Article

Effect of Smoking on Arterial Stiffness and Pulse Pressure Amplification

Department of Pharmacology and Therapeutics, Trinity College Dublin, and the Hypertension Clinic, St James's Hospital, Dublin, Ireland.
Hypertension (Impact Factor: 6.48). 01/2003; 41(1):183-7. DOI: 10.1161/01.HYP.0000047464.66901.60
Source: PubMed

ABSTRACT

The brachial artery pressure waveform is abnormal in smokers, but the effect of smoking on the aortic pressure waveform in both smokers and nonsmokers, particularly in the younger population, is unknown. We compared the acute and chronic effects of smoking on large-artery properties in 185 healthy young smokers and nonsmokers (mean+/-SD, 22+/-5 years). We matched 41 chronic smokers for age, height, weight, and gender with 116 nonsmokers. The augmentation index, a measure of arterial wave reflection in the aorta, was measured by applanation tonometry (Sphygmocor). We also compared augmentation index, aortic pulse wave velocity (Complior), and blood pressure in 28 subjects (11 chronic smokers) before and for 15 minutes after smoking 1 cigarette (nicotine content, 1.2 mg). Although brachial blood pressure was not different, the aortic systolic blood pressure (101+/-8 versus 97+/-9 mm Hg) and augmentation index (0.7+/-13 versus -5.7+/-14) were higher (P<0.01) in chronic smokers than in nonsmokers, whereas aortic-brachial pulse pressure amplification was reduced (13.7+/-8 versus 17.7+/-5 mm Hg, P<0.01). These effects were seen in both male and female subjects. Acutely in both groups, smoking significantly increased (P<0.01) both brachial and aortic blood pressure, augmentation index, and pulse wave velocity. No changes were seen after sham smoking. This study shows an acute increase in arterial stiffness after smoking 1 cigarette in chronic smokers and nonsmokers. Higher aortic systolic blood pressure and greater arterial stiffness, in part due to reduced pulse pressure amplification and increased arterial wave reflection, suggest that the adverse hemodynamic effects have hitherto been underestimated in young chronic smokers.

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    • "autonomic) mechanisms were implicated in these vascular changes. Previous studies reported arterial rigidity (Kool et al., 1993; Mahmud & Feely, 2003) attributed to reduced nitric oxide bioavailability (Nuttall et al., 2002; Tsuchiya et al., 2002), endothelium dysfunction (Karatzi et al., 2007a) and compromised vasodilatory capacity (Karatzi et al., 2007b; Winniford et al., 1986) immediately after smoking a cigarette. "
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    • "Smoking behaviour exhibits both chronic and acute effects on the vasculature. Specifically, vascular stiffening has been observed in chronic smokers (Failla et al. 1997; Kim et al. 2005; Kool et al. 1993; Lekakis et al. 1997; Mahmud and Feely 2003; Rehill et al. 2006) and immediately following 1 cigarette (Failla et al. 1997; Kim et al. 2005; Kool et al. 1993; Kubozono et al. 2011; Wiesmann et al. 2004). The transition from acute changes in vascular stiffness to vascular pathology has not been determined. "
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