SHORT-TERM AND LONG-TERM EFFECTS OF SMOKING ON ARTERIAL-WALL PROPERTIES IN HABITUAL SMOKERS
SHORT-TERM AND LONG-TERM EFFECTS OF SMOKING ON ARTERIAL-WALL PROPERTIES IN HABITUAL SMOKERS
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DOI：
10.1016/0735-1097(93)90773-t
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发表时间：
1993-12-01
影响因子：
24
通讯作者：
VANBORTEL, LMAB
中科院分区：
文献类型：
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作者：
KOOL, MJF;HOEKS, APG;VANBORTEL, LMAB
目标。本研究调查了吸烟对习惯吸烟者的血流动力学功能以及大动脉的扩张性和顺应性的短期影响。此外，没有测量吸烟对非吸烟者的影响，但比较了吸烟者和非吸烟者（基础状态）之间的血管壁特性。 背景。吸烟是众所周知的动脉粥样硬化危险因素。大动脉扩张性和顺应性的丧失可能在动脉粥样硬化的发生中发挥作用。方法。颈总动脉和肱动脉的扩张性和顺应性系数是通过使用血管壁运动检测器根据收缩期间的动脉壁位移和舒张末期直径以及根据上臂评估的脉压来确定的。通过多普勒超声心动图测量心功能（心输出量、每搏输出量）。全身血管阻力计算为平均动脉压除以心输出量。结果。对于习惯吸烟的人来说，吸一支烟会导致血压（6%）和心率（14%）急剧上升。心脏指数增加（16%），主要是因为心率明显增加。卒中和全身血管阻力指标没有显着变化。手腕咬合后吸烟增强了前臂血流量（17%），但前臂总血流量没有变化，表明肌肉血流量增加，皮肤血流量减少。由于血压升高，有弹性的颈总动脉直径增加了3%（被动现象）。颈动脉的扩张性下降（7%），因此颈动脉顺应性得以保留。相反，尽管血压较高，但肌性肱动脉的直径没有变化，表明血管张力增加。肱骨扩张性和顺应性下降（分别为 18% 和 19%）。习惯吸烟者在血压、心脏功能、血管阻力和大动脉血管壁特性方面与不吸烟者相当。习惯吸烟者的心率较高（14%）。结论。这些数据表明，对于习惯吸烟的人来说，吸一支烟会导致动脉壁硬度短期增加，这可能对动脉有害，并增加斑块破裂的风险。除了心率较高外，没有观察到吸烟对血流动力学变量和动脉僵硬度有明显的长期影响。由于急性心血管事件主要是由斑块破裂引起，因此吸烟的短期影响可能比这些急性缺血事件的长期影响更重要。
Objectives. This study investigated the short term effects of smoking on hemodynamic function and distensibility and compliance of large arteries in habitual smokers. In addition, the effect of smoking was not measured in nonsmokers, but vessel wall properties were compared between smokers and nonsmokers (basal state).Background. Smoking is a well known risk factor for atherosclerosis. Loss of distensibility and compliance of large arteries may play a role in the onset of atherosclerosis.Methods. The distensibility and compliance coefficients of the common carotid and brachial arteries were determined from the arterial wall displacement during systole and the end-diastolic diameter by using a vessel wall movement detector and from the pulse pressure as assessed in the upper arm. Cardiac function (cardiac output, stroke volume) was measured with Doppler echocardiography. Systemic vascular resistance was calculated as mean arterial pressure divided by cardiac output.Results. In habitual smokers, smoking one cigarette caused a sharp increase in blood pressure (6%) and heart rate (14%). Cardiac index increased (16%), mainly because of the marked increase in heart rate. Stroke and systemic vascular resistance indexes did not change significantly. Smoking enhanced forearm blood flow after wrist occlusion (17%), but total forearm blood how was unchanged, suggesting an increase in muscle blood how and a decrease in skin flow. Because of higher blood pressure, the diameter of the elastic common carotid artery increased by 3% (passive phenomenon). Distensibility of the carotid artery decreased (7%), and as a result, carotid compliance was preserved. In contrast, despite higher blood pressure, the diameter of the muscular brachial artery did not change, suggesting an increased vascular tone. Brachial distensibility and compliance decreased (18% and 19%, respectively). Habitual smokers were comparable to nonsmokers with regard to blood pressure, cardiac function, vascular resistance and vessel wall properties of large arteries. Heart rate was higher in habitual smokers (14%).Conclusions. These data indicate that in habitual smokers, smoking one cigarette causes short-term increases in arterial wall stiffness that might be harmful to the artery and increase the risk for plaque rupture. Except for a higher heart rate, no obvious long-term effect of smoking was observed on hemodynamic variables and arterial stiffness. Because acute cardiovascular events are mainly due to plaque rupture, the short-term effects of smoking might be a more important risk than long-term effects for these acute ischemic events.