Background/Introduction Tobacco cigarette smoking is related with atherosclerosis progression, blood pressure increase and changes in sympathetic nerve activity. However, there are scarce data on the impact of e-cigarettes that have been proposed as less harmful alternatives on the cardiovascular system and sympathetic drive. Purpose This study aimed to assess the acute effects of tobacco cigarettes, e-cigarettes and sham smoking on blood pressure and sympathetic nervous system in healthy subjects. Methods We studied 10 normotensive male habitual smokers (mean age 33 years, body mass index: 24.1 kg/m2, office blood pressure=117/72 mmHg) free of cardiovascular disease. The study design was randomized and placebo controlled with 3 experimental sessions (sham smoking, tobacco cigarette smoking, and e-cigarette smoking) in random order, each session on a separate day. Subjects smoked 2 tobacco cigarettes containing 1.1 mg nicotine or simulate smoking (sham smoking) with the 2 cigarettes separated by 5 minutes, while 45 minutes after finishing the second cigarette, subjects smoked a third cigarette or sham cigarette. Additionally, participants smoked e-cigarettes for a period of 5 and 30 minutes. In all occasions, sympathetic drive was assessed by muscle sympathetic nerve activity (MSNA) (baroreflex-dependent) and skin sympathetic nerve activity (SSNA) (baroreflex-independent) based on established methodology (microneurography). Results After the first, second and third tobacco cigarette smoking there was markedly and significantly increase in mean arterial pressure (by 11.2±1.4%, 12.3±1.3% and 13.1±1.4%, respectively, p<0.05 for all) and heart rate (by 25.1±3.7%, 26.3±2.7% and 25.9±3.7%, respectively, p<0.05 for all). Similarly e-cigarette smoking at 5 and 30 minutes was accompanied by augmentation of mean arterial pressure (by 10.9±1.2% and 12.8±1.4%, respectively, p<0.05 for both) and heart rate (by 22.5±3.3% and 23.9±3.8%, respectively, p<0.05 for both). Regarding the effect on sympathetic nervous system, the first, second and third tobacco cigarette smoking was accompanied by lower MSNA (by 28.1±4.4%, 29.6±5.3% and 30.1±5.2%, respectively, p<0.05 for all), whereas SSNA was increased (by 98.2±19.4%, 100.2±22.7% and 101.5±21.6%, respectively, p<0.05 for all). Additionally, e-cigarette smoking at 5 and 30 minutes caused a decrease in MSNA (by 26.9±3.6%, and 28.3±5.1%, respectively, p<0.05 for both), and an augmentation in SSNA (by 97.9±20.1% and 100.9±20.6%, respectively, p<0.05 for both). Sham smoking was devoid of any effects on blood pressure, MSNA and SSNA. Conclusions E-cigarette smoking acutely increases blood pressure and has a detrimental effect on sympathetic nerve activity regulation similar to tobacco smoking in healthy subjects. Our findings underscore the negative impact of e-cigarettes on cardiovascular and autonomic nervous system and could aid further recommendation in their use.

Background: Testosterone deficiency and smoking are both associated with erectile dysfunction (ED) and cardiovascular (CV) mortality risk. Purpose: Aim of this study is to investigate the association between smoking and testosterone levels in patients with ED, a population with particularly high CV risk. Methods: We measured total testosterone (TT) levels in 761 ED patients (mean age 56±7 years) without manifest cardiovascular/atherosclerotic disease. Within this population, there were 378 smokers, 118 non-smokers, and 265 ex-smokers. Ex-smokers were included if they had stopped smoking at least 6 months earlier and had smoked a minimum of six cigarettes a day while actively smoking. Results: Compared to smokers, never-smokers and ex-smokers were older (overall P<0.01). The three groups had similar prevalence of hypertension, dyslipidemia and type II diabetes. Current smokers had significantly higher TT compared to ex-smokers and never-smokers even after adjustment for age (overall P<0.01, left figure). However, within smokers TT levels were inversely correlated to the amount of tobacco exposure (overall P<0.01, right figure). Smoking was an independent influencing factor for the levels of TT in multivariate logistic regression models before and after adjusting for age, body mass index, fasting blood glucose, triglycerides and C-reactive protein (OR = 1.52, 95% CI: 1.27-2.36, P<0.001). Smoking and testosterone levelsConclusions: Smoking can lead to an increase in testosterone levels, but this can decrease with chronic exposure to tobacco by long-term smoking. Further studies should be conducted to evaluate how much of the unfavorable of smoking on CV outcomes are mediated by their effect on testosterone levels. Background/Introduction: Tobacco cigarette smoking is related with blood pressure increase and changes in sympathetic nerve activity. There are scarce data on the impact of electronic cigarettes that have been proposed as less harmful alternatives on the cardiovascular system and sympathetic drive. Purpose: This study aimed to assess the acute effects of tobacco cigarettes, electronic cigarettes and sham smoking on blood pressure and sympathetic nervous system in healthy subjects. Methods: We studied 10 normotensive male habitual smokers (mean age 33 years, office blood pressure=117/72 mmHg) free of cardiovascular disease. The study design was randomized and placebo controlled with 3 experimental sessions (sham smoking, tobacco cigarette smoking, and electronic cigarette smoking) in random order, each session on a separate day. Subjects smoked 2 tobacco cigarettes containing 1.1 mg nicotine or simulate smoking (sham smoking) with the 2 cigarettes separated by 5 minutes, while 45 minutes after finishing the second cigarette, subjects smoked a third cigarette or sham cigarette. Additionally, participants smoked electronic cigarettes for a period of 5 and 30 minutes. In all occasions, sympathetic drive was assessed by muscle sympathetic nerve activity (MSNA) (baroreflex-dependent) and skin sympathetic nerve ...