟高血压患者、吸烟正常血压者和吸烟高血压患者。他们还被分为吸烟者和非吸烟者以及高血压患者和正常血压者。选取年龄在31 - 65岁的男女患者。根据病史和相关实验室检查，排除继发性高血压、糖尿病、血脂异常、心肌病、瓣膜性心脏病以及正在服用口服避孕药的女性患者。进行M型超声心动图检查，并根据Devereux等人提出的公式计算左心室质量。左心室质量 = 0.8 [1.04（室间隔舒张末期厚度 + 左心室内径舒张末期值 + 左心室后壁舒张末期厚度）³ - （左心室内径舒张末期值）³] + 0.6克
非吸烟正常血压者、非吸烟高血压患者、吸烟正常血压者和吸烟高血压患者四组的平均左心室质量（克）分别为106.77±25.78、165.3±42.55、154.53±24.6和228.78±56.88。吸烟者和非吸烟者的平均左心室质量（克）比较分别为191.66±40.74和136.04±36.16（P < 0.001）。高血压患者和非高血压患者的平均左心室质量（克）比较分别为197.25±49.72和126.29±25.19（P < 0.001）。有两个危险因素即吸烟高血压患者与无任何危险因素即非吸烟正常血压患者的平均左心室质量（克）比较分别为228.78±56.88和106.77±25.78（P < 0.001）。而有一个危险因素的患者即吸烟正常血压者和非吸烟高血压患者的平均左心室质量（克）比较分别为165.3±42.55和154.53±24.6（P < 0.05）。
吸烟和高血压均会导致左心室质量增加，单独来看，高血压导致的增加幅度比吸烟更大。吸烟和高血压共同作用导致的左心室质量增加幅度大于它们单独作用时。吸烟本身可导致左心室质量增加，且独立于高血压之外。
