The Influence of Smoking Cessation on Hemodynamics and Arterial Compliance

Abstract

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.

The effect of smoking on arterial stiffness

“…However, it remains controversial whether arterial stiffness improves after smoking cessation; some studies show rapid improvement in AIx after smoking cessation, 42,58,59 whereas cfPWV did not improve after 6 months, 59 and another study showed no improvement in distensibility after 2 years. 59,60 A crosssectional study of middle-aged hypertensive patients found that AIx, cfPWV and T r (transit time) returned to baseline levels only after 10 years of smoking cessation.…”

“…Oren et al 58 and Polonia et al 59 observed a decrease in AIx after 6 months of smoking cessation; continuing smokers showed no such change. 58,59 Rehill et al 42 Berlin et al 25 Healthy male CS Before vs. after smoking brPWV Acute smoking: increase by 28% 15 min after smoking, return to baseline at 30 min…”

Chronic Smoking and Its Effect on Arterial Stiffness

“…Even in light smokers who do not smoke more than 20 cigarettes per day can be detected changes in arterial elasticity 7 . Recent research in this fi eld suggests that vascular function is improved even after six months after quitting smoking 8 . Rehill et all claim that positive changes in arterial elasticity can be seen even after 4 weeks of cigarette abstinence 9 .…”

Do Different Vascular Risk Factors Affect All Arteries Equally?

“…22 Smoking cessation reverses some of these deleterious effects (eg, arterial stiffness and anklebrachial pressure index). 23,24 Smoking acts synergistically with other vascular risk factors (such as hypertension, DM, and hyperlipidemia) to increase vascular morbidity and mortality. 25 It was demonstrated that smoking is associated with a variable magnitude of cardiovascular risk for different vascular diseases; the risk is highest for PAD and abdominal aortic aneurysms (AAAs) and lowest for cerebrovascular diseases.…”