Cigarette smoking is associated with an acute impairment of microvascular function in humans.

An effect on microvascular function has been proposed as a possible mechanism explaining the association of acute smoking with increased blood pressure and decreased insulin sensitivity. However, the effects of smoking on microvascular function have not been studied. We have investigated the acute effects of smoking on microvascular function in 12 healthy smokers. Before and after smoking a cigarette, we measured heart rate, blood pressure and capillary recruitment during peak reactive hyperaemia. We also measured endothelium-dependent and endothelium-independent vasodilatation of the skin microcirculation with iontophoresis of acetylcholine and sodium nitroprusside respectively combined with laser Doppler fluxmetry. To exclude non-specific changes, a control study with sham smoking was performed. The smoking and sham smoking studies were conducted in a randomized order. Compared with sham smoking, acute smoking caused increases in heart rate (smoking, 9.3+/-4.1 beats/min; sham, -1.3+/-3.0 beats/min; P < 0.001) and systolic blood pressure (smoking, 6.3+/-8.8 mmHg; sham, 0.8+/-4.4 mmHg; P < 0.05); decreases in absolute (smoking, -4.9+/-6.9 per mm(2); sham, 0.8+/-2.1 per mm(2); P = 0.01) and relative (smoking, -13.8+/-21.4%; sham, 1.9+/-6.9%; P = 0.02) capillary recruitment during peak reactive hyperaemia; and decreases in absolute [smoking, -62.4+/-47.7 perfusion units (PU); sham, -30.8+/-32.6 PU; P = 0.04] and relative (smoking, -147+/-163%; sham, 32+/-225%; P = 0.07) vasodilatation caused by acetylcholine. Absolute (smoking, -31.6+/-58.5 PU; sham, -8.4+/-44.0 PU; P = 0.3) and relative (smoking, -50.2+/-219.0%; sham, -17.1+/-139%; P = 0.7) vasodilatation caused by sodium nitroprusside were not affected. Thus acute smoking is associated with impaired capillary recruitment during peak reactive hyperaemia and impaired microvascular endothelium-dependent vasodilatation. These findings may explain the increased blood pressure and decreased insulin sensitivity that have been observed after acute smoking.

[1]  I. Gartside,et al.  Vitamin C modifies the cardiovascular and microvascular responses to cigarette smoke inhalation in man. , 2000, Clinical science.

[2]  C Bogardus,et al.  Skeletal muscle capillary density and fiber type are possible determinants of in vivo insulin resistance in man. , 1987, The Journal of clinical investigation.

[3]  H. Just,et al.  Antioxidant vitamin C improves endothelial dysfunction in chronic smokers. , 1996, Circulation.

[4]  S. Coppack,et al.  Endothelial Dysfunction: Cause of the Insulin Resistance Syndrome , 1997, Diabetes.

[5]  M. Winniford,et al.  Cigarette Smoking Increases Sympathetic Outflow in Humans , 1998 .

[6]  B. Waeber,et al.  Blunted vasodilatory responses in the cutaneous microcirculation of cigarette smokers. , 2001, American heart journal.

[7]  G. Parati,et al.  Persistent blood pressure increase induced by heavy smoking. , 1992, Journal of hypertension.

[8]  P. Raskin,et al.  Report of the expert committee on the diagnosis and classification of diabetes mellitus. , 1999, Diabetes care.

[9]  A. Frati,et al.  Acute Effect of Cigarette Smoking on Glucose Tolerance and Other Cardiovascular Risk Factors , 1996, Diabetes Care.

[10]  ChristodoulosStefanadis,et al.  Unfavorable Effect of Smoking on the Elastic Properties of the Human Aorta , 1997 .

[11]  A. Hudetz,et al.  Percolation phenomenon: the effect of capillary network rarefaction. , 1993, Microvascular research.

[12]  W. Mayhan,et al.  Effect of nicotine on endothelium-dependent arteriolar dilatation in vivo. , 1997, The American journal of physiology.

[13]  K. Kostner,et al.  Effects of vitamin E on chronic and acute endothelial dysfunction in smokers. , 2000, Journal of the American College of Cardiology.

[14]  K. Kugiyama,et al.  Cigarette smoke extract contracts isolated porcine coronary arteries by superoxide anion-mediated degradation of EDRF. , 1994, The American journal of physiology.

[15]  J. T. ter Maaten,et al.  Microvascular function relates to insulin sensitivity and blood pressure in normal subjects. , 1999, Circulation.

[16]  A. J. Honour,et al.  Direct arterial pressure, heart rate, and electrocardiogram during cigarette smoking in unrestricted patients. , 1975, American heart journal.

[17]  K. Kugiyama,et al.  Endothelium-dependent vasodilation in the brachial artery is impaired in smokers: effect of vitamin C. , 1997, The American journal of physiology.

[18]  J. T. ter Maaten,et al.  Capillary recruitment is impaired in essential hypertension and relates to insulin's metabolic and vascular actions. , 2001, Cardiovascular research.

[19]  J. Lekakis,et al.  Effects of acute cigarette smoking on endothelium-dependent arterial dilatation in normal subjects. , 1998, The American journal of cardiology.

[20]  A. Shore,et al.  Microvascular function in human essential hypertension. , 1994, Journal of hypertension.

[21]  Alan D. Lopez,et al.  Mortality from tobacco in developed countries: indirect estimation from national vital statistics , 1992, The Lancet.

[22]  W. Kannel,et al.  Smoking and hypertension as predictors of cardiovascular risk in population studies. , 1990, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[23]  C. Forrest,et al.  Effect of nicotine on vasoconstrictor and vasodilator responses in human skin vasculature. , 2001, American journal of physiology. Regulatory, integrative and comparative physiology.

[24]  A. Bergh,et al.  Cigarette smoke and hypoxia induce acute changes in testicular and celebral microcirculation , 2000, Upsala Journal of Medical Sciences.

[25]  T F Blaschke,et al.  Nicotine impairs endothelium‐dependent dilatation in human veins in vivo , 2000, Clinical pharmacology and therapeutics.

[26]  G. Yosipovitch,et al.  Chronic and Acute Effects of Cigarette Smoking on Skin Blood Flow , 1992, Angiology.

[27]  G. Mancia,et al.  Effects of cigarette smoking on carotid and radial artery distensibility , 1997, Journal of hypertension.

[28]  U. Smith,et al.  Smoking induces insulin resistance—a potential link with the insulin resistance syndrome , 1993, Journal of internal medicine.

[29]  G. Mancia,et al.  Acute effects of smoking on radial artery compliance in humans , 1994, Journal of hypertension.

[30]  A C Shore,et al.  Impaired microvascular dilatation and capillary rarefaction in young adults with a predisposition to high blood pressure. , 1997, The Journal of clinical investigation.

[31]  N. Markandu,et al.  Rarefaction of skin capillaries in borderline essential hypertension suggests an early structural abnormality. , 1999, Hypertension.

[32]  L. Ramsay,et al.  Effect of coffee and cigarette smoking on the blood pressure of patients with accelerated (malignant) hypertension. , 1995, Journal of human hypertension.

[33]  K. Kugiyama,et al.  Endothelium-dependent vasodilation in the brachial artery is impaired in smokers: effect of vitamin C. , 1997, American journal of physiology. Heart and circulatory physiology.

[34]  M. Reilly,et al.  Modulation of oxidant stress in vivo in chronic cigarette smokers. , 1996, Circulation.

[35]  P. Tonellato,et al.  Microvascular rarefaction and tissue vascular resistance in hypertension. , 1989, The American journal of physiology.

[36]  N. Benowitz.  Drug therapy. Pharmacologic aspects of cigarette smoking and nicotine addiction. , 1988, The New England journal of medicine.

[37]  R. C. Schultz,et al.  The Acute Effects of Cigarette Smoke Exposure on Experimental Skin Flaps , 1985, Plastic and reconstructive surgery.

[38]  J. T. ter Maaten,et al.  Impaired Skin Capillary Recruitment in Essential Hypertension Is Caused by Both Functional and Structural Capillary Rarefaction , 2001, Hypertension.

[39]  J. T. ter Maaten,et al.  Birth weight relates to blood pressure and microvascular function in normal subjects , 2000, Journal of hypertension.