Study Of Autonomic Functions In Male Current Tobacco Smokers And Non Smokers

Abstract

Background: Smoking is the third top risk for health loss in India, leading to nearly one million deaths each year in the country. The study aims To investigate interrelationship of parameters of Autonomic Function between current smokers and non smokers. Material And Methods: The Study was conducted at Physiology Department , Medical college, Vadodara. All patients were enrolled applying inclusion and exclusion criteria.The study compared the autonomic function test data of two groups of subjects. Asymptomatic male aged 19 - 44 yrs in current tobacco smokers as cases and healthy non smokers as controls. History, Anthropometric measurements, clinical examination, Vital Parameters( like Heart rate, SBP and DBP ) and ECG recorded in lead 2 for R-R interval . Autonomic functions Tests like Expiration: inspiration ratio, Valsalva ratio, Change in DBP in sustained hand grip test Development of orthostatic hypotension on standing, Heart rate response to standing (30:15 ratio) were Recorded. Results: Maximum incidence was seen in >31 yrs of age(majority 31-40 age gp) The mean height in smokers was lower than in non smokers(161.98 ±13.011vs 170.7 ± 6.011) cms. The Weight of Cases and Controls were 70.21± 8.46 and 75.43±8.00 kg respectively. BMI of Cases and Controls were 27.45 ± 6.52 and 25.96 ± 3.20 respectively. Mean resting SBP is 132.23 ± 10.45 vs 121.33 ±7.46 mmHg ; Mean resting DBP is 81.26 ±4.87 vs 78.33 ± 8.1 mmHg and Mean basal HR is 84.36 ±7.83 vs 79.86 ± 9.43 per minute. The mean value of HR response to E: I ratio in cases and controls are 1.11 ± 0.15 and 1.55 ± 0.24 respectively. The mean values of valsalva ratio in cases and controls are 1.086 ± 0.085 and 1.713 ± 0.312 respectively(p<0.0001). The mean values of increase in DBP (mmHg) during sustained handgrip test in cases and controls are 10.8 ± 4.78 and 23.43 ± 6.06 mmHg respectively( p<0.0001). The mean values of decrease in SBP (mmHg)during postural change from lying to standing in cases and controls are 15.26 ± 5.27 and 4.3 ± 2.53 mmHg respectively with statistically highly significant difference(p<0.0001). Mean values of 30:15 ratio in cases and controls is 0.947 ± 0.165 and 1.045 ± 0.042 respectively. The mean difference in E: I ratio is statistically significant (p<0.0026).Conclusion: Smoking is so debilitating that immediate cessation of habit is always the first step of program to improve one's health. Clinical symptoms of autonomic failure may appear late in the course of disease. Early assessment of degree of autonomic dysfunction can prevent hazardous complications related to Smoking. [Vagadiya A Natl J Integr Res Med, 2020; 11(2):27-33]