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Effects of smoking and smoking cessation on endothelial function: 1-year outcomes from a randomized clinical trial

Heather M Johnson1, Linda K Gossett, Megan E Piper

  • 1University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.

Journal of the American College of Cardiology
|March 19, 2010
PubMed

Insights

Smoking cessation significantly improves endothelial function, specifically flow-mediated dilation (FMD) of the brachial artery. These improvements in vascular health persist long-term, contributing to reduced cardiovascular disease risk in former smokers.

Area of Science:

  • Cardiovascular Research
  • Endothelial Function Studies
  • Smoking Cessation Research

Background:

  • Long-term effects of smoking and cessation on endothelial function remain under-described.
  • Endothelial dysfunction is a key factor in smoking-related cardiovascular disease.

Purpose of the Study:

  • To determine if smoking cessation improves brachial artery flow-mediated dilation (FMD).
  • To assess the long-term impact of smoking cessation on endothelial function.

Main Methods:

  • A 1-year, prospective, double-blind, randomized, placebo-controlled trial involving 1,504 smokers.
  • Flow-mediated dilation (FMD) measured via B-mode ultrasonography; cessation verified by carbon monoxide levels.
  • Comparison of FMD changes between quitters and continued smokers; multivariable regression identified predictors of FMD.

Main Results:

  • 36.2% of participants successfully quit smoking after 1 year.
  • Flow-mediated dilation (FMD) increased significantly in quitters (6.2% to 7.2%, p=0.005), but not in those who continued smoking.
  • Improved FMD in quitters remained significant after controlling for confounding factors.

Conclusions:

  • Smoking cessation leads to sustained improvements in endothelial function, despite potential weight gain.
  • These vascular improvements may partially explain the reduced cardiovascular disease risk associated with quitting smoking.
  • Pharmacotherapies for smoking cessation are effective in improving endothelial health.
Abstract

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