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Forearm endothelial response in smokeless tobacco users compared with cigarette smokers and nonusers of tobacco
Mark C Granberry1, Eugene S Smith, Rhonda D Troillett
1Cooperative Pharmacy Program, College of Health Sciences and Human Services, University of Texas-Pan American, Edinburg, Texas 78539, USA.
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.
