Smoking cessation is associated with regression of electrocardiographic left ventricular hypertrophy: A 6-year retrospective observational study

BACKGROUND: Electrocardiographic left ventricular hypertrophy is a known risk factor for cardiovascular morbidity and mortality. Although smoking cessation has general cardiovascular benefits, its impact on left ventricular hypertrophy regression remains unclear. OBJECTIVE: To investigate whether smoking cessation is associated with regression of electrocardiographic left ventricular hypertrophy. METHODS: We analyzed data from 752 non-hypertensive participants (695 males; mean age, 47.8 ± 9.2 years) who underwent annual health checkups. Left ventricular hypertrophy was defined using the Sokolow-Lyon criteria (SV1 + RV5 > 3.5 mV). Measurements were compared between baseline and 6 years after smoking cessation. Multivariable logistic regression analysis was used to identify predictors of left ventricular hypertrophy progression. RESULTS: After 6 years, the average left ventricular voltage decreased significantly (2.47 → 2.41 mV, p < 0.0001), and the prevalence of left ventricular hypertrophy declined from 8.4% to 6.5%. This regression occurred despite increases in body weight (65.7 → 68.1 kg, p < 0.0001) and systolic blood pressure (112.8 → 122.0 mmHg, p < 0.0001). Left ventricular hypertrophy regression was observed in both participants who received antihypertensive medication and in those who did not. Multivariable analysis identified antihypertensive medication as an independent predictor of electrocardiographic LVH regression. CONCLUSIONS: Smoking cessation is associated with regression of electrocardiographic left ventricular hypertrophy, independent of weight gain or increases in blood pressure.