1
|
Garu A, Nitta E, Yoshida Y, Yata E, Tsunematsu A, Araki T, Nagai A, Yano S. Does overnight duty affect vascular endothelial function? BMC Cardiovasc Disord 2021; 21:467. [PMID: 34579658 PMCID: PMC8474775 DOI: 10.1186/s12872-021-02277-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The reactive hyperemia index (RHI), which is obtained from the measurement of peripheral arterial tonometry (PAT), is highly associated with the percentage change in the end-diastolic arterial diameter (%flow-mediated dilatation) at reactive hyperemia. Low RHI is reported to be a mortality risk in patients with a high risk of cardiovascular (CV) disease. CV events are thought to be induced by physical and mental stress, including long-term fatigue and lack of sleep. However, the relationship between fatigue, lack of sleep, and endothelial function has not yet been established. METHODS Healthy hospital workers (n = 13, 6 men and 7 women) with an average age of 31.6 years were assigned to this study after they provided written informed consent. During the study period, we conducted 72 measurements of reactive hyperemia-peripheral arterial tonometry (RH-PAT) in the morning before or after their duty. At each measurement of the RH-PAT, we recorded the participants' hours of sleep and evaluated their degree of fatigue using a visual analog scale (VAS). RESULTS Although the VAS was significantly less (36 ± 16% and 64 ± 12%, p < 0.001) and the hours of sleep were longer (6.0 ± 1.1 h and 2.3 ± 1.0 h, p < 0.001) before duty compared to those after duty, the RHI was comparable between them (2.12 ± 0.53 vs. 1.97 ± 0.50, p = 0.21). The VAS score was significantly higher in participants with low RHI (< 1.67) than in those with normal RHI (≥ 2.07) (59 ± 13% and 46 ± 21%, respectively, p < 0.05). However, binary logistic regression showed no significant association between low RHI and the VAS when adjusted for systemic blood pressure (SBP) and heart rate variability (HRV). In a simple regression analysis, the RHI was significantly correlated with the VAS score but not with sleep duration. A multiple linear regression analysis also showed no significant association between the RHI and VAS scores after adjustment for SBP and HRV. CONCLUSIONS Vascular endothelial function was not associated with overnight duty, hours of sleep, or degree of fatigue in healthy young adults. Since the RHI may be decreased in severe fatigue conditions through autonomic nerve activity, one should consider the physical and mental conditions of the examinee when evaluating the RH-PAT results.
Collapse
Affiliation(s)
- A Garu
- Department of Neurology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Eri Nitta
- Department of Clinical Laboratory Medicine, Shimane University Hospital, Shimane, Japan
| | - Yuri Yoshida
- Department of Clinical Laboratory Medicine, Shimane University Hospital, Shimane, Japan
| | - Erika Yata
- Department of Clinical Laboratory Medicine, Shimane University Hospital, Shimane, Japan
| | - Akari Tsunematsu
- Department of Clinical Laboratory Medicine, Shimane University Hospital, Shimane, Japan
| | - Tsuyoshi Araki
- Department of Clinical Laboratory Medicine, Shimane University Hospital, Shimane, Japan
| | - Atsushi Nagai
- Department of Neurology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Shozo Yano
- Department of Clinical Laboratory Medicine, Shimane University Hospital, Shimane, Japan. .,Department of Laboratory Medicine, Faculty of Medicine, Shimane University, Shimane, Japan.
| |
Collapse
|
2
|
Dong R, Lv Q, Gao Y, He C, Tan S, Zhang M, Zhou T. Carotid artery blood velocity decreases in patients with coronary slow flow: A manifestation of systemic arteriosclerosis. Echocardiography 2019; 36:2234-2240. [PMID: 31755583 DOI: 10.1111/echo.14540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 10/08/2019] [Accepted: 10/25/2019] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Coronary slow flow phenomenon (CSFP) could be a manifestation of systemic arteriosclerosis, as coronary and carotid arteries have similar intimal thickening. However, as an initial cause of arteriosclerosis, hemodynamic changes in carotid arteries have rarely been studied. METHODS Twenty patients with angiography-proven CSFP and 39 patients with normal coronary flow (NCF) were enrolled. TIMI frame counts (CTFC) were investigated. Carotid intima-media thickness (CIMT), peak systolic velocity (PSV), and end-diastolic velocity (EDV) were measured by ultrasonography, and shear rate (SR) and resistance index (RI) were calculated. RESULTS The results showed that PSV, EDV, SR, and RI were significantly lower in patients with CSFP (p<0.01), but CIMT was significantly increased (P < 0.01). PSV, EDV, SR, and RI were negatively correlated with CTFC, while CIMT was positively correlated with CTFC. Logistic regression analysis revealed that PSV (OR = 0.95, P < 0.01) could be an independent protective factor against CSFP, but CIMT (OR = 1.10, P < 0.05) and male gender (OR = 9.89, P < 0.01) could be risk factors for CSFP. CONCLUSIONS The slow flow phenomenon was observed in both coronary and carotid arteries, which could be a characteristic manifestation of systemic arteriosclerosis in CSFP; the lower wall shear stress may be the underlying mechanism. Carotid ultrasound could be applied in the noninvasive diagnosis of CSFP in the future.
Collapse
Affiliation(s)
- Rui Dong
- Department of Cardiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Qian Lv
- Department of Cardiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yannan Gao
- Department of Cardiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Caiyun He
- Department of Cardiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Siyuan Tan
- Department of Cardiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Mingyu Zhang
- Department of Cardiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Tao Zhou
- Department of Cardiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| |
Collapse
|
3
|
Zhou Z, Chen P, Peng H. Are healthy smokers really healthy? Tob Induc Dis 2016; 14:35. [PMID: 27891067 PMCID: PMC5111288 DOI: 10.1186/s12971-016-0101-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/10/2016] [Indexed: 12/21/2022] Open
Abstract
Cigarette smoke contains more than 4500 chemicals which have toxic, mutagenic and carcinogenic effects. Strong evidences have shown that current smokers take a significantly higher risk of cardiovascular diseases, chronic obstructive pulmonary disease (COPD) and lung cancer than nonsmokers. However, less attention has been paid to the smoking induced abnormalities in the individuals defined as healthy smokers who are normal with spirometry, radiographic images, routine physical exam and categorized as healthy control group in many researches. Actually, ‘healthy smokers’ are not healthy. This narrative review focuses on the smoking related pathophysiologic changes mainly in the respiratory system of healthy smokers, including inflammation and immune changes, genetic alterations, structural changes and pulmonary dysfunction.
Collapse
Affiliation(s)
- Zijing Zhou
- Department of Respiratory Medicine, the Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, Hunan 410011 People's Republic of China
| | - Ping Chen
- Department of Respiratory Medicine, the Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, Hunan 410011 People's Republic of China
| | - Hong Peng
- Department of Respiratory Medicine, the Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, Hunan 410011 People's Republic of China
| |
Collapse
|
4
|
Sapper TN, Mah E, Ahn-Jarvis J, McDonald JD, Chitchumroonchokchai C, Reverri EJ, Vodovotz Y, Bruno RS. A green tea-containing starch confection increases plasma catechins without protecting against postprandial impairments in vascular function in normoglycemic adults. Food Funct 2016; 7:3843-53. [PMID: 27494176 PMCID: PMC6378873 DOI: 10.1039/c6fo00639f] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Postprandial hyperglycemia (PPH) increases cardiovascular disease risk regardless of glucose intolerance by transiently impairing vascular endothelial function (VEF) by limiting nitric oxide bioavailability in an oxidative stress-dependent manner. Preclinical studies show that green tea catechins attenuate PPH by inhibiting starch digestion. We hypothesized that a starch-based confection containing catechin-rich green tea extract (GTE) would limit PPH-mediated impairments in VEF in normoglycemic adults. We formulated a unique GTE confection and then conducted a double-blind, randomized, controlled, crossover study in healthy men (n = 15; 25.3 ± 1.0 years; 22.4 ± 1.8 kg m(-2)) in which they ingested starch confections (50 g carbohydrate) formulated with or without GTE (1 g) prior to evaluating sensory characteristics of confections and plasma glucose, biomarkers of lipid peroxidation and nitric oxide homeostasis, and brachial artery flow-mediated dilation (FMD) at 30 min intervals for 3 h. Sensory evaluation of confections indicated acceptable consumer appeal and an inability to distinguish between confections regardless of GTE. Plasma catechins concentrations increased following ingestion of the GTE confection. However, plasma glucose peaked at 60 min (P < 0.05) following confection ingestion and was unaffected throughout the postprandial period by the GTE confection (P > 0.05). FMD was significantly decreased only at 60 min regardless of confections containing GTE. Also at 60 min, both confections similarly increased plasma malondialdehyde while decreasing arginine and increasing asymmetric dimethylarginine/arginine. The successfully formulated GTE-containing confection effectively delivered catechins, but without mitigating PPH-mediated impairments in VEF in association with oxidative stress that likely limits nitric oxide bioavailability.
Collapse
Affiliation(s)
- Teryn N Sapper
- Human Nutrition Program, The Ohio State University, Columbus, Ohio 43210, USA.
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Nordskog BK, Brown BG, Marano KM, Campell LR, Jones BA, Borgerding MF. Study of cardiovascular disease biomarkers among tobacco consumers, part 2: biomarkers of biological effect. Inhal Toxicol 2015; 27:157-66. [PMID: 25787701 PMCID: PMC4496813 DOI: 10.3109/08958378.2015.1013227] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
An age-stratified, cross-sectional study was conducted in the US among healthy adult male cigarette smokers, moist snuff consumers, and non-tobacco consumers to evaluate cardiovascular biomarkers of biological effect (BoBE). Physiological assessments included flow-mediated dilation, ankle-brachial index, carotid intima-media thickness and expired carbon monoxide. Approximately one-half of the measured serum BoBE showed statistically significant differences; IL-12(p70), sICAM-1 and IL-8 were the BoBE that best differentiated among the three groups. A significant difference in ABI was observed between the cigarette smokers and non-tobacco consumer groups. Significant group and age effect differences in select biomarkers were identified.
Collapse
Affiliation(s)
- Brian K Nordskog
- R.J. Reynolds Tobacco Company , Winston-Salem, NC 27102 , USA and
| | | | | | | | | | | |
Collapse
|
6
|
Bentur L, Hellou E, Goldbart A, Pillar G, Monovich E, Salameh M, Scherb I, Bentur Y. Laboratory and Clinical Acute Effects of Active and Passive Indoor Group Water-Pipe (Narghile) Smoking. Chest 2014; 145:803-809. [DOI: 10.1378/chest.13-0960] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
7
|
Athyros VG, Katsiki N, Doumas M, Karagiannis A, Mikhailidis DP. Effect of tobacco smoking and smoking cessation on plasma lipoproteins and associated major cardiovascular risk factors: a narrative review. Curr Med Res Opin 2013; 29:1263-74. [PMID: 23879722 DOI: 10.1185/03007995.2013.827566] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cigarette smoking, active or passive, kills about 6 million people each year worldwide. Cardiovascular disease (CVD) is responsible for 40% of all smoking-related deaths, lung cancer accounts for 20% of all smoking-related deaths, and chronic obstructive pulmonary disease is related to another 20% of deaths. In this narrative review we consider the relationship between cigarette smoking and CVD. We discuss disease states and/or CVD risk factors related to smoking, such as dyslipidaemia, vascular inflammation, endothelial dysfunction, arterial stiffness, insulin resistance, type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and non-alcoholic fatty liver disease (NAFLD) as well as their complex interrelations. Smoking cessation can correct abnormalities related to smoking; however, success rates are relatively low. In cases of inability to quit, measures to minimize the adverse effects of smoking specifically related to CVD should be taken. Smokers should receive best practice treatment, according to guidelines, as for non-smokers.
Collapse
Affiliation(s)
- Vassilios G Athyros
- Second Prop. Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital , Thessaloniki , Greece
| | | | | | | | | |
Collapse
|
8
|
Mendes ES, Cancado JED, Rebolledo P, Arana J, Parker M, Gonzalez A, Hurwitz BE, Wanner A. Airway Vascular Endothelial Function in Healthy Smokers Without Systemic Endothelial Dysfunction. Chest 2013; 143:1733-1739. [DOI: 10.1378/chest.12-1033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
9
|
Cakmak G, Alkan FA, Korkmaz K, Saglam ZA, Karis D, Yenigun M, Ercan M. Blood viscosity as a forgotten factor and its effect on pulmonary flow. TRANSLATIONAL RESPIRATORY MEDICINE 2013; 1:3. [PMID: 27234385 PMCID: PMC6733503 DOI: 10.1186/2213-0802-1-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 01/09/2013] [Indexed: 11/15/2022]
Abstract
Background The effect of smoking on blood viscosity is widely known. There are, however, few studies on the effect of blood viscosity on pulmonary circulation. Methods We aimed to observe the relationship between blood viscosity and pulmonary circulation among smokers and non-smokers. The study comprised 114 subjects in three groups: group 1, ex-smokers; group 2, smoked at least 10 packs/year and still smoking; group 3, never smoked. Blood viscosity (BV), pulmonary blood flow (PBF), and right ventricular systolic pressure (RVSP) were measured in all subjects. Results PBF was significantly lower in group 1 compared with group 3 (p < 0.05). BV in group 1 was significantly higher than group 3 (p < 0.05) while BV in group 2 was significantly higher than group 3 (p < 0.05). PBF in group 2 was significantly lower than group 3 (p = 0.01). Conclusions We believe that BV is a significant and forgotten factor that plays an important role in pulmonary and cardiovascular diseases. BV may affect PF even during the course of smoking, and before the clinical onset of chronic obstructive pulmonary disease (COPD). Therefore, individuals at risk of pulmonary hypertension could be detected earlier with a simple blood test.
Collapse
Affiliation(s)
- Gulfidan Cakmak
- Department of Chest Disease, Haseki Training and Research Hospital, Millet St Fatih, Istanbul, 34096, Turkey.
| | - Fatma Ates Alkan
- Department of Biophysics, Istanbul University Cerrahpasa Medical Faculty, Fatih, Istanbul, 34098, Turkey
| | - Kazim Korkmaz
- Department of Cardiology Disease, Haseki Training and Research Hospital, Millet St Fatih, Istanbul, 34096, Turkey
| | - Zuhal Aydan Saglam
- Department of Family Practitioners, Haseki Training and Research Hospital, Millet St Fatih, Istanbul, 34096, Turkey
| | - Denizhan Karis
- Department of Biophysics, Istanbul University Cerrahpasa Medical Faculty, Fatih, Istanbul, 34098, Turkey
| | - Mustafa Yenigun
- Department of Internal Disease, Haseki Training and Research Hospital, Millet St Fatih, Istanbul, 34096, Turkey
| | - Meltem Ercan
- Department of Biophysics, Istanbul University Cerrahpasa Medical Faculty, Fatih, Istanbul, 34098, Turkey
| |
Collapse
|
10
|
Barbarash NA, Kuvshinov DY, Chichilenko MV, Kolesnikov AO. Nitric oxide and human aging. ADVANCES IN GERONTOLOGY 2012. [DOI: 10.1134/s2079057012010043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
11
|
Kubozono T, Miyata M, Ueyama K, Hamasaki S, Kusano K, Kubozono O, Tei C. Acute and Chronic Effects of Smoking on Arterial Stiffness. Circ J 2011; 75:698-702. [DOI: 10.1253/circj.cj-10-0552] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Takuro Kubozono
- Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
| | - Masaaki Miyata
- Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
| | - Kiyo Ueyama
- Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
| | - Shuichi Hamasaki
- Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
| | - Ken Kusano
- JA Kagoshima Kouseiren Medical Health Care Center
| | | | - Chuwa Tei
- Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
| |
Collapse
|
12
|
Shimada S, Hasegawa K, Wada H, Terashima S, Satoh-Asahara N, Yamakage H, Kitaoka S, Akao M, Shimatsu A, Takahashi Y. High blood viscosity is closely associated with cigarette smoking and markedly reduced by smoking cessation. Circ J 2010; 75:185-9. [PMID: 21071876 DOI: 10.1253/circj.cj-10-0335] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cigarette smoking is an independent risk factor for cardiovascular events such as myocardial infarction and stroke. To date, a useful and convenient method of predicting such events in smokers has not been established. The rheological properties of blood assessed by the microchannel method reflect the blood's viscosity and the state of microthrombus formation, which may predict cardiovascular thrombotic events. METHODS AND RESULTS Blood fluidity was assessed in 74 smoking patients (54 men, 20 women, mean age 57.9 years) by measuring the blood passage time (BPT) in an aliquot (100 µl) of blood using the Micro Channel Array Flow Analyzer. BPT was significantly related with smoking variables such as daily consumption of tobacco (r = 0.236, P = 0.044), Brinkman's index (r = 0.252, P = 0.033), the Fagerstrom Test for Nicotine Dependence (r = 0.257, P = 0.029), and the score of a self-rating depression scale (r = 0.236, P < 0.05). Multivariate regression analysis revealed that an independent BPT determinant was daily consumption of tobacco (r = 0.326, P = 0.045). Furthermore, smoking cessation markedly decreased BPT from 63.0 s to 49.7 s (P = 0.002) at 3 months after the start of therapy. CONCLUSIONS Unfavorable blood rheology is closely associated with cigarette smoking and may reflect increased cardiovascular risk in smokers. The study results also suggest that such risk can be reduced after only 3 months of smoking cessation.
Collapse
Affiliation(s)
- Sayaka Shimada
- Clinical Research Institute, Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Kayrak M, Bacaksiz A, Vatankulu MA, Ayhan SS, Taner A, Unlü A, Yazici M, Ulgen MS. Association between exaggerated blood pressure response to exercise and serum asymmetric dimethylarginine levels. Circ J 2010; 74:1135-41. [PMID: 20453387 DOI: 10.1253/circj.cj-09-0419] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The exaggerated blood pressure response to exercise (EBPR) is an independent predictor of hypertension. Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide inhibitor and higher plasma levels of ADMA are related to increased cardiovascular risk. The aim of this study is to identify the relationship between ADMA and EBPR. METHODS AND RESULTS A total of 66 patients (36 with EBPR and 30 as controls) were enrolled in the study. EBPR is defined as blood pressure (BP) measurements > or =200/100 mmHg during the treadmill test. All the subjects underwent 24-h ambulatory BP monitoring. L-arginine and ADMA levels were measured using a high performance lipid chromatography technique. The serum ADMA levels were increased in the EBPR group compared to the healthy controls (4.0+/-1.4 vs 2.6+/-1.1 micromol/L respectively, P=0.001), but L-arginine levels were similar in the 2 groups (P=0.19). The serum ADMA levels were detected as an independent predictor of EBPR (odds ratio 2.28; 95% confidence interval 1.22-4.24; P=0.002). CONCLUSIONS Serum ADMA levels might play a role in EBPR to exercise.
Collapse
Affiliation(s)
- Mehmet Kayrak
- Department of Cardiology, Selcuk University Meram School of Medicine Hospital, Meram, Konya, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
14
|
|
15
|
Tsukahara H, Noda K, Saku K. A randomized controlled open comparative trial of varenicline vs nicotine patch in adult smokers: efficacy, safety and withdrawal symptoms (the VN-SEESAW study). Circ J 2010; 74:771-8. [PMID: 20154405 DOI: 10.1253/circj.cj-09-0803] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND It has been suggested that anti-smoking therapy gives encouraging results, but this has not been verified by well-randomized study protocols. The present study was a randomized controlled trial of varenicline vs nicotine patch in adult smokers for comparison of efficacy, safety and withdrawal symptoms. METHODS AND RESULTS The 32 adult smokers were randomly divided into a varenicline group (VG, n=16) and a nicotine patch group (NG, n=16). The primary endpoints were the 12- and 24-week smoking-abstinence rates, safety and withdrawal symptoms including stress. No significant difference in abstinence rates was observed between the 2 groups over weeks 9-12 (71.4% vs 78.6% in the VG and NG, respectively), and weeks 9-24 (64.3% vs 71.4%, respectively). The frequencies of inability to concentrate at 2, 4, and 8 weeks, and wakeful nights at 2 weeks were higher in the VG than in the NG. Adverse side-effects associated with a gastrointestinal disorder occurred in 14 cases and 1 case in the VG and NG, respectively, and skin allergy was seen in 0 and 9 cases, respectively. CONCLUSIONS The selection of treatment depends on the balance of desired acuteness of cessation of smoking and side-effects, such as psychiatric and gastrointestinal problems or skin allergy.
Collapse
Affiliation(s)
- Hitomi Tsukahara
- Department of Clinical and Applied Science, Graduate School of Medical Sciences, Fukuoka University, Fukuoka, Japan
| | | | | |
Collapse
|
16
|
Tamura Y, Naemura A, Inoue A, Ijiri Y, Seki J, Yada T, Goto M, Shinohara M, Kawashima S, Giddings JC, Yamamoto J. Impaired endothelial function may be due to decreased aortic tetrahydrobiopterin, assessed by a new flow-mediated vasodilation in vivo in hypercholesterolemic/atherogenic mice. Blood Coagul Fibrinolysis 2009; 20:699-705. [PMID: 19741507 DOI: 10.1097/mbc.0b013e328331fd18] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Tetrahydrobiopterin (BH4) is an important cofactor for endothelial nitric oxide synthase activity. The relationship between endothelial function in vivo and aortic BH4 level is not fully understood, however. In the present study, we aimed to clarify whether reduction of aortic BH4 levels contributes to endothelial dysfunction in vivo using spontaneously hyperlipidemic mice. To estimate endothelial function in vivo and in real-time state, we developed a flow-mediated vasodilation (FMV) method in mice, which measured changes in the diameter of the femoral artery in response to increased blood flow. C57BL/6 mice and apoE/low-density lipoprotein receptor double knock-out mice were fed a low-fat diet (LFD) or a high-fat diet (HFD) for 12 weeks from 6 weeks of age. HFD feeding impaired FMV in double knock-out mice, but not in C57BL/6 mice. Furthermore, HFD feeding reduced plasma NOx concentration and aortic BH4 level in double knock-out mice. Conversely, exogenous injection of BH4 (2 mg/kg) markedly increased aortic BH4 levels and restored endothelial function. In conclusion, we demonstrated that HFD feeding impaired nitric oxide-mediated endothelial function and reduced BH4 level in vivo, and that acute augmentation of aortic BH4 levels improved endothelial function. These findings indicate that BH4 is a critical determinant of nitric oxide-mediated endothelial function in hypercholesterolemia.
Collapse
Affiliation(s)
- Yukinori Tamura
- Laboratory of Physiology, Faculty of Nutrition, Kobe Gakuin University, Kobe, Japan.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Affiliation(s)
- Jiang Xie
- School of Public Health and Family Medicine, Capital University of Medical Sciences
| | - Dayi Hu
- School of Public Health and Family Medicine, Capital University of Medical Sciences
| | - Xian Wang
- Cardiovascular Center of Beijing Army General Hospital
| | - Yali Luo
- Institute of Basic Medicine, Capital University of Medical Sciences
| | - Jinwen Wang
- Cardiovascular Center of Beijing Army General Hospital
| |
Collapse
|