Short communication| Volume 240, ISSUE 2, P330-332, June 2015

Effect of smoking on endothelium-independent vasodilatation


      • Whether smoking impairs endothelium-independent vasodilatation is doubtful.
      • Previous studies used high doses of nitrates to assess nitrate-mediated dilation (NMD).
      • An early impairment of NMD in smokers was shown by low doses of nitroglycerin (NTG).
      • A dose of 30 μg of NTG seems the most useful to identify impaired NMD.



      Smoking induces an impairment of endothelium-dependent vasodilatation. In this study we assessed whether smoking also causes an impairment of endothelium-independent vasodilatation.


      We studied 2 groups of young healthy subjects: 1) 12 medical students (24.5 ± 0.9 years; 6 male) without cardiovascular risk factors (CVRFs), except smoking (≥10 cigarettes/day); 2) 12 matched controls (24.5 ± 1.1 years; 6 male) without any CVRF. Nitrate-mediated dilatation (NMD) of the brachial artery was assessed in response to the random administration of 4 different doses (10, 20, 30 and 40 μg) of sublingual nitroglycerin (NTG). Flow-mediated dilatation (FMD) was also assessed.


      The increasing doses of NTG determined a progressive increase of NMD in both groups, but the dose–response curve was significantly lower in smokers compared to controls (p < 0.001). FMD was also lower in smokers, compared to controls (6.12 + 0.6 vs. 8.06 + 0.9%, p < 0.001).


      Our data show that smoking induces an early impairment of endothelium-independent arterial dilatation.


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        • Celermajer D.S.
        • Sorensen K.E.
        • Georgakopoulos D.
        • et al.
        Cigarette smoking is associated with dose-related and potentially reversible impairment of endothelium-dependent dilation in healthy young adults.
        Circulation. 1993; 88: 2149-2155
        • Zeiher A.M.
        • Schächinger V.
        • Minners J.
        Long-term cigarette smoking impairs endothelium-dependent coronary arterial vasodilator function.
        Circulation. 1995; 92: 1094-1100
        • McVeigh G.E.
        • Lemay L.
        • Morgan D.
        • et al.
        Effects of long-term cigarette smoking on endothelium-dependent responses in humans.
        Am. J. Cardiol. 1996; 78: 668-672
        • Lekakis J.
        • Papamichael C.
        • Vemmos C.
        • et al.
        Effect of acute cigarette smoking on endothelium-dependent brachial artery dilatation in healthy individuals.
        Am. J. Cardiol. 1997; 79: 529-531
        • Ozaki K.
        • Hori T.
        • Ishibashi T.
        • et al.
        Effects of chronic cigarette smoking on endothelial function in young men.
        J. Cardiol. 2010; 56: 307-313
        • Thorne S.
        • Mullen M.J.
        • Clarkson P.
        • Donald A.E.
        • Deanfield J.E.
        Early endothelial dysfunction in adults at risk from atherosclerosis: different responses to L-arginine.
        J. Am. Coll. Cardiol. 1998; 32: 110-116
        • Poredos P.
        • Orehek M.
        • Tratnik E.
        Smoking is associated with dose-related increase of intima-media thickness and endothelial dysfunction.
        Angiology. 1999; 50: 201-208
        • Esen A.M.
        • Barutcu I.
        • Acar M.
        • et al.
        Effect of smoking on endothelial function and wall thickness of brachial artery.
        Circ. J. 2004; 68: 1123-1126
        • Ghiadoni L.
        • Faita F.
        • Salvetti M.
        • et al.
        Assessment of flow-mediated dilation reproducibility: a nationwide multicenter study.
        J. Hypertens. 2012; 30: 1399-1405
        • Nerla R.
        • Tarzia P.
        • Sestito A.
        • et al.
        Effect of bariatric surgery on peripheral flow-mediated dilation and coronary microvascular function.
        Nutr. Metab. Cardiovasc Dis. 2012; 22: 626-634
        • Gemignani V.
        • Faita F.
        • Ghiadoni L.
        • et al.
        A system for real-time measurement of the brachial artery diameter in B-mode ultrasound images.
        IEEE Trans. Med. Imaging. 2007; 26: 393-404
        • Adams M.R.
        • Robinson J.
        • McCredie R.
        • et al.
        Smooth muscle dysfunction occurs independently of impaired endothelium-dependent dilation in adults at risk of atherosclerosis.
        J. Am. Coll. Cardiol. 1998; 32: 123-127
        • Maruhashi T.
        • Soga J.
        • Fujimura N.
        • et al.
        Nitroglycerine-induced vasodilation for assessment of vascular function: a comparison with flow-mediated vasodilation.
        Arterioscler. Thromb. Vasc. Biol. 2013; 33: 1401-1408
        • Raitakiri O.T.
        • Seale J.P.
        • Celermajer D.S.
        Impaired vascular resposnes to nitroglycerin in subjects with coronary atherosclerosis.
        Am. J. Cardiol. 2001; 87: 217-219
        • Verbeuren T.J.
        • Jordaens F.H.
        • Van Hove C.E.
        • et al.
        Release and vascular activity of endothelium-derived relaxing factor in atherosclerotic rabbit aorta.
        Eur. J. Pharmacol. 1990; 191: 173-184
        • Sorensen K.E.
        • Kristensen I.B.
        • Celermajer D.S.
        Atherosclerosis in the human brachial artery.
        J. Am. Coll. Cardiol. 1997; 29: 318-322
        • Raij L.
        • DeMaster E.G.
        • Jaimes E.A.
        Cigarette smoke-induced endothelium dysfunction: role of superoxide anion.
        J. Hypertens. 2001; 19: 891-897
        • Morrow J.D.
        • Frei B.
        • Longmire A.W.
        • et al.
        Increase in circulating products of lipid peroxidation (F2-isoprostanes) in smokers. Smoking as a cause of oxidative damage.
        N. Engl. J. Med. 1995; 332: 1198-1203