Electronic Cigarette Use and Blood Pressure Endpoints: a Systematic Review
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PREVENTION OF HYPERTENSION: PUBLIC HEALTH CHALLENGES (Y YANO, SECTION EDITOR)
Electronic Cigarette Use and Blood Pressure Endpoints: a Systematic Review Irene Martinez-Morata 1 & Tiffany R. Sanchez 1 & Daichi Shimbo 2 & Ana Navas-Acien 1 Accepted: 15 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review E-cigarettes (e-cigs) release toxic chemicals known to increase blood pressure (BP) levels. The effects of ecigs on BP, however, remain unknown. Studying BP may help characterize potential cardiovascular risks of short- and long-term e-cig use. We summarized published studies on the association of e-cig use with BP endpoints. Recent Findings Thirteen e-cig trials (12 cross-over designs) and 1 observational study evaluated systolic and diastolic blood pressure (SBP and DBP). All trials included at least one e-cig arm with nicotine, 6 a no-nicotine e-cig arm, and 3 a placebo arm. SBP/DBP increased in most nicotine e-cig arms, in some non-nicotine e-cig arms, and in none of the placebo arms. The observational study followed e-cig users and nonsmokers for 3.5 years with inconsistent findings. Summary The use of e-cigs with and without nicotine may result in short-term elevations of both SBP and DBP. Prospective studies that investigate the long-term cardiovascular impact of e-cig use are needed. Keywords Blood pressure . Electronic-cigarettes . Hypertension . Nicotine
Introduction Hypertension and cigarette smoking are the two leading causes of premature mortality worldwide. In 2017, high systolic blood pressure (SBP) was responsible for 10.4 million deaths, followed by cigarette smoking, responsible for 7.10 million deaths [1, 2]. Early diagnosis and treatment of hypertension play a crucial role in preventing clinical cardiovascular events including myocardial infarction and stroke [3••].
This article is part of the Topical Collection on Prevention of Hypertension: Public Health Challenges * Irene Martinez-Morata [email protected] * Ana Navas-Acien [email protected] 1
Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Irving Medical Center, 722 West 168th Street, New York, NY 10032, USA
2
Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
Electronic cigarettes (e-cigs) have been introduced in the market in recent years, promoted in part as a harm reduction strategy for smoking cessation. E-cigs, however, are also being marketed to never smokers and a rapidly increasing number of adolescents and young adults who have never smoked are using e-cigs. In the USA, for instance, e-cigs are the most commonly used tobacco product among youth, with 3.6 million middle and high school students using them in 2020 [4]. It is estimated that around 40% of e-cig users between 18 and 24 years have never smoked cigarettes before [5]. E-cigs are chargeable devices that produce an aerosol from heating an e-liquid with a coil. E-cig aerosols
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