SMOKING STATUS AND NICOTINE ADMINISTRATION DIFFERENTIALLY MODIFY HEMODYNAMIC STRESS REACTIVITY IN MEN AND WOMEN

Objectives: To investigate the impact of cigarette smoking and oral co ntraceptive (OC) use on hemodynamic stress responses of women. Also, t o examine gender differences in stress reactivity as a function of smo king status and acute nicotine administration. Methods: Thirty men and 46 women, differing in smoking status and OC use, were tested for car diovascular stress responses to a variety of behavioral and physical s tressors. Each was tested twice, once under a transdermal nicotine pat ch condition and once under a placebo patch condition. Impedance cardi ography was used to estimate hemodynamic reactivity noninvasively. Res ults: In response to behavioral stressors, women smokers, irrespective of OC use or nicotine vs placebo, demonstrated significantly blunted cardiac output and heart rate reactivity to stressors, and showed sign ificantly greater estimated total peripheral resistance (TPR) under st ress relative to women nonsmokers. There were no differences in hemody namic stress reactivity between men smokers and nonsmokers. The only s ignificant effect involving nicotine administration on stress reactivi ty was seen in men where, regardless of smoking status, nicotine incre ased heart rate reactivity to all stressors relative to placebo respon ses. Conclusions: Results suggest that cigarette smoking may act diffe rently in men and women to increase risk for cardiovascular disease (C VD). For men, nicotine may exert pathogenic influences via increasing the magnitude of heart rate reactivity to stressors. For women, howeve r, smoking seems to have deleterious effects on hemodynamic stress rea ctivity patterns, reducing myocardial but increasing TPR contributions to blood pressure responses.