Cigarette smoking is associated with consistent changes in small arteries and arterioles. Recently, arterial compliance was determined in smokers; however, the effect of smoking cessation on arterial compliance has not yet been investigated. The objective of the study was to assess how smoking cessation, achieved with use of behavioral and pharmacologic therapy, influences vascular compliance and arterial stiffness in smokers. In an open-label study, 60 habitual smokers were treated for 2 months with buproprion 300 mg per day and personal and group conversations in order to facilitate smoking cessation. Hemodynamic variables, including vascular compliance and augmentation index (AI), were measured twice, at the beginning of the study and after 6 months. Of the 60 smokers, 35 stopped smoking and 25 failed at the end of the 2-month treatment period. Of the 35 who were initially successful, 12 went back to smoking, and thus only 23 remained nonsmokers at the end of 6 months. Smoking cessation was accompanied by significantly lower arterial pressure and heart rate but by weight gain. Among the 23 subjects who stopped smoking for 6 months capacitive compliance (C(1)) did not change but oscillatory compliance (C(2)) rose significantly (from 5.1 +/-2.3 to 6.3 +/-3.0 p<0.01), and AI decreased significantly (from 63.1 +/-22 to 50.6 +/-17 p<0.05), whereas in smokers who still smoked after this period, both C(1) and C(2) and augmentation index did not change significantly from their basal values. The authors conclude that smoking cessation improves arterial stiffness as assessed by the augmentation index, owing mainly to increasing the small artery compliance, which is known to be an early index of endothelial damage.
Thrombosis is the major complication of Polycythemia Vera (PV) and the main cause of morbidity and mortality. Hypercoagulability is principally secondary to hypervisosity of the whole blood. Blood viscosity is an exponential function of the hematocrit, and red cell aggregation increases in high hematocrit level, creating the potential for vascular stasis. PV is also associated with endothelial dysfunction that can predispose to arterial disease. Reduction of the red cell mass to a safe level by phlebotomy is the first principle of therapy in PV. Such an effective therapy may have some effect on the arterial compliance in PV patients; nevertheless, to the best of or knowledge, the influence of phlebotomies on arterial hemodynamic parameters has not be studied in PV patients. In this study we estimated the influence of phlebotomies on large arteries (C1) and small arteries compliance (C2) in PV patients by non invasive method. Hemodynamic parameters were studied by Pulse Wave Analysis using the HDI-Pulse Wave CR2000 (Minneapolis MN, USA) immediatly before and after venesection (300–500cc of blood) (short effect of phlebotomy) and repeated within 3 months, after the hematocrit has been reduced to below 45% in male and 42% in female (long effect). Seventen PV (10 males) patients diagnosed according to the PVSG criterias have been included. 37 phlebotomies were performed with analysis of short effect (for 3 patients phlebotomy was performed 5 times, for one patient- 4 times, for five-twice, and for eight- once). There were 10 mesurements of long time effect of the phlebotomy. The median age of the patients was 66 years (range 48–82). The median hematocrit level was 49.3% (range 46.5–62) before phlebotomy. 47 measurements of the arterial compliance were performed (two patients visited 6 times, one- five times, one-4 times, three- 3 times, seven- twicely, and 3 patients once). The mean large artery compliance (C1) before phlebotomy was 12.0 ml/mmHg x 10 (range 4.5–28.6), in 36 measurements these parameters were normal for gender and age adjustment, and in 11 they were borderline. Immediately after phlebotomy the mean large artery compliance was 12.6 ml/mmHg x 10 (range 5.2–20.1). The mean small artery compliance (C2) before and immediately after phlebotomy were 4.4 mg/mmHg x 10(range 1.2–14.3) and 5.5 mg/mmHg x 10 (range 1.2 – 15.6) respectively (delta C2 1.1- not statistically significant). In 47 measurements of C2 before phlebotomy, 22 were within normal range, 6 borderline, and 19 pathological.. In 37, C2 measurements after phlebotomy, 21 were within normal range, 4 borderline and 12 pathological. The long term effect analysis demonstrates that the mean C1 after hematocrit normalization was13.8 mg/mmHg x 10 (delta 1.8- not statistically significant). The mean C2 after hematocrit normalization was 4.76 mg/mmHg x 10 (delta 0.36- not significant). In conclusion, phlebotomy has no significantly short or long term influence on large and small artery compliance in PV patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.