Published October 10, 2011
Smokers tend to suffer heart attacks years earlier than non-smokers, suggests a new study from Michigan.
"Individuals who smoke are much more likely to have a heart attack, and will present with a heart attack a decade or more earlier," said Dr. Gregg Fonarow, a cardiologist at the David Geffen School of Medicine at the University of California, Los Angeles, who wasn't involved in the new study.
The findings, he said, also show that "you could have a heart attack in the absence of other risk factors if you smoke."
Researchers led by Dr. Michael Howe from the University of Michigan Health System in Ann Arbor studied about 3,600 people who were hospitalized with a heart attack or unstable angina -- pain caused by low blood flow to the heart that is often a precursor to a heart attack.
One-quarter of the patients were current smokers. And on average, they were younger with fewer health problems than non-smokers with heart trouble.
Non-smoking men were 64 years old at hospital admission, on average, compared to 55 for male smokers. For female heart patients, average ages were 70 for non-smokers and 57 for smokers.
Smokers were less likely to have other health problems that are linked to heart risks, including high cholesterol, high blood pressure and diabetes.
That and their younger age explained why researchers also found that people who lit up were less likely to die in the six months following an attack than non-smokers.
That "smoker's paradox" -- the idea that smokers who have a heart attack have better outcomes, including a lower risk of death, than non-smokers -- didn't last. The difference in death over the next six months -- five percent in male non-smokers, versus three percent in male smokers, and eight and six percent in female non-smokers and smokers, respectively -- was explained by age and other risk factors.
Fonarow said the findings are just one more example of the heart dangers posed by smoking, but emphasized that kicking the habit can erase those extra risks.
"It's never too late to quit, and the benefits are very early," he told Reuters Health.
"Even within a few days of stopping smoking, there is a reduction in (heart) risk. As time goes by, within one to two years much of that risk is gone for heart attacks," he added. "From a coronary risk standpoint, there is an immediate benefit and that continues to extend over time."
The findings, published in the American Journal of Cardiology, also showed that female smokers were more likely than male smokers to have another heart attack or other heart problems in the next few months after the initial attack or angina.
"The real key messages are that smoking is a tremendous risk factor for having acute coronary events (earlier)... and that these risks may be even greater in women than in men," Fonarow said.