Smoking cessation is associated with regression of electrocardiographic left ventricular hypertrophy, independent of weight gain or increases in blood pressure.
Average left ventricular voltage decreased significantly over 6 years following smoking cessation.
The prevalence of electrocardiographic left ventricular hypertrophy declined from 8.4% to 6.5% over 6 years after smoking cessation.
LVH regression following smoking cessation occurred despite significant increases in body weight and systolic blood pressure.
Antihypertensive medication was identified as an independent predictor of electrocardiographic LVH regression in multivariable analysis.
The study population was predominantly male and middle-aged, drawn from participants undergoing annual health checkups.
This research suggests that quitting smoking is linked to a reduction in an abnormality called left ventricular hypertrophy (LVH), which is a thickening or enlargement of the heart's main pumping chamber detectable on an electrocardiogram (ECG). LVH is a known risk factor for serious heart problems. The study followed 752 mostly male, non-hypertensive participants for 6 years after they stopped smoking and found that average heart voltage readings decreased and the proportion of participants with LVH dropped from about 8.4% to 6.5%. A notable finding was that this improvement in heart measures happened even though the participants gained weight and had increases in blood pressure after quitting smoking — two changes that would typically be expected to worsen LVH. The benefit of smoking cessation on LVH appeared to work through a separate mechanism from these other factors. People who were also taking blood pressure medications were especially likely to show LVH regression, but improvement was seen even in those not on such medications. This research suggests that the cardiovascular benefits of quitting smoking may extend beyond just reducing blood pressure or preventing weight gain, and may directly help reverse certain structural heart changes. The findings add to the understanding of why smoking cessation is recommended as a key step in protecting heart health, and highlight that even people who gain weight after quitting may still experience meaningful cardiac benefits.
Ninomiya Y, Kawasoe S, Kubozono T, Sai E, Nuruki N, Kamada H, et al.. (2026). Smoking cessation is associated with regression of electrocardiographic left ventricular hypertrophy: A 6-year retrospective observational study.. PloS one. https://doi.org/10.1371/journal.pone.0357409