title: Hemodynamic and autonomic effects of smokeless tobacco in healthy young men.
abstract: OBJECTIVE
  The aim of this study was to investigate the acute hemodynamic and autonomic effects of smokeless tobacco.
  
  
  BACKGROUND
  Smokeless tobacco use is increasing. Its cardiovascular effects are not well understood.
  
  
  METHODS
  Sixteen healthy, male, habitual snuff tobacco users (aged 22 +/- 1 year) were studied, using a randomized, double-blind, placebo-controlled, crossover design with two separate experimental sessions: placebo and tobacco. Muscle sympathetic nerve activity (MSNA), electrocardiogram, blood pressure, calf blood flow, nicotine, and catecholamines were measured.
  
  
  RESULTS
  Snuff tobacco increased plasma nicotine from 2.8 +/- 0.5 ng/ml to 10.4 +/- 1.1 ng/ml. Mean blood pressure increased by 10 +/- 1 mm Hg, and heart rate increased by 16 +/- 2 beats/min. Peripheral vascular resistance, MSNA, and norepinephrine concentration did not change with tobacco, but epinephrine increased by approximately 50%.
  
  
  CONCLUSIONS
  Oral snuff tobacco increases heart rate, blood pressure, and epinephrine. Despite the increase in blood pressure, there is no decrease in either MSNA or peripheral vascular resistance. Smokeless tobacco is a powerful autonomic and hemodynamic stimulus. Catecholamine release from the adrenal medulla likely contributes to this response.
authors.affiliation: Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Wolk
authors.forename: Abu S M
authors.initials: AS
authors.lastname: Shamsuzzaman
authors.forename: Anna
authors.initials: A
authors.lastname: Svatikova
authors.forename: Christine M
authors.initials: CM
authors.lastname: Huyber
authors.forename: Corey
authors.initials: C
authors.lastname: Huck
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Narkiewicz
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000187:drug effects*; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004562:Electrocardiography; D004837:Epinephrine / Q000378:metabolism; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000187:drug effects; D009638:Norepinephrine / Q000378:metabolism; D012016:Reference Values; D013564:Sympathetic Nervous System / Q000187:drug effects; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D015415:Biomarkers; D009638:Norepinephrine; D004837:Epinephrine