title: Blood pressure circadian rhythm and endothelial function in heavy smokers: acute effects of transdermal nicotine.
abstract: Nicotine replacement therapy appears to be safe when used by healthy patients to aid in smoking cessation; however, the immediate acute effects of nicotine replacement therapy on the circadian rhythm of blood pressure (BP) and endothelial function in heavy smokers are not well understood. Twenty-six heavy smokers were requested to stop smoking for 48 hours. BP and heart rate were recorded over 48 hours by ambulatory BP monitoring, with beat-to-beat changes being monitored for the first 10 hours by a noninvasive finger device. The reactivity of the brachial artery was evaluated using flow-mediated dilation immediately after smoking cessation, before the application of a 21-mg nicotine patch or placebo patch, and 24 hours after patch placement. Transdermal nicotine caused a mild but significant elevation in BP in the early morning in 21 of 26 volunteers. The decrease in nocturnal BP was attenuated in patients with the nicotine patch compared with the placebo patch; this was associated with impaired endothelium-dependent vasodilation.
authors.affiliation: Department of Pharmacology, University Hospital and Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Yugar-Toledo
authors.forename: Silvia Elaine
authors.initials: SE
authors.lastname: Ferreira-Melo
authors.forename: Maricene
authors.initials: M
authors.lastname: Sabha
authors.forename: Eduardo Arantes
authors.initials: EA
authors.lastname: Nogueira
authors.forename: Otávio Rizzi
authors.initials: OR
authors.lastname: Coelho
authors.forename: Fernanda Marciano
authors.initials: FM
authors.lastname: Consolin Colombo
authors.forename: Maria Cláudia
authors.initials: MC
authors.lastname: Irigoyen
authors.forename: Heitor
authors.initials: H
authors.lastname: Moreno
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D001916:Brachial Artery; D002940:Circadian Rhythm / Q000502:physiology*; D004305:Dose-Response Relationship, Drug; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D009566:Nitrates / Q000097:blood; D009573:Nitrites / Q000097:blood; D016540:Smoking Cessation; D013929:Thromboxane B2 / Q000097:blood; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology
chemical_list: D009566:Nitrates; D009573:Nitrites; D013929:Thromboxane B2; D009538:Nicotine