A5918 Electronic cigarette acutely increases blood pressure in hypertensive patients. Evaluation by non -invasive continuous (beat-to-beat) blood pressure monitoring

Abstract

Objectives: There are evidences showing that nicotine replacement by electronic cigarettes (ECs), may help to stop smoking long-term. However, a high proportions of smokers who quit cigarette smoking continue to use ECs long-term, switching from an addiction to an other. The vascular effect of ECs containing nicotine is very similar to that of conventional cigarettes with a negative acute effect on cardiovascular and autonomic nervous system but little is known about its influence on blood pressure (BP) and it's duration in hypertensive subject. Methods: This is a randomized, cross-over and placebo controlled study. We considered 30 mild-to-moderate hypertensive patients on pharmacological treatment and adequate BP control (< 140/90 mmHg). Patients (22 males, mean age 54 ± 21 years) were former smokers, who quitted tobacco cigarette in favor of ECs, at least 6 months before. BP and heart rate (HR) were measured by continuous non-invasive BP pressure and ECG monitoring (SOMNOtouch NIBP). BP and HR were evaluated during a 30 minute rest in sitting position; in random order, during other 30 minutes after smoking ECs (inhalation equivalent to 0.8 mg of nicotine of a regular cigarette) or placebo ECs (no nicotine but same flavor and device). Results: ECs vaping was accompanied by significant (p < 0.05) increase in BP and HR that lasted about 30 minutes (average 28 ± 11 minutes). Compared to placebo, the ECs increased systolic BP by 9,6 ± 4,1 mmHg; diastolic BP by 7.1 ± 3.9 mmHg; HR by 16.4 ± 13 bpm’. Conclusion: ECs smoking caused a significant and long-lasting rise in BP and HR in hypertensive patients. Considering that the habitual daily number of inhalations in ECs smokers is high (> 20), the BP rise caused by ECs smoking appears markedly and clinically relevant.