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Role of exercise testing in assessment of the cardiovascular system function in Zarda users

Background: Zarda is a widely used form of smokeless tobacco in India. Cigarette smoking has extensive effects on cardiovascular functions. Zarda is prepared by the user by mixing tobacco with lime in the palm and gives the user the choice to change the combination. This study aims to determine the effect of Zarda on the cardiovascular system adaptability to exercise. There are conflicting opinions about the degree of adaptability of the cardiovascular system in delivering the physiological needs in case of severe exercise. Role of the normal cardiovascular system in delivering oxygen to meet the demands of various degrees of exercise has been a topic of considerable debate. The effect of Zarda usage on this phenomenon is studied here. Materials and Methods: Cardiovascular functions were assessed after maximal exercise testing by recording parameters such as maximum heart rate (HR), delta HR, recovery HR and maximum oxygen pulse in two groups′ viz., Zarda users and non-user controls. Results: On studying the differences in cardiovascular functions in users and controls, there was a significant difference in maximum HR. The other parameters such as delta HR and maximum oxygen pulse were on the higher side in controls while the recovery HR was significantly lower in the control group, which was consistently maintained after exercise testing. Based on these findings it is suggested that there is a higher adaptability of the cardiovascular system to the exercise stimulus in the form of better VO 2 max, faster recovery of the exercise HR and a lesser risk for cardiovascular mortality as suggested by the higher delta HR in non-Zarda users.