Vapes may pose lower cardiovascular risks in people with HIV compared to cigarettes, a new study has found.
The UCLA-led study, published in the Journal of the American Heart Association, examined how smoking and vaping affect the early stages of atherogenesis – the build-up of fats and cholesterol in the arteries that can lead to a heart attack.
It found that vapes are less likely to cause changes associated with atherogenesis, compared to cigarettes, among people who had been diagnosed with HIV.
People with HIV more likely to smoke
While smoking has dropped to an all-time low among the general population in the U.S., this hasn’t been the case for people living with HIV. The leading cause of death for people with HIV is cardiovascular disease.
“Tobacco smoking is the leading cause of preventable cardiovascular death in the U.S., and people living with HIV/AIDs smoke at rates two to three times higher than the general population,” said study author Dr. Holly Middlekauff, a cardiologist and professor of medicine and physiology at the David Geffen School of Medicine at UCLA.
“Our findings suggest that switching to electronic cigarettes could be a promising harm reduction strategy for this vulnerable population.”
For the three-day study, researchers recruited people living with HIV aged between 21 and 60 who had been smoking cigarettes for at least one year. They were not excluded if they also vaped. On separate days, the participants (27 men and one woman) either smoked a cigarette, vaped, or puffed on an empty straw, in random order.
Cigarettes caused greatest changes
Blood samples and heart rates were taken before and after each exposure and special lab tests assessed the blood’s propensity for causing atherogenesis. Cigarettes were found to have the strongest effect.
The researchers said their data would benefit from a larger clinical trial looking at the cardiovascular risks of vapes in people living with HIV who smoke.
“This is an important area of study as it could determine if switching completely to electronic cigarettes as part of a harm reduction strategy would satisfy the powerful addiction to nicotine while ultimately reducing future heart attack risk for those living with HIV,” Middlekauff said.
Nicotine ruled out as cause
The study concluded: “Compared with combusted tobacco cigarettes (TCs), electronic cigarettes (ECs) deliver comparable levels of nicotine accompanied by lower levels of the non-nicotine toxicants and carcinogens that largely drive the early steps in premature inflammatory atherosclerosis (where the arteries become narrowed, increasing the risk of a heart attack).
“Thus, switching to ECs has been proposed as a harm reduction strategy. However, it remains unproven whether ECs are less atherogenic and thus less harmful than TCs.”
It added: “Although long‐term clinical trial data are needed, the results from our study support the notion that ECs are less atherogenic than TCs and justify larger studies examining their relative atherogenic effects.”
The researchers said that nicotine levels were similar following acute smoking or vaping and yet the cigarettes were “more atherogenic.” This supports the conclusion that the non-nicotine ingredients in cigarettes were “driving these greater changes,” not the nicotine.
