title: Vascular Functional and Morphological Alterations in Smokers during Varenicline Therapy.
abstract: BACKGROUND
  Varenicline has been reported to achieve high rates of smoking cessation. It remains undetermined whether varenicline therapy improves vascular function in smokers.
  
  
  METHODS
  Consecutive Seventy-two smokers (age 57 ± 12 years) who succeeded in complete smoking cessation and 46 normal healthy volunteers (age 24 ± 3 years) with no cardiovascular risk factors were enrolled into this study. Vascular function and structure were assessed by flow-mediated dilation (FMD), nitroglycerin-induced vasodilation, and brachial artery intima-media thickness (baIMT) at baseline and 20 weeks after the initiation of varenicline therapy in smokers. FMD and baIMT were measured simultaneously using a semi-automatic vessel wall-tracking software program. 75 μg dose of a nitroglycerin tablet were sublingually administered for the nitroglycerin-induced vasodilation measurement.
  
  
  RESULTS
  Exhaled-carbon monoxide concentration decreased significantly (20.0 ± 11.1 ppm at baseline vs 1.9 ± 1.5 ppm after 20 weeks, p < 0.001). FMD was significantly improved after 20 weeks (4.09% ± 1.83% at baseline vs 4.77% ± 2.33% after 20 weeks, p = 0.010), whereas nitroglycerin-induced vasodilation and baIMT were not significantly changed.
  
  
  CONCLUSIONS
  Smoking cessation with varenicline therapy significantly increased FMD without significant changes of nitroglycerin-induced vasodilation or baIMT from baseline to 20 weeks. It appears to improve vascular function in smokers, which depends on endothelial function rather than on vascular smooth muscle function or changes in vascular structure.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Takemoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Norioka
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Iguchi
authors.forename: Kenei
authors.initials: K
authors.lastname: Shimada
authors.forename: Makiko
authors.initials: M
authors.lastname: Maeda
authors.forename: Mina
authors.initials: M
authors.lastname: Morimura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fujio
authors.forename: Junichi
authors.initials: J
authors.lastname: Azuma
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirohashi
authors.forename: Taichi
authors.initials: T
authors.lastname: Shuto
mesh_terms: D000328:Adult; D000368:Aged; D001552:Benzazepines / Q000009:adverse effects / Q000627:therapeutic use*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D005996:Nitroglycerin / Q000008:administration & dosage; D011810:Quinoxalines / Q000009:adverse effects / Q000627:therapeutic use*; D020127:Recovery of Function; D012907:Smoking / Q000009:adverse effects* / Q000503:physiopathology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D014463:Ultrasonography; D000068580:Varenicline; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D014665:Vasodilator Agents; D005996:Nitroglycerin; D000068580:Varenicline