Smokers paradox puzzles doctors

NineMSN ^ | 2 Sep 2003 | Judy Skatssoon

[CSM]

Smoking might give you a heart attack but smokers have better chances of surviving a heart attack than non-smokers, according to a puzzling phenomenon dubbed "smokers paradox".

The apparently "protective" effect of smoking in heart attack patients was highlighted in a study confirming smoker's paradox among older patients, released at an international cardiology conference.

Cardiologist Hector Bueno, of the Hospital General Universitario Gregorio Maranon in Madrid, told the European Society of Cardiology congress in Vienna that in the past the paradox had been attributed to smokers being likely to experience heart attack at a younger age than non-smokers.

To see if the paradox also applied in an older age group, Dr Bueno studied 677 patients aged 75 and over who had been admitted to hospital with their first heart attack between 1988-1997.

He found that smokers tended to arrive at hospital earlier after a heart attack than non-smokers and while in hospital showed a lower incidence of complications.

Meanwhile, smokers were less likely to die in hospital after a heart attack, with 22 per cent of smokers dying compared to 33 per cent of non-smokers.

In a statistical analysis, smokers had a massive 75 per cent better chance of surviving heart attack than non-smokers, the study showed.

"The smoker's paradox can also be observed in elderly patients with acute myocardial infarct (heart attack)," Dr Bueno concluded.

Professor Garry Jennings, director of Melbourne's Baker Heart Research Institute, said there were a number of explanations for smoker's paradox.

"Smoker's paradox has been talked about a fair bit," he said.

"It's the notion that although smoking's bad for you ... smokers who have cardiac events tend to do better."

Smokers tended to have "stiffer" lungs, making them less prone to pulmonary congestion, or fluid on the lungs, and often had lower blood pressure than non-smokers, he said.

They also had higher levels of carbon monoxide in their blood, which helped them retain oxygen.

"In a sense they've been in training for things to get bad and get into a low oxygen state as can happen after an heart attack," he said.

Smokers were also more likely to die of sudden cardiac death, which meant most of them probably never made it to hospital in the first place.

The paradox should by no means be interpreted as an endorsement of smoking, Prof Baker said.

"There's nothing in this that says people with heart disease should take up smoking," he said.

Dr Bueno added the results of his study were likely influenced by the non-smoking group having a lower risk profile than the non-smoking group, as they were slightly younger than the non-smokers and had a lower incidence of diabetes and high blood pressure among their group.

* Judy Skatssoon was a guest of Servier Australia at the ESC congress.

[CSM]

"Smoking might give you a heart attack but smokers have better chances of surviving a heart attack than non-smokers, according to a puzzling phenomenon dubbed "smokers paradox"."

Doctors aren't sure if heart attacks can be caused by smoking, but they are sure that the survival rate is higher. Kinda endorses it......

[CSM]

One more to start the day!

[dirtboy]

Well, I guess the smart approach is to not smoke, but start chain smoking if you have a heart attack...

[tdadams]

Beer, red wine, dark chocolate, and now cigars. Who knew all my vices would eventually turn out to be so healthy!

[VadeRetro]

Doctors aren't sure if heart attacks can be caused by smoking, but they are sure that the survival rate is higher. Kinda endorses it......

Smokers were also more likely to die of sudden cardiac death, which meant most of them probably never made it to hospital in the first place...

"There's nothing in this that says people with heart disease should take up smoking," he said.

Nah! Wishful thinking.

[CSM]

"Smoking might give you a heart attack ....."

"probably never made it to hospital in the first place..."

When "facts" can't be shown use vague language then state that individuals should not partake in the terrible behavior.

[theDentist]

WHen my folks smoked, they never seemed to catch a cold. When they quit, they seemed to catch them all the time. Dad took up smoking again and no colds again. Mom still gets them.

[Conspiracy Guy]

I'm speechless. I come from a long line of male smokers. Not one of us has ever had a heart attack or lung cancer. Most live well into their 80's and even 90's. We are tall, slim, and spend more time doing things than worrying about things. So do non-smokers have a higher incidence of diabetes? Are non-smokers a higher risk group than smokers?

[VadeRetro]

When "facts" can't be shown use vague language then state that individuals should not partake in the terrible behavior.

We're talking about whether thoroughly dusting your lungs with ash particles multiple times daily is good or bad. I could just about guess "bad" without doing much of a study.

Unless, perhaps, non-smokers suffer from too much oxygen. I tend to doubt that because if such an environmental pressure existed we'd simply have evolved less efficient lungs. There would have been no need to invent them with cigarettes.

[VadeRetro]

WHen my folks smoked, they never seemed to catch a cold.

Stinking up the air around you makes people keep their distance.

[CSM]

Actually, smokers are found to have less incidents of stress related diseases. They tend to be more easy going and less apt to be stressed. Smoking a cig is relaxing and enjoyable, so these stress related diseases are less likely to hit a smoker.

In addition, as the rate of smoking has decreased the rate of children with asthma and alergies has increased. This would suggest that the lack of exposure to ETS, hasn't allowed the lungs to strengthen themselves and learn to "fight" impurities in the air. It would be similar to giving vaccinations, inject a small amount of the disease to allow your body to build a tolerance.

It must be regulated that all parents smoke a cig a day in front of their kids, that way they will be less likely to develop allergies. It is for the chilrun don't ya know!

[Ff--150]

FWIW it's the sugar in and coating tobacco artificially causing the myriad health problems, not the tobacco per se. Read Sugar Blues by William Duffy for more info.

[jmc813]

In addition, as the rate of smoking has decreased the rate of children with asthma and alergies has increased. This would suggest that the lack of exposure to ETS, hasn't allowed the lungs to strengthen themselves and learn to "fight" impurities in the air. It would be similar to giving vaccinations, inject a small amount of the disease to allow your body to build a tolerance.

Thoughts?

[CSM]

"FWIW it's the sugar in and coating tobacco artificially causing the myriad health problems, not the tobacco per se. Read Sugar Blues by William Duffy for more info."

I have never heard this before. Do you have some links for research or is the info in this book only? I am interested in this theory......

BTW, have you seen the new F150? Look for the KO of the add campaign tonight!

[Ff--150]

Can't link you, but this book can be found at Amazon.com, and google "Sugar Blues--tobacco" is where I'm going to check later.

From memory the tobacco companies have hybridized or coated the tobacco making the sugar itself addicting, with the health problems caused by the reaction to glucose not the nicotine. Top of my head recall.

In Spain, in the seventies, I smoked a couple Turkish cigarettes, I believe, which must have been different tobacco. The taste was remarkable, and though I smoked 2 or 3 packs then, after that first one it was hours before I forced myself to smoke the second.

Those new 150's might be worth a look, but have no complaints with the one I have now.

[Gabz]

In Spain, in the seventies, I smoked a couple Turkish cigarettes, I believe, which must have been different tobacco. The taste was remarkable, and though I smoked 2 or 3 packs then, after that first one it was hours before I forced myself to smoke the second.

I have found the same thing with RYO cigarettes. I smoke no where near what I smoke when smoking regulars. there are also less burn additives, so they go out if left unattended, unlike regular ones.

[Ff--150]

I have found the same thing with RYO cigarettes. I smoke no where near what I smoke when smoking regulars. there are also less burn additives, so they go out if left unattended, unlike regular ones.

that's right--"no where near." I wonder though if the sugar makes the regular cigarettes burn as you mentioned, for our bodies use sugar for fuel. Remember, the Indians regarded tobacco as sacred.

[Ff--150]

http://www.lsc.org/tobacco/farming/growing/curing.html

Sorry the best I can do. The tobacco made for cigarettes is flue-cured which makes its sugar content high (addictive, my statement), making its nicotine level in the mid to high range...

[CSM]

Good information. Thanks. Currently I smoke cigs made by Indians and not sold on the open market. I started because it represents a major cost advantage, now I think I am getting past this issue as well. I will have to research it to verify my thoughts.