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Predictors of the effects of smoking cessation on the endothelial function of conduit and digital vessels

Hypertension Research volume 44, pages 63–70 (2021)Cite this article

A Comment to this article was published on 22 October 2020

Abstract

Smoking predisposes individuals to endothelial dysfunction. Flow-mediated dilation (FMD) and reactive hyperemia peripheral artery tonometry (RH-PAT) are used to assess endothelial function. However, whether smoking cessation demonstrates comparable effects on endothelial function evaluated by FMD and RH-PAT remains unclear. Thus, we aimed to evaluate the effects of smoking cessation on endothelial function evaluated simultaneously by FMD and RH-PAT and clarify the factors associated with these effects. Fifty-eight consecutive current smokers (mean ± standard deviation; age, 64 ± 11 years) who visited our smoking cessation outpatient department and succeeded with smoking cessation were enrolled. Twenty-one continued smokers were enrolled as age- and sex-matched controls. Clinical variables, FMD, and natural logarithmic transformation of the reactive hyperemia index (Ln-RHI) were examined before and 20 weeks after treatment initiation. In 58 smokers who succeeded with smoking cessation, FMD significantly improved (3.80 ± 2.24 to 4.60 ± 2.55%; p = 0.013), whereas Ln-RHI did not (0.59 ± 0.28 to 0.66 ± 0.22; p = 0.092). Spearman’s rank correlation coefficient between changes in FMD and Ln-RHI was −0.004, and the intraclass correlation coefficient for a two-way mixed effects model was <0.001 (p = 0.499). In multivariate analysis, the presence of an increase in FMD was inversely correlated with the Brinkman index and changes in systolic blood pressure (SBP), whereas Ln-RHI was positively correlated with changes in SBP and inversely correlated with baseline body mass index. These factors may predict the varying effects of smoking cessation on the endothelial function of the conduit and digital vessels.

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References

  1. Teo KK, Ounpuu S, Hawken S, Pandey MR, Valentin V, Hunt D, et al. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study. Lancet. 2006;368:647–58.

    Article  Google Scholar 

  2. Kobayashi M, Takemoto Y, Norioka N, Iguchi T, Shimada K, Maeda M, et al. Vascular functional and morphological alterations in smokers during varenicline therapy. Osaka City Med J. 2015;61:19–30.

    CAS  PubMed  Google Scholar 

  3. Flammer AJ, Anderson T, Celermajer DS, Creager MA, Deanfield J, Ganz P, et al. The assessment of endothelial function—from research into clinical practice. Circulation. 2012;126:753–67.

    Article  Google Scholar 

  4. Hamburg NM, Keyes MJ, Larson MG, Vasan RS, Schnabel R, Pryde MM, et al. Cross-sectional relations of digital vascular function to cardiovascular risk factors in The Framingham Heart Study. Circulation. 2008;117:2467–74.

    Article  Google Scholar 

  5. Tomiyama H, Yoshida M, Higashi Y, Takase B, Furumoto T, Kario K, et al. Autonomic nervous activation triggered during induction of reactive hyperemia exerts a greater influence on the measured reactive hyperemia index by peripheral arterial tonometry than on flow-mediated vasodilation of the brachial artery in patients with hypertension. Hypertens Res. 2014;37:914–8.

    Article  Google Scholar 

  6. Allan RB, Delaney CL, Miller MD, Spark JI. A comparison of flow-mediated dilatation and peripheral artery tonometry for measurement of endothelial function in healthy individuals and patients with peripheral arterial disease. Eur J Vasc Endovasc Surg. 2013;45:263–9.

    Article  CAS  Google Scholar 

  7. Johnson HM, Gossett LK, Piper ME, Aechlimann SE, Korcarz CE, Baker TB, et al. Effects of smoking and smoking cessation on endothelial function: 1-year outcomes from a randomized clinical trial. J Am Coll Cardiol. 2010;55:1988–95.

    Article  CAS  Google Scholar 

  8. Xue C, Chen QZ, Bian L, Yin ZF, Xu ZJ, Zang AL, et al. Effects of smoking cessation with nicotine replacement therapy on vascular endothelial function, arterial stiffness, and inflammation response in healthy smokers. Angiology. 2019;70:719–25.

    Article  CAS  Google Scholar 

  9. Lavi S, Prasad A, Yan EH, Mathew V, Simari RD, Rihal CS, et al. Smoking is associated with epicardial coronary endothelial dysfunction and elevated white blood cell count in patients with chest pain and early coronary artery disease. Circulation. 2007;115:2621–7.

    Article  Google Scholar 

  10. Perkins KA, Karelitz JL, Jao NC. Optimal carbon monoxide criteria to confirm 24-hr smoking abstinence. Nicotine Tob Res. 2013;15:978–82.

    Article  CAS  Google Scholar 

  11. Cropsey KL, Trent LR, Clark CB, Stevens EN, Lahti AC, Hendricks PS. How low should you go? Determining the optimal cutoff for exhaled carbon monoxide to confirm smoking abstinence when using cotinine as reference. Nicotine Tob Res. 2004;16:1348–55.

    Article  Google Scholar 

  12. Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the international brachial artery reactivity task force. J Am Coll Cardiol. 2002;39:257–65.

    Article  Google Scholar 

  13. Iguchi T, Takemoto Y, Shimada K, Matsumoto K, Nakanishi K, Otsuka K, et al. Simultaneous assessment of endothelial function and morphology in the brachial artery using a new semiautomatic ultrasound system. Hypertens Res. 2013;36:691–7.

    Article  Google Scholar 

  14. McCrea CE, Skulas-Ray AC, Chow M, West SG. Test-retest reliability of pulse amplitude tonometry measures of vascular endothelial function: Implications for clinical trial design. Vasc Med. 2012;17:29–36.

    Article  Google Scholar 

  15. Hamburg NM, Palmisano J, Larson MG, Sullivan LM, Lehman BT, Vasan RS, et al. Relation of brachial and digital measures of vascular function in the community: the Framingham heart study. Hypertension. 2011;57:390–6.

    Article  CAS  Google Scholar 

  16. Lee DH, Ha MH, Kim JR, Jacobs JrDR. Effects of smoking cessation on changes in blood pressure and incidence of hypertension: a 4-year follow-up study. Hypertension. 2001;37:194–8.

    Article  CAS  Google Scholar 

  17. Greene SB, Aavedal MJ, Tyroler HA, Davis CE, Hames CG. Smoking habits and blood pressure change: a seven year follow up. J Chronic Dis. 1977;30:401–13.

    Article  CAS  Google Scholar 

  18. Schnabel RB, Schulz A, Wild PS, Sinning CR, Wilde S, Eleftheriadis M, et al. Noninvasive vascular function measurement in the community cross-sectional relations and comparison of methods. Circ Cardiovasc Imaging. 2011;4:371–80.

    Article  Google Scholar 

  19. Celermajer DS, Sorensen KE, Georgakopoulos D, Bull C, Thomas O, Robinson J, et al. Cigarette smoking is associated with dose-related and potentially reversible impairment of endothelium-dependent dilation in healthy young adults. Circulation. 1993;88:2149–55.

    Article  CAS  Google Scholar 

  20. Hosokawa S, Hiasa Y, Miyazaki S, Ogura R, Miyajima H, Ohara Y, et al. Effects of smoking cessation on coronary endothelial function in patients with recent myocardial infarction. Int J Cardiol. 2008;128:48–52.

    Article  Google Scholar 

  21. Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular diseases. J Am Coll Cardiol. 2004;43:1731–7.

    Article  CAS  Google Scholar 

  22. Kishimoto S, Matsumoto T, Maruhashi T, Iwamoto Y, Kajikawa M, Oda N, et al. Reactive hyperemia-peripheral arterial tonometry is useful for assessment of not only endothelial function but also stenosis of the digital artery. Int J Cardiol. 2018;260:178–83.

    Article  Google Scholar 

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Acknowledgements

This study was supported, in part, by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science and Culture of Japan (15K08649, 19K07943). We thank Ryoichi Kita and Yukie Imai for their excellent technical assistance.

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Authors and Affiliations

  1. Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan

    Kazuo Fukumoto, Yasuhiko Takemoto, Naoki Norioka, Hiroki Namikawa, Yoshihiro Tochino & Taichi Shuto

  2. Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan

    Yasuhiko Takemoto & Minoru Yoshiyama

  3. Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan

    Kanae Takahashi & Ayumi Shintani

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  1. Kazuo Fukumoto
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Correspondence to Yasuhiko Takemoto.

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Fukumoto, K., Takemoto, Y., Norioka, N. et al. Predictors of the effects of smoking cessation on the endothelial function of conduit and digital vessels. Hypertens Res 44, 63–70 (2021). https://doi.org/10.1038/s41440-020-0516-z

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