E-Cigarettes and Cardiopulmonary Health: Review for Clinicians.
E-Cigarettes and Cardiopulmonary Health: Review for Clinicians.
复制标题
电子烟与心脏健康：临床医生评论
DOI：
10.1161/circulationaha.121.056777
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发表时间：
2022-01-18
期刊：
影响因子：
37.8
通讯作者：
Tarran R
中科院分区：
文献类型：
--
作者：
Neczypor EW;Mears MJ;Ghosh A;Sassano MF;Gumina RJ;Wold LE;Tarran R
电子香烟（电子香烟）是电池供电的电子尼古丁输送系统，其使用丙二醇/植物甘油基质将蒸发的尼古丁和调味剂输送到身体。电子烟成为商业上可用的，但没有证据表明其风险，长期安全性或戒烟效果。最近的临床试验表明，电子烟的使用与咨询可能有效地减少香烟，但不是尼古丁依赖。然而，观察性研究的荟萃分析表明，电子烟的使用与戒烟无关。心血管研究报告了交感神经激活、血管硬化和内皮功能障碍，这些与不良心血管事件相关。到目前为止，大多数电子烟使用者的肺部临床试验使用标准肺量计作为主要结局指标，报告肺功能没有变化。然而，急性和慢性研究报告了电子烟使用者肺部疾病的生物标志物增加。虽然这些研究是在成年受试者中进行的，但超过30%的高中适龄青少年报告使用电子烟。使用电子烟对青少年和年轻人心肺终点的影响尚未研究。由于不良的临床发现以及电子烟使用与从未吸烟者呼吸道疾病发病率增加之间的关联，需要进行大型纵向研究以了解电子烟的风险状况。根据疾病控制和预防中心的建议，临床医生应监测电子烟使用的健康风险，不鼓励非吸烟者和青少年使用电子烟，并不鼓励吸烟者在不减少或停止吸烟的情况下进行双重使用。
Electronic cigarettes (e-cigarettes) are battery powered electronic nicotine delivery systems that use a propylene glycol/vegetable glycerin base to deliver vaporized nicotine and flavorings to the body. E-cigarettes became commercially available without evidence regarding their risks, long-term safety, or efficacy for smoking cessation. Recent clinical trials suggest that e-cigarette use with counseling may be effective in reducing cigarette, but not nicotine-dependence. However, meta-analyses of observational studies demonstrate that e-cigarette use is not associated with smoking cessation. Cardiovascular studies reported sympathetic activation, vascular stiffening, and endothelial dysfunction, which are associated with adverse cardiovascular events. To date, the majority of pulmonary clinical trials in e-cigarette users utilized standard spirometry as the primary outcome measure, reporting no change in lung function. However, acute and chronic studies reported increased biomarkers of pulmonary disease in e-cigarette users. While these studies were conducted in adult subjects, >30% of high school-age adolescents reported e-cigarette use. The effects of e-cigarette use on cardiopulmonary endpoints in adolescents and young adults remains unstudied. Due to adverse clinical findings and associations between e-cigarette use and increased incidence of respiratory diseases in people who have never smoked, large longitudinal studies are needed to understand the risk profile of e-cigarettes. Consistent with the Centers for Disease Control and Prevention recommendations, clinicians should monitor the health risks of e-cigarette use, discourage nonsmokers and adolescents from using e-cigarettes, and discourage smokers from engaging in dual use without cigarette reduction or cessation.