A Study of Heart Rate Variability among Gutkha Chewers from a Rural Farming Background in India

Abstract

Background: Modernisation of life style has affected the population even in rural areas leading to addiction. Smokeless tobacco is presumed to be less of an evil by the rural folk. Gutkha addicts are likely to suffer from mental and physical exhaustion leading to stress. This is important in view of the prevailing socio-economic as well as the healthcare system available in any developing country. Therefore the present study is designed to measure heart rate variability among this special group of population. Methods: 15 male subjects were enrolled from among the rural farm labors who regularly chewgutkha. They were free from any type of physical and mental health issues, non smokers. Each individual volunteer was subjected to HRV analysis on three occasions: the first record was performed on the first day of their arrival in the hospital as subjects during the lean season. The second observation was recorded after 3 months of farming activity. The final HRV analysis was done after 6 months of farming activity. Two types of parameters were analysed: time domain and frequency domain. Statistical analysis was done using paired t-test. Results: Both the HRV parameters – time and frequency domain, showed decreased values during the third month and sixth month recording as compared to the first week recording. The decrease is much more during the sixth month recording as compared to the third month recording. Statistically significant decrease is observed in mean RR interval, heart rate, VLF and LF only when the first week recording is compared with the third month recording but when the first week recording was compared with the sixth month recording significant decrease was found in mean RR interval and heart rate. Conclusion: Subjects involved in taking gutkha are likely to undergo a lot of physical and mental stress, thus affecting their autonomic status. This adds up to the stress induced by their occupation. HRV analysis using short term ECG recording was used to detect changes consequent to this stress. It was found that almost all HRV parameters measuring heart rate complexity were decreased in the period of farming activity.