Influence of inhaled nicotine source on arterial stiffness.

INTRODUCTION: Tobacco smoking leads to changes in hemodynamic parameters such as heart rate and systolic or diastolic blood pressure. It has a direct influence on the elasticity of blood vessels and increases arterial stiffness, which can result in development of atherosclerosis. Data show that the nicotine in tobacco smoke probably is responsible for these changes. Electronic cigarettes (e-cigarettes) were supposedly a healthier alternative to combustible cigarettes because they imitate a process of cigarettes smoking but generate nicotine aerosol without the toxic substances from tobacco combustion. However, the use of e-cigarettes is still controversial because their toxicity, safety and long term use health impact have not been sufficiently studied. AIM: The aim of this study was to evaluate changes in arterial stiffness parameters after smoking a cigarette or e-cigarette use. METHODS: Fifteen healthy women, aged 19-25 years old, smoking ≥5 cigarettes per day for at least two years participated in the study. A non-invasive measurement of arterial stiffness parameters - Stiffness Index (SI) and Reflection Index (RI) - was conducted and systolic and diastolic blood pressure and heart rate were measured before and after smoking a conventional cigarette as well as use of an e-cigarette. RESULTS: Statistically significant changes in the SI and RI were observed before and after smoking of a conventional cigarette [SI: 6.75m/s (6.66 - 6.85, 95% CI) vs 6.56m/s (6.46 - 6.65. 95% CI), p=0.0056; RI: 54.0% (51.5 - 56.7, 95% CI) vs 49.6% (47.5 - 51.8, 95% CI), p=0.010]. The use of e-cigarettes resulted in no statistically significant changes in the SI and RI. After both product use systolic and diastolic blood pressure and heart rate increased but the changes were not statistically significant. CONCLUSIONS: In contrast to conventional cigarette use, the use of electronic cigarettes causes no changes in arterial stiffness. This may indicate lower bioavailability of nicotine from the e-cigarette or an additional effect of other substances present in cigarette smoke but absent in an e-cigarette aerosol.