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Otsuka R, Watanabe H, Hirata K, et al. Acute Effects of Passive Smoking on the Coronary Circulation in Healthy Young Adults. JAMA. 2001;286(4):436–441. doi:10.1001/jama.286.4.436
Author Affiliations: Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka, Japan.
Context Recent studies have shown that passive smoking is a risk factor for
ischemic heart disease and may be associated with vascular endothelial dysfunction.
The acute effects of passive smoking on coronary circulation in nonsmokers
are not known.
Objective To determine the acute effects of passive smoking on coronary circulation
using coronary flow velocity reserve (CFVR), assessed by noninvasive transthoracic
Design, Setting, and Participants Cross-sectional study conducted from September 2000 to November 2000
among 30 Japanese men (mean age, 27 years; 15 healthy nonsmokers and 15 asymptomatic
active smokers) without history of hypertension, diabetes mellitus, or hyperlipidemia.
Main Outcome Measures Coronary flow velocity reserve, calculated as the ratio of hyperemic
to basal coronary flow velocity induced by intravenous infusion of adenosine
triphosphate and measured in each participant before and after a 30-minute
exposure to environmental tobacco smoke.
Results Heart rate and blood pressure responses to adenosine triphosphate infusion
were not affected by passive smoking exposure in either group. Passive smoking
exposure had no effect on basal coronary flow velocity in either group. Mean
(SD) CFVR in nonsmokers was significantly higher than that in active smokers
before passive smoking exposure (4.4 [0.91] vs 3.6 [0.88], respectively; P = .02), while CFVR after passive smoking exposure did
not differ between groups (P = .83). Passive smoking
exposure significantly reduced mean (SD) CFVR in nonsmokers (4.4 [0.91] vs
3.4 [0.73], respectively; P<.001).
Conclusions Passive smoking substantially reduced CFVR in healthy nonsmokers. This
finding provides direct evidence that passive smoking may cause endothelial
dysfunction of the coronary circulation in nonsmokers.
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