title: Forearm endothelial response in smokeless tobacco users compared with cigarette smokers and nonusers of tobacco.
abstract: OBJECTIVE
  To compare brachial artery flow-mediated dilation (FMD) in subjects who use smokeless tobacco, smoke cigarettes, or do not use any tobacco product.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  University-affiliated outpatient clinic.
  
  
  METHODS
  Seventeen apparently healthy volunteers who for more than 1 year smoked at least 10 cigarettes/day, used at least two containers of smokeless tobacco/week, or did not use any tobacco product.
  
  
  RESULTS
  Baseline characteristics of subjects were similar among the three groups except for mean age and serum cotinine level. Baseline brachial artery diameter, endothelium-dependent FMD induced by reactive hyperemia, and endothelium-independent dilation induced by administration of sublingual nitroglycerin were measured. Mean FMD over baseline was 4.1% +/- 0.7% in subjects who used smokeless tobacco, 3.9% +/- 5.1% in cigarettes smokers, and 12.2% +/- 5.7% in nonusers of tobacco (p=0.01). Endothelium-independent dilation induced by nitroglycerin was not statistically different among the three groups.
  
  
  CONCLUSIONS
  Brachial artery FMD, a surrogate for endothelial dysfunction, was significantly impaired in smokeless tobacco users and cigarette smokers compared with nonusers of tobacco.
authors.affiliation: Cooperative Pharmacy Program, College of Health Sciences and Human Services, University of Texas-Pan American, Edinburg, Texas 78539, USA.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Granberry
authors.forename: Eugene S
authors.initials: ES
authors.lastname: Smith
authors.forename: Rhonda D
authors.initials: RD
authors.lastname: Troillett
authors.forename: John F
authors.initials: JF
authors.lastname: Eidt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001916:Brachial Artery / Q000187:drug effects* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects*; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D014664:Vasodilation / Q000187:drug effects*