Betel-Quid Chewing, Heart Failure, and Premature Ventricular Contractions in Patients with Cardiopulmonary Symptoms

Tien-Chi Huang, Wei-Tsung Wu, Ying-Chih Chen, Frances M. Yang, Wei-Chung Tsai and Chien-Hung Lee
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Tien-Chi Huang: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
Wei-Tsung Wu: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
Ying-Chih Chen: Division of Cardiology, Ministry of Health and Welfare Hengchun Tourism Hospital, Pingtung 94641, Taiwan
Frances M. Yang: Department of Occupational Therapy Education, Medical Center, Kansas University, KS 66045, USA
Wei-Chung Tsai: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
Chien-Hung Lee: Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung 80708, Taiwan

IJERPH, 2020, vol. 17, issue 20, 1-12

Abstract: Betel-quid (BQ) is a commonly used psychoactive substance that renders a specific cardiotoxicity. The purpose of this study was to investigate the association between BQ chewing and premature ventricular contractions (PVC) in patients with cardiopulmonary symptoms, and examine the potential influences of cardiovascular and chronic diseases on such relationship. Participants were 146 patients with cardiopulmonary symptoms who participated in 24-h Holter electrocardiogram monitoring during 2012–2018 in a hospital serving residents that lived in a BQ high prevalence area. Data on substance uses and medical histories for cardiovascular and chronic diseases were collected. Baron–Kenny method was employed to evaluate possible mediation. In patients with cardiopulmonary symptoms, 36.3% were BQ users and 63.7% were nonusers. Adjusting for covariates, BQ chewing was significantly associated with heart failure and diabetes mellitus (adjusted odds ratio (aOR) = 3.4 and 2.3, respectively), but only heart failure was significantly correlated with a low and high level of PVC. Additionally controlling for the effect of heart failure, the risk of high PVC for BQ users reduced from 3.60 to 2.88; however, the risk for BQ chewers remained significant (95% CI: 1.06–7.84). Heart failure was found to explain 27.7% of the excessive effect of BQ use on high PVC. In conclusion, BQ use is directly associated with an elevated risk of high PVC in patients with cardiopulmonary symptoms. The higher risk might be elevated among patients who suffered heart failure. Given several research limitations, the findings from this study offer future opportunities for validation.

Keywords: areca nut; betel-quid; premature ventricular contraction; heart failure; substance use; cardiovascular disease (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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