January 1, 2004Open Access

Effect of Smoking on Endothelial Function and Wall Thickness of Brachial Artery

Structured PICO

Does chronic and acute cigarette smoking impair endothelial function and increase brachial artery wall thickness in healthy young adults?

Population

40 healthy subjects, including 20 long-term heavy smokers (mean age 27±9 years, 15 males, smoking average 25 cigarettes/day) and 20 age-matched non-smoking hospital staff (mean age 25±7 years, 14 males). All participants were free from other risk factors for CAD.

Intervention

Acute smoking of one cigarette (1.1 mg nicotine, 15 mg tar) with measurements taken 30 minutes after smoking.

Comparator

Baseline measurements (before smoking) and a non-smoking control group.

Outcome

Brachial artery wall thickness (BA-WT), flow-mediated dilatation (FMD %), and nitroglycerine-mediated dilatation (NMD %).surrogate

Chronic and acute cigarette smoking disrupts vessel wall morphology and impairs endothelial function, suggesting early subclinical atherosclerosis.

Abstract

BACKGROUND: Impaired flow mediated dilatation (FMD) and increased wall thickness (WT) of the brachial artery have been associated with atherosclerosis and its risk factors. In this study we sought to determine brachial artery wall thickness in chronic smokers and the instantaneous effect of smoking on brachial artery endothelium dependent vasodilator function in smokers and non-smokers. METHOD AND RESULTS: Using a high-resolution ultrasound, WT of posterior brachial artery wall, the diameter of brachial artery at rest and during reactive hyperemia (FMD %), as well as after sublingual administration of nitroglycerine (nitroglycerine mediated dilatation (NMD) %) was measured in 20 smokers and 20 non-smokers. Wall thickness (WT) of the posterior brachial artery wall and the wall index (WI) were greater in smokers than non-smokers. The baseline brachial artery diameter was comparable in smokers and non-smokers. Flow mediated dilation (FMD) was found to be less in smokers than non-smokers. The NMD in smokers also did not differ significantly from that in non-smokers. Flow mediated dilation significantly reduced after smoking compared to baseline in both groups. However, NMD remained unchanged after smoking in both groups. CONCLUSIONS: Increased WT and impaired endothelium-dependent dilatation of brachial artery suggests that cigarette smoking disrupts vessel wall morphology long before atherosclerosis is manifest.

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