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Norepinephrine and Epinephrine Release and Adrenergic Mediation of Smoking-Associated Hemodynamic and Metabolic Events
Abstract
We studied the effects of cigarette smoking, sham smoking and smoking during adrenergic blockade in 10 subjects to determine whether smoking released the sympathetic neurotransmitter norepinephrine, as well as the adrenomedullary hormone epinephrine, and whether smoking-associated hemodynamic and metabolic changes were mediated through adrenergic mechanisms. Smoking-associated increments in mean (+/- S.E.M.) plasma norepinephrine (227 +/- 23 to 324 +/- 39 pg per milliliter, P less than 0.01) and epinephrine (44 +/- to 113 +/- 27 pg per milliliter, P less than 0.05) were demonstrated. Smoking-associated increments in pulse rate, blood pressure, blood glycerol and blood lactate/pyruvate ratio were prevented by adrenergic blockade; increments in plasma growth hormone and cortisol were not. Since significant smoking-associated increments, in pulse rate, blood pressure and blood lactate/pyruvate ratio, preceded measurable increments in plasma catecholamine concentrations, but were adrenergically mediated, these changes should be attributed to norepinephrine released locally from adrenergic axon terminals within the tissues rather than to increments in circulating catecholamines.
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“mean plasma epinephrine concentrations rise nearly 2-fold during quiet standing (6), ~3-fold during cigarette smoking (26), from 2–13-fold during mild to heavy exercise (27), and 50fold during insulin-induced hypoglycemia (28).”
From Epinephrine plasma metabolic clearance rates and physiologic thresholds for metabolic and hemodynamic actions in man. (1980) · cites this paper as [26]
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“Smoking is associated with adrenergic stimulation [26].”
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“This could be due to the presence of high circulating levels of cortisol in smokers.(39) Elevated cortisol has been attributed to the preferential deposition of fat centrally and is associated with greater VAT.”
BackgroundAcute smoking-induced alterations in Doppler echocardiographic measurements in chronic smokers.
Karakaya, O., Barutçu, İ., Esen, A. M., et al. (2006) · PubMed · Cited by 29
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“Caffeine assumption has also been shown to acutely increase both systolic and diastolic blood pressure [6] with no significant changes in heart rate [7,8], whereas an adrenergic-mediated acute increase in blood pressure and heart rate has been observed after cigarette smoking [9].”
BackgroundClinical Assessment of Sympathetic Responses to Stress
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Environmental Tobacco Smoke, Cardiovascular Disease, and the Nonlinear Dose-Response Hypothesis
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“In summary, smoking-related acute platelet aggregation probably results from sensitization of platelets by epinephrine released by the adrenals following nicotine binding to specific receptors (Cryer et al., 1976; Smith et al., 1998).”
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“While nicotine undoubtedly has localised peripheral effects, on pulse pressure for instance (Cryer et al. 1976), the fact that nicotine decreased decision time without affecting movement time argues for a central rather than a peripheral locus for the enhancement effects of nicotine on performance.”
Metadata
- Authors
- Cryer, P. E., Haymond, M. W., Santiago, J. V., & Shah, S. D.
- Affiliations
- Washington University in St. Louis (US)
- ORCID
- Haymond, Morey W.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1976-09-09
- Volume
- 295
- Issue
- 11
- Pages
- 573-577
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2341712066
- Semantic Scholar
- 61a71636dc3f81cda5208adbb0e928b8f3d3f442
- Cited by
- 1,101
- References
- 29
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 10 · 2023: 14 · 2022: 18 · 2021: 19 · 2020: 22 · 2019: 20 · 2018: 14 · 2017: 22 · 2016: 24 · 2015: 13 · 2014: 23 · 2013: 15 · 2012: 19
- FWCI
- 19.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Receptor Mechanisms and Signaling
- Keywords
- cigarette smoking, norepinephrine, epinephrine, sympathetic nervous system, adrenergic blockade, plasma catecholamines, hemodynamic response, blood pressure, pulse rate, blood lactate, growth hormone, cortisol, adrenergic neurotransmission
- MeSH terms
- Adult, Blood Pressure, Epinephrine, Glycerol, Hemodynamics, Humans, Hydrocortisone, Lactates, Male, Norepinephrine, Phentolamine, Propranolol, Pulse, Pyruvates, Smoking, Growth Hormone, Sympathetic Nervous System, Sympatholytics
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