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      E-cigarettes and cigarettes worsen peripheral and central hemodynamics as well as arterial stiffness: A randomized, double-blinded pilot study

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          Abstract

          The introduction of electronic cigarettes has led to widespread discussion on the cardiovascular risks compared to conventional smoking. We therefore conducted a randomized cross-over study of the acute use of three tobacco products, including a control group using a nicotine-free liquid. Fifteen active smokers were studied during and after smoking either a cigarette or an electronic cigarette with or without nicotine (eGo-T CE4 vaporizer). Subjects were blinded to the nicotine content of the electronic cigarette and were followed up for 2 hours after smoking a cigarette or vaping an electronic cigarette. Peripheral and central blood pressures as well as parameters of arterial stiffness were measured by a Mobil-O-Graph® device. The peripheral systolic blood pressure rose significantly for approximately 45 minutes after vaping nicotine-containing liquid ( p<0.05) and for approximately 15 minutes after smoking a conventional cigarette ( p<0.01), whereas nicotine-free liquids did not lead to significant changes during the first hour of follow-up. Likewise, heart rate remained elevated approximately 45 minutes after vaping an electronic cigarette with nicotine-containing liquid and over the first 30 minutes after smoking a cigarette in contrast to controls. Elevation of pulse wave velocity was independent from mean arterial pressure as well as heart rate in the electronic cigarette and cigarette groups. In this first of its kind trial, we observed changes in peripheral and central blood pressure and also in pulse wave velocity after smoking a cigarette as well as after vaping a nicotine-containing electronic cigarette. These findings may be associated with an increased long-term cardiovascular risk.

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          Most cited references19

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          2013 ESH/ESC Practice Guidelines for the Management of Arterial Hypertension.

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            Validation of a brachial cuff-based method for estimating central systolic blood pressure.

            The prognostic value of central systolic blood pressure has been established recently. At present, its noninvasive assessment is limited by the need of dedicated equipment and trained operators. Moreover, ambulatory and home blood pressure monitoring of central pressures are not feasible. An algorithm enabling conventional automated oscillometric blood pressure monitors to assess central systolic pressure could be of value. We compared central systolic pressure, calculated with a transfer-function like method (ARCSolver algorithm), using waveforms recorded with a regular oscillometric cuff suitable for ambulatory measurements, with simultaneous high-fidelity invasive recordings, and with noninvasive estimations using a validated device, operating with radial tonometry and a generalized transfer function. Both studies revealed a good agreement between the oscillometric cuff-based central systolic pressure and the comparator. In the invasive study, composed of 30 patients, mean difference between oscillometric cuff/ARCSolver-based and invasive central systolic pressures was 3.0 mm Hg (SD: 6.0 mm Hg) with invasive calibration of brachial waveforms and -3.0 mm Hg (SD: 9.5 mm Hg) with noninvasive calibration of brachial waveforms. Results were similar when the reference method (radial tonometry/transfer function) was compared with invasive measurements. In the noninvasive study, composed of 111 patients, mean difference between oscillometric cuff/ARCSolver-derived and radial tonometry/transfer function-derived central systolic pressures was -0.5 mm Hg (SD: 4.7 mm Hg). In conclusion, a novel transfer function-like algorithm, using brachial cuff-based waveform recordings, is suited to provide a realistic estimation of central systolic pressure.
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              Central blood pressure measurements and antihypertensive therapy: a consensus document.

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                Author and article information

                Journal
                Vascular Medicine
                Vasc Med
                SAGE Publications
                1358-863X
                1477-0377
                July 09 2018
                July 09 2018
                : 1358863X1877969
                Affiliations
                [1 ]Medizinische Klinik III, Campus Luebeck, Universitätsklinikum Schleswig-Holstein, Luebeck, Germany
                [2 ]Medizinische Klinik II, Campus Luebeck, Universitätsklinikum Schleswig-Holstein, Luebeck, Germany
                [3 ]Sana Klinik Luebeck, Luebeck, Germany
                [4 ]Practice for Cardiology and Angiology Landsberg, Landsberg, Germany
                [5 ]German Center for Lung Research (DZL), ARCN, Kiel/Luebeck/Großhansdorf/Borstel, Germany
                [6 ]Cardiology Kiel, Kiel, Germany
                Article
                10.1177/1358863X18779694
                29985113
                32b15bf8-a3af-4860-b05d-d7b755e6338e
                © 2018

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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