加热烟草制品对动脉僵硬度的影响,Vascular Medicine

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加热烟草制品对动脉僵硬度的影响
Vascular Medicine ( IF 3.0 ) Pub Date : 2020-07-28 , DOI: 10.1177/1358863x20943292
Klaas Frederik Franzen _{1,

2} , Svenja Belkin _{1,

2} , Torsten Goldmann _{2,

3} , Michael Reppel ₄ , Henrik Watz _{2,

5} , Kai Mortensen ₆ , Daniel Droemann _{1,

2}

Affiliation

加热烟草制品 (HTP) 可能会对心血管系统产生负面影响。1 HTP 是电子烟和可燃香烟的混合体。它使用电池的能量将烟草加热至 250°C 至 350°C 之间的温度并蒸发其中所含的尼古丁。2,3 虽然 HTP 仅将烟草加热至 350°C，但它们会产生含有尼古丁和烟碱的气溶胶。烟、焦油和有害化学物质的含量低于传统香烟。2,4 然而，人们对 HTP 对心血管系统的影响知之甚少，尤其是当使用动脉僵硬作为心血管系统相关副作用的预后标志时。我们和其他人最近表明，传统香烟和含有尼古丁的电子烟都会对动脉僵硬产生显着影响。5-7 本研究的目的是确定 HTP 与电子烟和传统香烟相比对动脉僵硬度的急性影响。在一项部分双盲随机交叉试验中，研究了 20 名活跃、健康的吸烟者（10 名男性和 10 名女性；21.9 ± 2.6 岁；1 ± 1 py）在吸烟或吸电子烟期间和之后的至少 48访问之间的小时数。7 在筛选过程中，所有参与者都接受了纳入标准的检查：(i) 主动吸烟或吸电子烟；(ii) 没有精神健康障碍；(iii) 无心血管疾病；(iv) 没有甲状腺疾病；(v) 非糖尿病患者；(vi) 体格检查无异常；(vii) 无高血压；(viii) 无高胆固醇血症。此外，女性参与者必须使用口服避孕药才能纳入研究。如果参与者之前参加过任何其他类型的研究并且他们声明严格不吸烟，则将其排除在外。受试者提供书面知情同意书。该研究获得了当地伦理委员会（AZ 15-171 和修正案）的批准，并在 DRKS（德国临床试验注册：DRKS00012919）注册。受试者必须在测量前 24 小时戒酒和戒烟/电子烟。休息 30 分钟后，受试者在吸烟或吸电子烟后 2 小时进行随访。四个不同的研究访问包括：(a) HTP 2.2（IQOS，菲利普和莫里斯；0.5 毫克尼古丁）；(b) 一根烟草香烟 (Cig)（万宝路黄金、菲利普和莫里斯；0.5 毫克尼古丁）；(c) 含尼古丁 (ECig(+)) 的电子烟（16 mg/mL，烟草味）；(d) 不含尼古丁的电子烟 (ECig(–))（0 mg/mL，烟草味）（均为 DIPSE，eGo-T CE4 蒸发器，第三代，3.3 伏，1.5 欧姆，7.26 瓦）。访问 (c) 和 (d) 被未参与研究人员团队的人员设盲。每位受试者必须每 30 秒抽至少一口电子烟，连续抽吸 10 口，每次持续 4 秒。8 每次吸烟或取暖时抽一根烟或一根烟。外周血压使用传统的血压监测仪（Omron MIT Elite PlusTM，Omron，Kyoto，Japan）测量，而中心血压和动脉僵硬度参数使用 Mobil-O-GraphTM（IEM，Stolberg，Germany）测量，如前所述7 组间差异通过双向重复测量方差分析 (ANOVA) 计算，并在 p < 0.05 时进行事后检验。外周收缩压 (SBP)（基线 122.3 ± 8。8 mmHg) 在 Cig、ECig(+) 和 HTP 组内显着增加超过 +3%（p < 0.05；图 1A）。60 分钟后 SBP 回到基线。对平均动脉压 (MAP) 观察到类似的影响。心率 (HR)（基线 70.0 ± 9.0 bpm）最初在 Cig 和加热烟草制品对动脉僵硬度的影响中增加了 9% 以上

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The impact of heated tobacco products on arterial stiffness

Heated tobacco products (HTPs) might lead to negative side effects on the cardiovascular system.1 An HTP is a hybrid between an e-cigarette and a combustible cigarette. It uses the energy of a battery to heat tobacco to temperatures between 250°C and 350°C and to evaporate the nicotine it contains.2,3 Although HTPs heat tobacco up to 350°C only, they generate aerosols containing nicotine as well as smoke, tar, and lower levels of harmful chemicals than conventional cigarettes.2,4 However, little is known about the effects of HTPs on the cardiovascular system, especially when using arterial stiffness as a marker for prognostic relevant side effects on the cardiovascular system. We and others recently showed that both conventional cigarettes and e-cigarettes containing nicotine induce significant effects on arterial stiffness.5–7 The purpose of the current study was to determine the acute effects of HTPs compared to e-cigarettes and conventional cigarettes on arterial stiffness. Twenty active, healthy smokers (10 men and 10 women; 21.9 ± 2.6 years; 1 ± 1 py) were studied during and after smoking or vaping in a partly double-blinded randomized, cross-over trial with wash-out of at least 48 hours between visits.7 During the screening, all participants were checked for inclusion criteria: (i) active smoking or vaping; (ii) no mental health disorders; (iii) no cardiovascular diseases; (iv) no thyroid disease; (v) non-diabetic; (vi) no abnormalities in physical examinations; (vii) no hypertension; and (viii) no hypercholesterolemia. Furthermore, female participants had to be using oral contraceptives to be included in the study. Participants were excluded if previously enrolled in any other kind of study and if they declared being strict nonsmokers. Subjects provided written informed consent. The study was approved by the local ethics committee (AZ 15-171 and amendment) and registered at DRKS (German Clinical Trials Register: DRKS00012919). The subjects had to abstain from alcohol and smoking/ vaping for 24 hours prior to the measurements. After resting for 30 minutes, the subjects were followed up 2 hours after smoking or vaping. The four different study visits consisted of: (a) HTP 2.2 (IQOS, Philip & Morris; 0.5 mg nicotine); (b) a tobacco cigarette (Cig) (Marlboro Gold, Philip & Morris; 0.5 mg nicotine); (c) e-cigarette with nicotine (ECig(+)) (16 mg/mL, tobacco flavor); and (d) e-cigarette without nicotine (ECig(–)) (0 mg/mL, tobacco flavor) (both DIPSE, eGo-T CE4 vaporizer, third generation, 3.3 volts, 1.5 ohms, 7.26 watts). Visits (c) and (d) were blinded by a person not involved in the investigator’s team. Each subject had to vape the e-cigarette with a minimum of a puff every 30 seconds for 10 puffs, each lasting for 4 seconds.8 Each smoking or heating session took a single cigarette or heet. Peripheral blood pressure was measured using a conventional blood pressure monitor (Omron MIT Elite PlusTM, Omron, Kyoto, Japan), while central blood pressure and parameters of arterial stiffness were measured by Mobil-O-GraphTM (IEM, Stolberg, Germany) as previously described.7 Differences between the groups were calculated by two-way repeated-measures analysis of variance (ANOVA) and a post hoc test was performed at p < 0.05. Peripheral systolic blood pressure (SBP) (baseline 122.3 ± 8.8 mmHg) increased significantly within the Cig, ECig(+), and HTP groups by more than +3% (p < 0.05; Figure 1A). SBP returned to baseline after 60 minutes. Similar effects were observed for mean arterial pressure (MAP). Heart rate (HR) (baseline 70.0 ± 9.0 bpm) initially increased more than 9% in the Cig and The impact of heated tobacco products on arterial stiffness

更新日期：2020-07-28

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