Cardiovascular and adrenergic effects of cigarette smoking during immediate non‐selective and selective beta adrenoceptor blockade in humans

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Abstract
The cardiovascular and adrenergic responses to cigarette smoking during acute selective and non-selective .beta.-adrenoceptor blockade were studied in 7 young healthy volunteers in a double blind cross-over fashion. Heart rate, arterial blood pressure, forearm blood flow and plasma levels of adrenaline [epinephrine] and noradrenaline [norepinephrine] were determined before and during the terminal 5 min period of 15 min smoking test. During smoking, plasma concentrations of adrenaline increased markedly and evenly by .apprx. 0.3 ng/ml in all 3 experimental sessions. Plasma concentrations of noradrenaline were unchanged. Propranolol, a non-selective .beta.-blocker, caused a marked rise in diastolic and mean blood pressure and forearm vascular resistance during smoking. This response was not seen in the control series or after selective .beta.1 blockade with atenolol. This difference is due to propranolol''s blockade of adrenaline''s vasodilating effect mediated by .beta.2 receptors in the resistance vessels. Atenolol attenuated the systolic blood pressure response and tachycardia induced by cigarette smoking compared to placebo. Selective .beta.1 blockers may be preferable in the management of patients who are habitual smokers.