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Cardiovascular injury induced by tobacco products: assessment of risk factors and biomarkers of harm. A Tobacco Centers of Regulatory Science compilation

Year: 2019
Type: article
Abstract: Although substantial evidence shows that smoking is positively and robustly associated with cardiovascular disease (CVD), the CVD risk associated with the use of new and emerging tobacco products, such as electronic cigarettes, hookah, and heat-not-burn products, remains unclear. This uncertainty stems from lack of knowledge on how the use of these products affects cardiovascular health. Cardiovascular injury associated with the use of new tobacco products could be evaluated by measuring changes in biomarkers of cardiovascular harm that are sensitive to the use of combustible cigarettes. Such cardiovascular injury could be indexed at several levels. Preclinical changes contributing to the pathogenesis of disease could be monitored by measuring changes in systemic inflammation and oxidative stress, organ-specific dysfunctions could be gauged by measuring endothelial function (flow-mediated dilation), platelet aggregation, and arterial stiffness, and organ-specific injury could be evaluated by measuring endothelial microparticles and platelet-leukocyte aggregates. Classical risk factors, such as blood pressure, circulating lipoproteins, and insulin resistance, provide robust estimates of risk, and subclinical disease progression could be followed by measuring coronary artery Ca 2+ and carotid intima-media thickness. Given that several of these biomarkers are well-established predictors of major cardiovascular events, the association of these biomarkers with the use of new and emerging tobacco products could be indicative of both individual and population-level CVD risk associated with the use of these products. Differential effects of tobacco products (conventional vs. new and emerging products) on different indexes of cardiovascular injury could also provide insights into mechanisms by which they induce cardiovascular harm.
DOI: 10.1152/ajpheart.00591.2018
Authors: Daniel J. Conklin, Suzaynn Schick, Michael J. Blaha, Alex Carll, Andrew DeFilippis, Peter Ganz, Michael E. Hall, Naomi Hamburg, Tim O’Toole, Lindsay Reynolds, Sanjay Srivastava, Aruni Bhatnagar
Institutions: University of Louisville, University of California, San Francisco, Johns Hopkins University, University of Mississippi Medical Center, Boston University, Wake Forest University Health Sciences, Wake Forest University
Language: English
Subfield: Physiology
Field: Medicine
Open Access status: bronze
Awards: G146293445, G1714133423, American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Cardiovascular Toxicity of Tobacco Products and Constituents, G3894149073, G4819713524, G5217188016, G5475226964, G5478999684, G766588337, G790231811, G8588115036, Renal Sinus Fat, Hypertension, and Altered Kidney Function, American Heart Association Tobacco Center for Regulatory Science (A-TRAC) 2.0
OpenAlex ID: W2911618344
FWCI: 7.406
Cites: 408
Cited by: 98
Related to: 10