PS-C12-1: HEATED TOBACCO PRODUCTS VS TRADITIONAL TOBACCO CIGARETTES EFFECTS ON BLOOD PRESSURE AND OTHER CARDIOVASCULAR RISK PREDICTORS AMONG SMOKERS: A META-ANALYSIS

Abstract

Introduction: Over the last decades, a large body of evidence has already demonstrated the association between traditional tobacco cigarette (TTC) smoking and cardiovascular events. More recently, heated tobacco products (HTPs) have been introduced, to potentially reduce exposure to harmful constituents in cigarette smoke and reduce the health burden of smoking-related diseases. Methods: Randomized controlled trials comparing TTCs and HTPs with outcomes on blood pressure (BP), heart rate (HR) and other predictors of cardiovascular risk such as flow mediated dilatation (FMD), pulse wave velocity (PWV), high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (Tg) and total cholesterol (TC) were searched through PubMed, Google Scholar and Cochrane database. A total of 13 studies were included. Results: Pooled analysis of studies showed that HTPs showed significant difference compared to TTCs on HR (MD -3.16 beats per minute [bpm] with 95% CI of -5.41 to -0.91, p = 0.006), FMD (in % change) (MD + 2.53% with 95% CI of 0.17 to 4.89, p = 0.04) and HDL (MD 0.18 mg/dL with 95% CI of 0.07 to 0.28, p = 0.0009). No significant differences were noted on systolic BP, diastolic BP, LDL, Tg and TC. Only 1 study had complete report of outcomes on PWV, showing no significant difference. Conclusion: Evaluating the effects on BP, HR and other known predictors of cardiovascular risk, HTPs, compared to TTCs, showed significant reduction in HR, and significant increases in FMD and HDL cholesterol, which may impact favorably in terms of cardiovascular risk reduction. There are no statistically significant differences in BP, LDL cholesterol, Tg, TC and PWV. Larger and long-term studies are still needed to support the cardiovascular benefits of HTPs.