The Influence of Smoking and of Oral and Transdermal Nicotine on Blood Pressure, and Haematology and Coagulation Indices

Andrew D Blann; Christopher Steele; Charles N McCollum

doi:10.1055/s-0038-1657692

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1997; 78(03): 1093-1096
DOI: 10.1055/s-0038-1657692

Rapid Communication

Schattauer GmbH Stuttgart

The Influence of Smoking and of Oral and Transdermal Nicotine on Blood Pressure, and Haematology and Coagulation Indices

Authors

Andrew D Blann

¹The Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, The City Hospital, Birmingham
Christopher Steele

²The Practice, Manchester, University Hospital of South Manchester, Didsbury, UK
Charles N McCollum

³The Department of Surgery, University Hospital of South Manchester, Didsbury, UK

Abstract

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Summary

Nicotine is helpful in stopping smoking but its influence on cardiovascular risk factors is incomplete. Our aim was to determine its effect on blood pressure, routine haematology indices, and coagulation indices relevant to thrombosis. Eighteen subjects were seen whilst smoking (cotinine levels 1119 ± 414 ng/ml), again after stopping smoking but while using nicotine chewing gum and/or skin patches (392 ± 198 ng/ml), and again when not using nicotine (cotinine undetectable). There were no significant changes in blood pressures, platelet count, mean platelet volume, viscosity or anti-thrombin III. However, white blood cell count (p = 0.003), lymphocyte count (p = 0.016), red blood cell count (p = 0.02), haemoglobin (p <0.001), fibrinogen (p <0.001) and von Willebrand factor (p = 0.001) all fell between the first and second samples (when still using nicotine) but not between the second and third samples (when off nicotine). Oral and/or transdermal nicotine does not influence blood pressure or the haematology and coagulation indices we have measured.

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References

References
1 Bartecchi CE, MacKenzie TD, Schrier RW. The human cost of tobacco use. New Engl J Med 1994; 330: 907-912
2 Doll R, Peto R, Wheatley K, Gray R, Sutherland I. Mortality in relation to smoking: 40 years’ observations on male British doctors. Br Med J 1994; 309: 901-911
3 Hansen EF, Andersen LT, von EybenFE. Cigarette smoking and age at first acute myocardial infarction, and influence of gender and extent of smoking. Am J Cardiol 1993; 71: 1439-1442
4 Auerbach O, Hammond EC, Garfinkel L. Smoking in relation to athero sclerosis of the coronary arteries. New Engl J Med 1965; 273: 775-779
5 Bain C, Hennekens CH, Rosner B, Speizer FE, Jesse MJ. Cigarette con sumption and deaths from coronary heart disease. Lancet 1978; 01: 1087-1088
6 Krupski WC. The peripheral vascular consequences of smoking. Ann Vase Surg 1991; 05: 291-304
7 Powell JT. Smoking and arterial disease – News of the old enemy. Eur J Vase Surg 1991; 05: 227-228
8 Zalokar JB, Richard JL, Claude JR. Leukocyte count, smoking and myo cardial infarction. New Engl J Med 1981; 304: 465-468
9 Meade TW, Imeson J, Stirling Y. Effects of changes in smoking and other characteristics on clotting and the risk of ischaemic heart disease. Lancet 1987; 02: 986-988
10 Kario K, Matsuo T, Nakao K. Cigarette smoking increases the mean plate let volume in elderly patients with risk factors for atherosclerosis. Clin Lab Haemat 1992; 14: 281-287
11 Lowe GDO, Wood DA, Douglas JT, Riemersma RA, Macintyre CCA, Takase T, Tuddenham EGD, Forbes CD, Elton RA, Oliver MF. Relation ships of plasma viscosity, coagulation and fibrinolysis to coronary risk factors and angina. Thromb Haemost 1991; 65: 339-343
12 Allen RA, Kluft C, Brommer EJP. Effect of chronic smoking on fibrinoly sis. Arteriosclerosis 1985; 05: 443-450
13 Belch JJF, McArdle BM, Bums P, Lowe GDO, Forbes CD. The effects of acute smoking on platelet behavior, fibrinolysis and haemorheology in habitual smokers. Thromb Haemost 1984; 51: 6-8
14 Blann AD, McCollum CN. Adverse influence of cigarette smoking on the endothelium. Thromb Haemost 1993; 70: 707-711
15 De CesarisR, Ranieri G, Filitti V, Bonfantino MV, Andriani A. Cardiovas cular effects of smoking. Cardiology 1992; 81: 233-237
16 Wilhelmsen L. Coronary heart disease: epidemiology of smoking and intervention studies of smoking. Am Heart J 1988; 115: 242-249
17 Wilhelmsen L. Smoking as a cardiovascular risk factor – new strategies for smoking cessation. Lewiston, NY: Hogrefe & Huber; 1991
18 Law M, Tang JL. An analysis of the effectiveness of interventions intended to help people stop smoking. Arch Intern Med 1995; 155: 1933-1941
19 Transdermal Nicotine Study group. Transdermal nicotine for smoking ces sation. J Amer Med Assoc 1991; 266: 3133-3138
20 Tonnesen P, Norregaard J, Simonsen K, Sawe U. A double blind trial of a 16-hour transdermal nicotine patch in smoking cessation. New Engl J Med 1991; 325: 311-315
21 Khosla S, Laddu A, Ehrenpreis S, Somberg JC. Cardiovascular effects of nicotine: Relation to deleterious effects of cigarette smoking. Am Heart J 1994; 127: 1669-1672
22 Henningfield JE. Nicotine medications for smoking cessation. New Engl J Med 1995; 333: 1196-1203
23 Benowitz NL. Smoking-induced coronary vasoconstriction: Implications for therapeutic use of nicotine. J Amer Coll Cardiol 1993; 22: 648-649
24 Jarvis MJ, Tunstall-Pedoe H, Feyerabend C, Vesey C, Saloojee Y. Com parison of tests used to distinguish smokers from non-smokers. Am J Public Health 1987; 77: 1435-1438
25 Feyerabend C, Russell MAH. A rapid gas-liquid chromatographic deter mination of cotinine in biological fluids. Analyst 1980; 105: 993-1001
26 Zimmermann M, McGeachie J. The effect of nicotine on aortic endothelial cell turnover. Atherosclerosis 1985; 58: 39-47
27 Blaes N, Piovella F, Samaden A, Boutherin-Falson O, Ricetti M. Nicotine alters fibronectin and factor Vll/vWf in human vascular endothelial cells. Br JHaem 1986; 64: 675-687
28 Martin JF, Bath PMW, Burr ML. Influence of platelet size on outcome after myocardial infarction. Lancet 1991; 338: 1409-1411
29 Calori G, D’Angelo A, Valle PD, Ruotolo G, Ferini-Strambi L, Giusti C, Errera A, Gallus G. The effect of cigarette smoking on cardiovascular risk factors: a study of monozygotic twins discordant for smoking. Thromb Haemost 1996; 75: 14-18
30 Feher MD, Rampling MW, Brown J, Robinson R, Richmond W, Cholerton S, Bain BJ, Sever PS. Acute changes in atherogenic and thrombogenic fac tors with cessation of smoking. J Roy Soc Med 1990; 83: 146-148
31 Thomas GAO, Davies SV, Rhodes J, Russell MAH, Feyerabend C, Sawe U. Is transdermal nicotine associated with cardiovascular risk?. J Royal Coll Phys Lond 1995; 29: 392-396
32 Dacosta A, Guy JM, Tardy B, Gonthier R, Denis L, Lamaud M, Cerisier A, Vemeyre H. Myocardial infarction and nicotine patch: a contributing or causative factor?. Eur Heart J 1993; 14: 1709-1711
33 Sawe U, Maggiorelli F, Fomai E, Simonini P, Ferdeghini EM, Miccoli R, Testa R, Massetani R, Murri L, Paoletti P. Continuous and intermittent transdermal delivery of nicotine: Cardio-respiratory, metabolic effects and sleep patterns. J Smok Rel Dis 1995; 06: 25-33
34 Nyberg G, Panfilov V, Sivertsson R, Wilhelmsen L. Cardiovascular effects of nicotine chewing gum in healthy non-smokers. Eur J Clin Pharmacol 1982; 23: 303-307
35 Doussel JC, Gutierres JB, Dousset N. Hypercholesterolaemia after adminis tration of nicotine chewing gum. Lancet 1986; 02 1393
36 Folts JD, Bonebrake FC. The effects of cigarette smoke and nicotine on platelet thrombus formation in stenosed dog coronary arteries: inhibition with phentolamine. Circulation 1982; 65: 465-469
37 Smith JR, Landau SA. Smokers’ polycythaemia. New Engl J Med 1978; 298: 6-10
38 Blann AD, Seigneur M, Adams R, McCollum CN. Neutrophil elastase, von Willebrand factor, soluble thrombomodulin and percutaneous oxygen in peripheral atherosclerosis. Eur J Vase Endovasc Surg 1996; 12: 218-222
39 Smith FB, Lee AJ, Fowkes FGR, Rumley A, Lowe GDO. Smoking, hae mostatic factors and the severity of aorto-iliac and femoro-popliteal dis ease. Thromb Haemost 1996; 75: 19-24
40 Benowitz NL. Nicotine and coronary heart disease. Trends Cardiovasc Med 1991; 01: 315-321
41 Working Group for the Study of Transdermal nicotine in patients with coro nary artery disease. Nicotine-replacement therapy for patients with coro nary artery disease. Arch Intern Med 1994; 154: 989-995