Mechanisms responsible for sympathetic activation by cigarette smoking in humans

Background: The pressor and tachycardic effects of cigarette smoking are associated with an increase in plasma catecholamines, suggesting the dependence of these effects on adrenergic stimulation. Whether the stimulation occurs at a central or a peripheral level and whether reflex mechanisms are involved is unknown. Methods and Results: In nine normotensive healthy subjects (age, 33.0±3.5 years, mean±SEM), we measured blood pressure (Finapres device), heart rate (ECG), calf blood flow and vascular resistance (venous occlusion plethysmography), plasma norepinephrine and epinephrine (high-performance liquid chromatography assay), and postganglionic muscle sympathetic nerve activity (microneurography from the peroneal nerve) while subjects were smoking a filter cigarette (nicotine content, 1.1 mg) or were in control condition. Cigarette smoking (which raised plasma nicotine measured by high-performance liquid chromatography from 1.0±0.9 to 44.2±7.1 ng/mL) markedly and significantly increased mean arterial pressure (+13.2±2.3%), heart rate (+30.3±4.7%), calf vascular resistance (+12.1±4.9%), plasma norepinephrine (+34.8±7.0%), and plasma epinephrine (+90.5±39.0%). In contrast, muscle sympathetic nerve activity showed a marked reduction (integrated activity -31.8±5.1%, P