Klonizakis Markos, Gumber Anil, McIntosh Emma, Brose Leonie S
Lifestyle, Exercise and Nutrition Improvement (LENI) Research Group, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield S10 2BP, UK.
Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield S10 2BP, UK.
Biology (Basel). 2021 Nov 19;10(11):1208. doi: 10.3390/biology10111208.
Smoking increases cardiovascular disease (CVD) risk by leading to endothelial injury. E-cigarettes remain a popular way to stop smoking. Evidence on their effect on cardiovascular health is growing but remains limited, particularly in the short-term. The main objective of this study was to compare short-term cardiovascular effects in smokers who quit smoking using e-cigarettes with or without nicotine or prescription nicotine replacement therapy (NRT). This was a single-centre (Sheffield, UK) pragmatic three-arm randomised controlled trial which recruited adult smokers (≥10 cigarettes per day), who were willing to attempt to stop smoking with support (n = 248). Participants were randomised to receive either: (a) behavioral support and e-cigarettes with 18 mg/mL nicotine (n = 84); (b) behavioral support and e-cigarettes without nicotine (n = 82); (c) behavioral support and NRT (n = 82). Flow Mediated Dilation (%FMD), peak cutaneous vascular conductance responses to acetylcholine (ACh) and sodium nitroprusside (SNP) and mean arterial pressure (MAP) were recorded at baseline and three days after stopping smoking. General Linear Models were used to compare changes between groups and changes from follow-up. Adjusting for baseline, at follow-up, all outcomes (for the 208 participants that completed the 3-day assessments) with the exception of SNP had improved significantly over baseline and there were no differences between groups (%FMD F = 1.03, p = 0.360, df = 2,207; ACh F = 0.172, p = 0.84, df = 2,207; SNP F = 0.382, p = 0.68, df = 2,207; MAP F = 0.176, p = 0.84, df = 2,207). For smokers ≥20 cigarettes per day, benefits were also pronounced. Smoking cessation showed positive cardiovascular impact even after a 3-day period and the effects did not differ between nicotine-containing e-cigarettes, nicotine-free e-cigarettes and NRT.
吸烟会导致内皮损伤，从而增加心血管疾病（CVD）风险。电子烟仍然是一种流行的戒烟方式。关于其对心血管健康影响的证据越来越多，但仍然有限，尤其是在短期内。本研究的主要目的是比较使用含尼古丁或不含尼古丁的电子烟或处方尼古丁替代疗法（NRT）戒烟的吸烟者的短期心血管效应。这是一项单中心（英国谢菲尔德）实用的三臂随机对照试验，招募了成年吸烟者（每天≥10支香烟），他们愿意在支持下尝试戒烟（n = 248）。参与者被随机分配接受以下治疗：（a）行为支持和含18 mg/mL尼古丁的电子烟（n = 84）；（b）行为支持和不含尼古丁的电子烟（n = 82）；（c）行为支持和NRT（n = 82）。在基线和戒烟三天后记录血流介导的舒张（%FMD）、对乙酰胆碱（ACh）和硝普钠（SNP）的峰值皮肤血管传导反应以及平均动脉压（MAP）。使用一般线性模型比较组间变化和随访变化。在调整基线后，随访时，除SNP外，所有结局（208名完成3天评估的参与者）均较基线有显著改善，且组间无差异（%FMD F = 1.03，p = 0.360，df = 2,207；ACh F = 0.172，p = 0.84，df = 2,207；SNP F = 0.382，p = 0.68，df = 2,207；MAP F = 0.176，p = 0.84，df = 2,207）。对于每天吸烟≥20支的吸烟者来说，益处也很明显。即使在3天之后，戒烟也显示出对心血管有积极影响，含尼古丁的电子烟、不含尼古丁的电子烟和NRT之间的效果没有差异。
