ABSTRACT
INTRODUCTION: Prolonged limb blood flow occlusion (ie, tourniquet application during limb surgery) causes transient microvascular dysfunction. We examined the ability of a local nitric oxide donor (transdermal nitroglycerin) administered during prolonged cuff forearm occlusion to protect against microvascular dysfunction and to alter brachial artery dilation. METHODS: Ten healthy men (28 ± 8 years) participated in the study. During the control visit, they completed three vascular occlusion tests in the right arm termed, PRE (5-min occlusion), POSTimmediate (20-min occlusion), and POST30min (5-min occlusion). During the nitroglycerin visit, subjects completed the same vascular occlusion tests, but with a nitroglycerin patch placed over the contralateral forearm during the 20-min occlusion test. Micro- and macrovascular function were assessed using the near-infrared spectroscopy-derived reperfusion upslope (reperfusion slope, %.s-1 ) and flow-mediated dilation (%FMD), respectively. RESULTS: The reperfusion slope (1.44 ± 0.72%.s-1 ) and the %FMD (15.0 ± 2.8%) of the POSTimmediate test of the nitroglycerin condition were significantly (P < .05) higher than the reperfusion slope (1.01 ± 0.37%.s-1 ) and %FMD (6.77 ± 1.8%) during the POSTimmediate test of the control visit. CONCLUSION: Transdermal nitroglycerin protects against ischemia-induced microvascular dysfunction and causes marked dilation of the brachial artery %FMD.