Acute and Chronic Effects of Smoking on the Arterial Wall Properties and the Hemodynamics in Smokers with Hypertension

Rhee, Moo Yong

Abstract

BACKGROUND AND OBJECTIVES
Smoking increases cardiovascular risk and it is known to acutely increase arterial stiffness in healthy smokers. We investigated the acute and chronic effects of smoking on the arterial mechanics in smokers with hypertension.
SUBJECTS AND METHODS
To evaluate the acute effects of smoking, the heart rate (HR), brachial blood pressure (BP), ankle systolic BP, heart-carotid pulse wave velocity (hcPWV), heart-femoral PWV (hfPWV), femoral-ankle PWV (faPWV), heart-brachial PWV (hbPWV), and the ankle-brachial index (ABI) were measured in male hypertensive smokers (n=22, 42+/-2 years, mean+/-SEM) and in normotensive smokers (n=30, 39+/-1 years) before and 5, 10 and 15 minutes after smoking 1 cigarette (nicotine content: 0.9 mg). To evaluate the chronic effects of smoking, we compared the HR, brachial BP, PWVs, ABI and carotid intima-media thickness (IMT) between the normotensive smokers and nonsmokers (n=32, 37+/-1 years), and also between the hypertensive smokers and nonsmokers (n=21, 48+/-2 years).
RESULTS
Smoking induced significant acute increases of the HR, brachial BP and hfPWV in the normotensive and hypertensive smokers (p<0.05), and smoking also induced significant acute increases in the faPWV and ankle systolic BP in the hypertensive smokers (p<0.05). The ABI, hcPWV and hbPWV in both groups, and the faPWV of the normotensives were not changed after smoking 1 cigarette (p>0.05). The magnitude of the increase in the HR, brachial BP and hfPWV after smoking were not different between the hypertensive and normotensive smokers. There was no significant differences (p>0.05) between the chronic normotensive smokers and the nonsmokers, and also between the hypertensive smokers and the non-smokers.
CONCLUSION
Smoking acutely increased the HR, brachial BP and aortic stiffness in hypertensive smokers and normotensive smokers, and it had a more significant impact on the femoral arterial stiffness in the hypertensive smokers than in the normotensive smokers. However there were no significant chronic effects of smoking on the hemodynamics, arterial stiffness and carotid IMT. Our findings suggest that the acute increase in aortic and femoral arterial stiffness after smoking may contribute to the increased incidence of adverse cardiovascular events in smokers with hypertension.