Changes in tobacco-related morbidity and mortality in French women: worrying trends.

BACKGROUND: The high prevalence of smoking among French women since the 1970s has been reflected over the past decade by a strong impact on the health of women. This paper describes age and gender differences in France of the impact of smoking on morbidity and mortality trends since the 2000s. METHODS: Smoking prevalence trends were based on estimates from national surveys from 1974 to 2017. Lung cancer incidence were estimated from 2002-12 cancer registry data. Morbidity data for chronic obstructive pulmonary disease (COPD) exacerbation and myocardial infarction were assessed through hospital admissions data, 2002-15. For each disease, number of deaths between 2000 and 2014 came from the national database on medical causes of death. The tobacco-attributable mortality (all causes) was obtained using a population-attributable fraction methodology. RESULTS: The incidence of lung cancer and COPD increased by 72% and 100%, respectively, among women between 2002 and 2015. For myocardial infarction before the age of 65, the incidence increased by 50% between 2002 and 2015 in women vs. 16% in men and the highest increase was observed in women of 45-64-year-olds. Mortality from lung cancer and COPD increased by 71% and 3%, respectively, among women. The estimated number of women who died as a result of smoking has more than doubled between 2000 and 2014 (7% vs. 3% of all deaths). CONCLUSIONS: The increase in the prevalence of smoking among women has a major impact on the morbidity and mortality of tobacco-related diseases in women and will continue to increase for a number of years.

Altered left ventricular volume and ejection fraction responses to supine dynamic exercise in athletes.

Two-dimensional echocardiography was used to determine the responses of left ventricular volumes, ejection fraction and segmental left ventricular motion to supine dynamic exercise in 22 professional athletes, comparing these responses with those in 22 age- and gender-matched healthy untrained individuals. End-systolic volume was significantly greater at rest and during exercise in the athletes (50 +/- 6 versus 29 +/- 4 ml and 40 +/- 5 versus 17 +/- 4 ml, respectively, p less than 0.001 for both). It decreased during exercise in all the untrained subjects, but did not change or increased in nine athletes (41%). End-diastolic volume was greater in the athletes at rest (143 +/- 12 versus 98 +/- 9 ml) and during exercise (157 +/- 14 versus 121 +/- 13 ml, p less than 0.01 for both). It increased in all the untrained subjects, but decreased or did not change in six athletes (27%). Ejection fraction was significantly lower in the athletes at rest and during exercise (65 +/- 4% versus 70 +/- 5% and 73 +/- 5% versus 86 +/- 5%, p less than 0.01 and 0.001, respectively); the values augmented normally in all the untrained subjects, but increased only by less than 5% units, did not change or decreased in nine athletes (41%). Eight athletes (36.5%) failed to demonstrate the expected symmetric hyperkinetic wall motion changes during exercise, which were seen in all the untrained subjects. No correlation was found between atypical responses to exercise and electrocardiographic patterns.(ABSTRACT TRUNCATED AT 250 WORDS)

Correlation between arrhythmias and abnormal systolic blood pressure response to exercise in mitral valve prolapse patients.

A wide variety of arrhythmias as well as exercise induced hypotension were described in some Mitral Valve Prolapse (MVP) patients. The aim of our study was to evaluate the correlation between the incidence of arrhythmias and the decrease of Systolic Blood Pressure (SBP), ST-T changes and prolonged QTc interval. 50 MVP patients (diagnosis confirmed by M-mode and 2-D echocardiography) underwent a complete clinical evaluation, 12 lead standard ECG, 24 hr. monitoring ECG and a submaximal exercise test. On the basis of the SBP response to effort, the patients were divided into 2 groups (gr.): gr. A, 18 patients with a decrease of the SBP during effort, mean 135 +/- 16.5 mmHg and gr. B, 32 patients with a normal increase of the SBP at the end of the effort, mean 168 +/- 14.7 mmHg (p less than 0.001). Arrhythmias were found in 83.33% among patients in gr. A and in 50% in gr. B (p less than 0.05). We did not find a significant difference concerning the types of arrhythmias between the 2 groups. Exercise induced ST-T changes, appeared in 55.55% in gr. A and in 25% in gr. B (p less than 0.05) but the incidence of arrhythmias in patients with ST-T changes was not significantly different between the 2 groups (5.55% and 6.25% respectively). Rhythm disturbances were found in 3 out of 4 patients with prolonged QTc in gr. A and in 2 out of 4 patients in gr. B (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)