Secondhand smoke exposure and aging caused synergistic effects on the activation of heart adaptive mechanisms. Active cigarette smoking influences all these pathways. Secondhand smoke exposure always makes human pathological cardiac hypertrophy. In left ventricular individual, secondhand smoke exposure may stimuli first a phase of cardiac hypertrophy. Secondhand smoke increases arterial stiffness and coronary cardiac disease events. Because of secondhand smoke exposure involves the combination of the smoke emitted by the burning end of a tobacco cigarette and the smoke exhaled by the smoker into the environment. Left ventricular pathological hypertrophy due to secondhand smoke exposure was observed in old-age patients, which leads to left ventricular remodeling and loss of function. Left ventricular pathological hypertrophy leads to ventricular remodeling and increases the risk of a cardiovascular event and mortality.