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Cigarette smoking and coronary blood flow.

Cigarette smoking is associated with an increased risk for vascular disease. The effects of smoking and nicotine on coronary and peripheral arterial function have been probed with various invasive and noninvasive techniques. The current review provides a brief summary of the available techniques for measuring coronary or peripheral arterial function and discusses the determinants of myocardial blood flow at rest and during stress. Finally, it summarizes research addressing the effects of smoking on coronary and peripheral arterial function. Acute and chronic smoking does not appear to alter substantially endothelium independent coronary vasodilatory capacity. In contrast, active and passive smoking alters coronary and peripheral arterial vasomotion in patients with and individuals without coronary artery disease (CAD). Therefore, the site of the damaging effects of smoking appears to be the coronary endothelium. The smoking history is correlated with the degree of vasomotor abnormalities. Further, the degree of smoking-induced endothelial dysfunction appears to increase with the severity of CAD. Finally, the coronary endothelial and peripheral arterial vasomotor dysfunction observed in active and passive healthy smokers appear to be to some degree reversible.