Electronic cigarettes may pose lower cardiovascular risks for people with HIV

Electronic cigarettes use may pose lower cardiovascular risks in people living with HIV compared to tobacco cigarette use, new UCLA-led research shows. The study, published in JAHA, uses a novel laboratory model to examine the early stages of atherogenesis-the buildup of fats and cholesterol in the arteries. The findings suggest that electronic cigarettes (ECs) have a lower likelihood of causing changes associated with atherogenesis, compared to tobacco cigarettes (TCs), among those living with HIV. 

 While smoking has dropped to all-time low levels in the U.S., this hasn't been the case for people living with HIV, who are disproportionately affected by tobacco-related health disparities. "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 Dr. Holly Middlekauff, a cardiologist and professor of medicine and physiology at the David Geffen School of Medicine at UCLA and corresponding author of the study. "Our findings suggest that switching to electronic cigarettes could be a promising harm reduction strategy for this vulnerable population." 

 As part of the three-day study, researchers recruited people living with HIV aged 21-60 who smoked tobacco cigarettes. On separate days, participants smoked a tobacco cigarette, an electronic cigarette, or puffed on an empty straw (control) in random order. Blood samples and electrocardiograms were taken before and after each exposure and special lab tests assessed the blood's propensity for causing atherogenesis, with tobacco cigarettes having the strongest effect. 

Researchers believe this data would benefit from a larger clinical trial looking at cardiovascular risks of electronic cigarettes in people living with HIV who smoke tobacco.

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."

Dr. Holly Middlekauff, cardiologist and professor of medicine and physiology, David Geffen School of Medicine, UCLA