IJE Advance Access first published online on April 17, 2007
This version published online on May 14, 2007
International Journal of Epidemiology, doi:10.1093/ije/dym031
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Effects of passive smoking on heart rate variability, heart rate and blood pressure: an observational study
1Institute of Social and Preventive Medicine, University of Basel, Switzerland.
2Department of Environmental Health, Harvard School of Public Health, Boston, MA.
3Division of Primary Care Medicine, University Hospitals, Geneva, Switzerland.
4Laboratoire de Physiologie Clinique et de l’Exercice, Université Jean Monnet, Saint-Etienne, France.
5Centre Valaisan de Pneumologie, Montana, Switzerland.
6Institute for Clinical Chemistry, University Hospital Zürich, Switzerland.
7Zürcher Höhenklinik, Wald, Switzerland.
8Service of Pulmonology, University Hospital Lausanne, Switzerland.
9Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
* Corresponding author. Institute of Social and Preventive Medicine, Steinengraben 49, 4051 Basel, Switzerland. E-mail: denise.felber{at}unibas.ch
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Abstract |
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Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for cardiovascular diseases and death, and autonomic dysfunction (specifically, reduced heart rate variability (HRV)) is a predictor of increased cardiac risk. This study tests the hypothesis that ETS exposure reduces HRV in the general population and discusses possible pathways.
Methods This cross-sectional study was conducted between 2001 and 2003 and is part of the SAPALDIA (Swiss Cohort Study on Air Pollution and Lung Diseases in Adults) study. The analysis included 1218 randomly selected non-smokers aged 50 and above who participated in 24-h electrocardiogram recordings. Other examinations included an interview, investigating health status (especially respiratory and cardiovascular health and health relevant behaviours and exposure to ETS) and measurements of blood pressure, body height and weight.
Results Subjects exposed to ETS at home or at work for more than 2 h/day had a difference of –15% in total power (95%CI: –26 to –3%), low frequency power (–28 to –1%), low/high frequency ratio (–26 to –3%) and –18% (–29 to –4%) in ultralow frequency power of HRV compared with subjects not exposed to ETS at home or work. We also found a 2.7% (–0.01 to 5.34%) higher heart rate during the recording in exposed subjects.
Conclusions Exposure to ETS at home and work is associated with lower HRV and with higher heart rate in an ageing population. Our findings suggest that exposure to ETS increases cardiac risk through disturbances in the autonomic nervous system.
Keywords Tobacco smoke pollution, heart rate variability, autonomic nervous system, heart rate, blood pressure
The work was performed at the Institute of Social and Preventive Medicine, University of Basel, Switzerland. 
Equal contributions.
SAPALDIA Team Study directorate: T Rochat (p), U Ackermann-Liebrich (e), JM Gaspoz (c), P Leuenberger (p), LJS Liu (exp), NM Probst Hensch (e/g), C Schindler (s). Scientific team: JC Barthélémy (c), W Berger (g), R Bettschart (p), A Bircher (a), O Brändli (p), M Brutsche (p), L Burdet (p), M Frey (p), MW Gerbase (p), D Gold (e/c/p), W Karrer (p), R Keller (p), B Knöpfli (p), N Künzli (e/exp), U Neu (exp), L Nicod (p), M Pons (p), E Russi (p), P Schmid-Grendelmeyer (a), J Schwartz (e), P Straehl (exp), JM Tschopp (p), A von Eckardstein (cc), JP Zellweger (p), E Zemp Stutz (e)>/>(a) allergology, (c) cardiology, (cc) clinical chemistry, (e) epidemiology, (exp) exposure, (g) genetic and molecular biology, (m) meteorology, (p) pneumology, (s) statistics
The originally published version of this paper was incorrect. The name of the second first author, Joel Schwartz, was misspelled.
Accepted 8 February 2007