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

作者：Daniel J. Conklin, Suzaynn F. Schick, Michael Joseph Blaha, Alex P. Carll, Andrew Paul DeFilippis, Peter Ganz, Michael E. Hall, Naomi M. Hamburg, Timothy E. O’Toole, Lindsay M. Reynolds, Sanjay Kumar Srivastava, Aruni Bhatnagar · 发表于：American Journal of Physiology-Heart and Circulatory Physiology · 年份：2019 · DOI：10.1152/ajpheart.00591.2018 · 被引用次数：99 · 研究领域：Cardiovascular Disease and Adiposity、Smoking Behavior and Cessation、Air Quality and Health Impacts

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 e...