INTRODUCTION Chronic hypertension is associated with left ventricular hypertrophy. Recent evidence suggests that secondhand smoke (SHS) exposure is associated with chronic hypertension, so we sought to examine the relationship between secondhand smoke exposure and electrocardiographic left ventricular (LV) mass among non-smokers. METHODS This analysis included 4982 non-smoker participants from the Third National Health and Nutrition Examination (NHANES-III). Non-smoking was defined by self-report and serum cotinine ≤10 ng/mL, a biomarker for tobacco exposure. SHS exposure was defined as serum cotinine level ≥1 ng/mL. LV mass was estimated using an electrocardiographic model developed and applied in NHANES-III then validated in the Cardiovascular Health Study. Multivariable linear regression was used to examine the cross-sectional association between SHS exposure (vs no exposure) with estimated LV mass index. In similar models, we also examined the associations of LV mass index across quartiles of serum cotinine (reference group, 1st quartile) and in subgroups stratified by age, race, sex, hypertension, and obesity. RESULTS About 9.8% (n=489) of the participants were exposed to SHS. Exposure to SHS was associated with an estimated 2.9 g/m2 increase in LV mass index, with a dose-response relationship between higher serum cotinine and LV mass index. These results were consistent in men and women, Whites and non-Whites, elderly and non-elderly, and those with and without hypertension. Significant effect modification was present among obese individuals with an estimated 4.8 g/m2 increase in LV mass index (interaction p=0.01). CONCLUSIONS In a racially diverse sample of non-smokers, SHS is associated with increased LV mass with a dose-response relationship between level of exposure and LV mass. Effect modification was present among obese individuals. These findings underscore the harmful effect of passive smoking on the cardiovascular system and highlight the need for more restrictions on smoking in public areas, especially in countries or regions with less-stringent public health policies.

中文翻译：

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接触二手烟与左心室质量增加有关。

引言 慢性高血压与左心室肥厚有关。最近的证据表明，二手烟 (SHS) 暴露与慢性高血压有关，因此我们试图检查非吸烟者的二手烟暴露与心电图左心室 (LV) 质量之间的关系。方法 该分析包括来自第三次全国健康和营养检查 (NHANES-III) 的 4982 名非吸烟者。不吸烟的定义是自我报告和血清可替宁≤10 ng/mL，这是烟草暴露的生物标志物。SHS 暴露定义为血清可替宁水平≥1 ng/mL。使用在 NHANES-III 中开发和应用的心电图模型估计 LV 质量，然后在心血管健康研究中进行验证。多变量线性回归用于检查 SHS 暴露（与未暴露相比）与估计的 LV 质量指数之间的横断面关联。在类似的模型中，我们还检查了血清可替宁四分位数（参考组，第一四分位数）和按年龄、种族、性别、高血压和肥胖分层的亚组中 LV 质量指数的关联。结果 大约 9.8% (n=489) 的参与者暴露于 SHS。暴露于 SHS 与 LV 质量指数估计增加 2.9 g/m2 相关，较高的血清可替宁和 LV 质量指数之间存在剂量反应关系。这些结果在男性和女性、白人和非白人、老年人和非老年人以及有和没有高血压的人中是一致的。肥胖个体中存在显着的效果改变，估计为 4。LV 质量指数增加 8 g/m2（交互作用 p=0.01）。结论 在不同种族的非吸烟者样本中，SHS 与 LV 质量增加相关，暴露水平与 LV 质量之间存在剂量反应关系。肥胖个体中存在效应改变。这些发现强调了被动吸烟对心血管系统的有害影响，并强调了在公共场所对吸烟进行更多限制的必要性，特别是在公共卫生政策不太严格的国家或地区。