Detecting Heart Disease with Toenails

A study by researchers at the University of California suggests that it might be possible to predict heart disease risk in women by measuring the nicotine content in their toenail clippings. Findings of the study have been published in the American Journal of Epidemiology.

Smoking is a known cause of heart disease and smokers generally tend to have a higher risk of heart disease than non-smokers. It is possible to test the presence of nicotine in the body by testing the amount of nicotine breakdown products in saliva or urine. However, such tests only give an idea if the exposure to nicotine or cigarette smoke is recent.

The analysis of toenails of more than 62,500 nurses was conducted by Dr. Wael Al-Delaimy and colleagues and showed that women who had heart disease had double the level of nicotine than those without the condition. Based on this finding, the researchers believe the test might provide a more accurate method of assessing risk than asking a person about his/her smoking history.

Over the 14 year period of the study from 1984 to 1998, 900 women developed heart disease. The researchers found that women who were in the top fifth for toenail nicotine content were thinner, less active, heavy drinkers, and had higher chances of having high blood pressure and a family history of heart disease compared to women who did not have that high levels of toenail nicotine.

Detailed analysis revealed that women with the top fifth levels of nicotine were at four times the risk of heart disease than those who had the bottom fifth levels. The researchers also found nicotine in the toenails to be a risk factor for heart disease regardless of the number of cigarettes smoked by a person.

According to Dr. Al-Delaimy, the slow growth rate of toenails of around 1cm a year might offer a longer-term estimate of a person’s total exposure to tobacco smoke. This would also give a better idea about a person’s exposure to passive smoking and smoking habits including how much smoke is inhaled with each puff.

“The use of toenail nicotine is a novel way to objectively measure exposure to tobacco smoke and could become a useful test to identify high-risk individuals in the future,” Dr. Al-Delaimy said. Elle Mason, a cardiac nurse at the British Heart Foundation (BHF) believes the study points to the health problems smokers are likely to face in the future.

“Men and women who smoke are around twice as likely to suffer a heart attack in their life time as those who don’t, and quitting smoking is one of the most effective ways to reduce this risk. People using nicotine replacement therapy should not be alarmed by this study as it is the other chemicals inhaled when smoking, such as carbon monoxide that cause the risk of heart disease, not nicotine,” she said.

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