Betel Nut Usage Is a Major Risk Factor for Coronary Artery Disease

Abstract

Aim:The objective of our study was to assess betel nut usage as one of the major risk factors associated with coronary artery disease.Methods:This case control study consisted of 300 controls and 300 cases. A structured questionnaire was administered to the participants to assess consumption of betel nut and confounding variables. A respondent was considered a regular consumer of betel nut if he/she consumed one or more pieces of betel nut every day for a period of greater than 6 months.Results:About 8 in 10 betel nut chewers developed coronary artery disease. After adjusting for diabetes and hypertension, the odds ratio analysis depicted 7.72 times greater likelihood for coronary artery disease in patients who chewed betel nut for more than 10 years.Conclusion:Our study concludes that betel nut chewing is a significant risk factor leading to the development of coronary artery disease.

Betel nut use and hyperglycemia

“…Its use generates euphoria 3 among users that contributes to widespread use; however, it has an array of negative effects including but not limited to oral, esophageal, and hepatocellular carcinoma, metabolic syndrome, hyperlipidemia, and type II diabetes. 1 The main alkaloid in the betel nut, acreoline, is toxic. It increases appetite, causes coronary artery spasm, interferes with insulin induced glucose uptake, and inhibits adiopogenic differentiation.…”

“…2 Multiple studies show high risk of diabetes, increased likelihood of coronary artery disease and all-cause mortality in betel nut users. (4,1) Specifically, Tseng's study demonstrated how, in Taiwan, increasing incidence ratios of type II diabetes with increasing age could be viewed as a dose-response relationship with betel nut chewing. 4 Reports are also available for acute toxic symptoms if betel nut is consumed in increased quantity; manifestations include palpitations, chest tightness, dyspnea, tachycardia and even MI and coma.…”

“…1 With approximately 700 million individuals or 10 % of the global population 2 chewing betel nut on regular basis, it is important to recognize its associated health hazards.…”

Paan(pan) andpaan(pan)masalashould be considered tobacco products: Table 1

“…Both have been implicated as possible contributing factors for the high rates of oral disease (oral and oral-pharyngeal cancer) found in the Indian subcontinent 6 12 13. IARC has concluded that areca (or betel) nut, with or without tobacco , is carcinogenic, given the presence of areca nut-derived nitrosamines 11 14–16.…”

“…Both products also contain high levels of toxic inorganic compounds, including heavy metals, and the use of paan has been shown to cause chromosomal dysfunction associated with the formation of oral precancerous lesions 17 18. In addition, other studies have shown that use of paan and paan masala may be related to acute cardiovascular risks, such as increases in heart rate and blood pressure, and that longer use may contribute to the onset of coronary artery disease 12 17 19…”