Key result
Smokeless tobacco use (4.1%) and cigarette smoking (3.9%) were associated with significantly impaired brachial artery flow-mediated dilation compared with nonusers (12.2%; p=0.01).
Why the study?
Does smokeless tobacco use or cigarette smoking impair brachial artery flow-mediated dilation in apparently healthy volunteers compared to nonusers?
Cross-Sectional (n=17)
No
Does smokeless tobacco use or cigarette smoking impair brachial artery flow-mediated dilation in apparently healthy volunteers compared to nonusers?
Absolute Event Rate: 4.1% vs 12.2%
p-value: p=0.01
Smokeless tobacco use is associated with significantly impaired endothelial function, comparable to the impairment observed in cigarette smokers.
May signal vascular risk from smokeless tobacco comparable to smoking; hypothesis-generating and should not yet change practice.
STUDY OBJECTIVE: To compare brachial artery flow-mediated dilation (FMD) in subjects who use smokeless tobacco, smoke cigarettes, or do not use any tobacco product. DESIGN: Cross-sectional study. SETTING: University-affiliated outpatient clinic. SUBJECTS: Seventeen apparently healthy volunteers who for more than 1 year smoked at least 10 cigarettes/day, used at least two containers of smokeless tobacco/week, or did not use any tobacco product. MEASUREMENTS AND MAIN RESULTS: Baseline characteristics of subjects were similar among the three groups except for mean age and serum cotinine level. Baseline brachial artery diameter, endothelium-dependent FMD induced by reactive hyperemia, and endothelium-independent dilation induced by administration of sublingual nitroglycerin were measured. Mean FMD over baseline was 4.1% +/- 0.7% in subjects who used smokeless tobacco, 3.9% +/- 5.1% in cigarettes smokers, and 12.2% +/- 5.7% in nonusers of tobacco (p=0.01). Endothelium-independent dilation induced by nitroglycerin was not statistically different among the three groups. CONCLUSION: Brachial artery FMD, a surrogate for endothelial dysfunction, was significantly impaired in smokeless tobacco users and cigarette smokers compared with nonusers of tobacco.
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Granberry et al. (2003) conducted a cross-sectional in Healthy volunteers (n=17). Smokeless tobacco use vs. Cigarette smokers and nonusers of tobacco was evaluated on Brachial artery flow-mediated dilation (FMD) (p=0.01). Smokeless tobacco use (4.1%) and cigarette smoking (3.9%) were associated with significantly impaired brachial artery flow-mediated dilation compared with nonusers (12.2%; p=0.01).
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