Circulation, Vol 88, 562-571, Copyright © 1993 by American Heart Association
ON Niedermaier, ML Smith, LA Beightol, Z Zukowska-Grojec, DS Goldstein and DL Eckberg
BACKGROUND. Although cigarette smoking is known to lead to widespread
augmentation of sympathetic nervous system activity, little is known about
the effects of smoking on directly measured human sympathetic activity and
its reflex control. METHODS AND RESULTS. We studied the acute effects of
smoking two research-grade cigarettes on muscle sympathetic nerve activity
and on arterial baroreflex-mediated changes of sympathetic and vagal neural
cardiovascular outflows in eight healthy habitual smokers. Measurements
were made during frequency- controlled breathing, graded Valsalva
maneuvers, and carotid baroreceptor stimulation with ramped sequences of
neck pressure and suction. Smoking provoked the following changes: Arterial
pressure increased significantly, and RR intervals, RR interval spectral
power at the respiratory frequency, and muscle sympathetic nerve activity
decreased. Plasma nicotine levels increased significantly, but plasma
epinephrine, norepinephrine, and neuropeptide Y levels did not change. Peak
sympathetic nerve activity during and systolic pressure overshoots after
Valsalva straining increased significantly in proportion to increases of
plasma nicotine levels. The average carotid baroreceptor- cardiac reflex
relation shifted rightward and downward on arterial pressure and RR
interval axes; average gain, operational point, and response range did not
change. CONCLUSIONS. In habitual smokers, smoking acutely reduces baseline
levels of vagal-cardiac nerve activity and completely resets vagally
mediated arterial baroreceptor-cardiac reflex responses. Smoking also
reduces muscle sympathetic nerve activity but augments increases of
sympathetic activity triggered by brief arterial pressure reductions. This
pattern of autonomic changes is likely to influence smokers' responses to
acute arterial pressure reductions importantly.
ARTICLES
Influence of cigarette smoking on human autonomic function
Department of Medicine, Hunter Holmes McGuire Department of Veterans Affairs Medical Center, Richmond, VA 23249.
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