Effects of smoking and smoking cessation on endothelial function: 1-year outcomes from a randomized clinical trial - PubMed (original) (raw)

Randomized Controlled Trial

. 2010 May 4;55(18):1988-95.

doi: 10.1016/j.jacc.2010.03.002. Epub 2010 Mar 17.

Affiliations

Randomized Controlled Trial

Effects of smoking and smoking cessation on endothelial function: 1-year outcomes from a randomized clinical trial

Heather M Johnson et al. J Am Coll Cardiol. 2010.

Abstract

Objectives: The purpose of this study was to determine whether smoking cessation improves flow-mediated dilation (FMD) of the brachial artery.

Background: The long-term effects of continued smoking and smoking cessation on endothelial function have not been described previously.

Methods: This was a 1-year, prospective, double-blind, randomized, placebo-controlled clinical trial of the effects of 5 smoking cessation pharmacotherapies. FMD was measured by B-mode ultrasonography before and 1 year after the target smoking cessation date. Cessation was verified by exhaled carbon monoxide levels. DeltaFMD was compared among study arms and between subjects who successfully quit smoking and those who continued to smoke. Predictors of baseline FMD and DeltaFMD were identified by multivariable regression.

Results: The 1,504 current smokers (58% female, 84% white) were 44.7 +/- 11.1 years of age and smoked 21.4 +/- 8.9 cigarettes/day. Baseline FMD was similar in each treatment arm (p = 0.499) and was predicted by BA diameter (p < 0.001), reactive hyperemia blood flow (p < 0.001), high-density lipoprotein cholesterol (p = 0.001), and carbon monoxide (p = 0.012) levels. After 1 year, 36.2% quit smoking. FMD increased by 1% (6.2 +/- 4.4% to 7.2 +/- 4.2%) after 1 year (p = 0.005) in those who quit, but did not change (p = 0.643) in those who continued to smoke. Improved FMD among quitters remained significant (p = 0.010) after controlling for changes in brachial artery diameter, reactive hyperemia, low-density lipoprotein cholesterol, and the presence of a home smoking ban.

Conclusions: Despite weight gain, smoking cessation leads to prolonged improvements in endothelial function, which may mediate part of the reduced cardiovascular disease risk observed after smoking cessation. (Smoking Cessation Medications: Efficacy, Mechanisms and Algorithms; NCT00332644).

Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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Figures

Figure 1

Figure 1

Absolute FMD values one year after quit date, expressed as percentages. Solid horizontal bars represent means, dashed horizontal bars represent medians. Box margins are the 25th and 75th percentiles. Whiskers are the 10th and 90th percentiles. Dots are the 5th and 95th percentiles.

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