Key result
Heated tobacco products improved biomarkers of oxidative stress and endothelial dysfunction compared to conventional cigarettes, but showed no relevant differences in acute effects on arterial stiffness.
Why the study?
Heated tobacco products are believed to reduce smoking-related disease burden, but their safety remains unclear given potentially toxic chemicals and increased nicotine concentrations.
Do heated tobacco products improve cardiovascular risk biomarkers compared to traditional cigarettes in smokers?
Systematic Review
Do heated tobacco products improve cardiovascular risk biomarkers compared to traditional cigarettes in smokers?
While heated tobacco products may improve certain cardiovascular biomarkers compared to traditional cigarettes, their acute effects on arterial stiffness and hemodynamics are similar, indicating they are not risk-free.
Supports partial harm reduction on oxidative and endothelial markers with heated tobacco products; extends RCT evidence distinguishing biomarker from stiffness effects.
Background: Heated tobacco products (HTP) are alternative forms to traditional cigarettes. Harmful components contained in HTP tobacco aerosol are in lower amounts than those in smoke from traditional cigarettes. That’s why HTP are believed to reduce the burden of smoking related-diseases. However, due to its potentially toxic chemicals and the increased concentration of nicotine, HTP devices may not be as safe as the industries claim. This review was completed to summarize effects of HTP on user’s health, in particular on cardiovascular system.Methods: A systematic search of the literature in PubMed database was performed to identify significant articles published from 2015 to 2021. For this review we selected randomized clinical trials that explore the effects of heat-not-burn cigarettes on the cardiovascular system. Independent and sponsored studies by the tobacco industry were included. Conclusion: The analysis of biomarkers of biological effect, such as those for oxidative stress, platelet activation, endothelial dysfunction, inflammation, antioxidant reserve and others showed differences between smokers and people using heated tobacco products in favor of the latter. However, studies comparing the acute effects of different tobacco products on arterial stiffness, heart rate and myocardial function indicated no relevant differences between IQOS and traditional cigarettes. So, Heated Tobacco Products appear less harmful. Nevertheless, due to conflicting information and the restricted knowledge of IQOS exposure, further long-therm human studies are needed to assess the potential benefit and risk of heated tobacco products
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Ghazaryan et al. (2022) conducted a systematic review in Cardiovascular risk in smokers. Heated Tobacco Products vs. Conventional cigarettes was evaluated on Cardiovascular biomarkers and acute hemodynamic effects. Heated tobacco products improved biomarkers of oxidative stress and endothelial dysfunction compared to conventional cigarettes, but showed no relevant differences in acute effects on arterial stiffness.
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