Lesser evil?
Electronic cigarettes use may pose lower cardiovascular risks in people living with HIV compared to tobacco cigarette use.
This is according to a UCLA-led research — “Atherogenic Effects of Acute Electronic Cigarette Compared With Tobacco Cigarette Smoking in People Living With HIV: A Randomized Crossover Trial” by Theodoros Kelesidis, Leila Fotooh Abadi, Isabelle Ruedisueli, Zoee U. D’Costa, and Holly R. Middlekauff — that was published in JAHA.
As part of the three-day research, researchers recruited people living with HIV aged 21-60 who smoked tobacco cigarettes. On separate days, participants smoked a tobacco cigarette, an electronic cigarette, or puffed on an empty straw (control) in random order. Blood samples and electrocardiograms were taken before and after each exposure and special lab tests assessed the blood’s propensity for causing atherogenesis, with tobacco cigarettes having the strongest effect.
The findings suggest that electronic cigarettes (ECs) have a lower likelihood of causing changes associated with atherogenesis, compared to tobacco cigarettes (TCs), among those living with HIV.
The research specifically found:
- The acute rise in plasma nicotine was similar after acute TC and EC use (7.32±0.86 ng/mL versus 6.30±0.92 ng/mL, P=0.69).
- The monocyte transendothelial migration after acutely smoking a TC increased by a mean of 0.65‐fold difference compared with the straw control (P<0.01).
- The monocyte transendothelial migration after using an EC was not significantly increased compared with the straw control.
- The monocyte‐derived foam cell formation after acutely smoking a TC was increased by a mean of 0.65‐fold difference compared with the straw control (P<0.001).
- The monocyte‐derived foam cell formation after acutely using an EC was not significantly increased compared with the straw control. These findings were present in PLWH with and without concurrent recreational drug use.
“Tobacco smoking is the leading cause of preventable cardiovascular death in the US (alone), and people living with HIV/AIDs smoke at rates two to three times higher than the general population,” said Middlekauff, a cardiologist and professor of medicine and physiology at the David Geffen School of Medicine at UCLA and corresponding author of the study. “Our findings suggest that switching to electronic cigarettes could be a promising harm reduction strategy for this vulnerable population.”
Researchers believe this data would benefit from a larger clinical trial looking at cardiovascular risks of electronic cigarettes in people living with HIV who smoke tobacco.
“This is an important area of study as it could determine if switching completely to electronic cigarettes as part of a harm reduction strategy would satisfy the powerful addiction to nicotine while ultimately reducing future heart attack risk for those living with HIV,” Middlekauff said.
