Wolk Robert, Shamsuzzaman Abu S M, Svatikova Anna, Huyber Christine M, Huck Corey, Narkiewicz Krzysztof, Somers Virend K
Mayo Clinic, Rochester, Minnesota 55905, USA.
J Am Coll Cardiol. 2005 Mar 15;45(6):910-4. doi: 10.1016/j.jacc.2004.11.056.
The aim of this study was to investigate the acute hemodynamic and autonomic effects of smokeless tobacco.
Smokeless tobacco use is increasing. Its cardiovascular effects are not well understood.
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.
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%.
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.
本研究旨在探讨无烟烟草的急性血流动力学和自主神经效应。
无烟烟草的使用正在增加。其对心血管的影响尚未完全了解。
对16名健康的男性习惯性鼻烟使用者（年龄22±1岁）进行研究，采用随机、双盲、安慰剂对照、交叉设计，有两个独立的实验阶段：安慰剂和烟草。测量肌肉交感神经活动（MSNA）、心电图、血压、小腿血流量、尼古丁和儿茶酚胺。
鼻烟使血浆尼古丁浓度从2.8±0.5 ng/ml增至10.4±1.1 ng/ml。平均血压升高10±1 mmHg，心率增加16±2次/分钟。外周血管阻力、MSNA和去甲肾上腺素浓度在使用烟草后未发生变化，但肾上腺素增加了约50%。
口服鼻烟可增加心率、血压和肾上腺素。尽管血压升高，但MSNA或外周血管阻力均未降低。无烟烟草是一种强大的自主神经和血流动力学刺激物。肾上腺髓质释放的儿茶酚胺可能促成了这种反应。
