Gonzalez · American journal of physiology. Heart and circulatory physiology 2021 · randomized crossover trial · n=15

Acute effects of electronic cigarettes on arterial pressure and peripheral sympathetic activity in young nonsmokers.

Cited 77 times in the scientific literature.

Level 2 - randomized trial

Individual randomized crossover trial in humans

PubMed 33164580 · doi:10.1152/ajpheart.00448.2020 · record verified 2026-08-29

What was done

In a randomized crossover trial, young nonsmoking participants inhaled from a nicotine-containing JUUL e-cigarette (59 mg/mL) and a nicotine-free placebo e-cigarette (0 mg/mL) across sessions separated by approximately 1 month. Investigators recorded baseline electrocardiogram, finger arterial pressure (n = 15), and muscle sympathetic nerve activity (MSNA, n = 10) during a 10-minute baseline rest, a 10-minute vaping protocol (1 puff every 30 s), and a 10-minute recovery period.

What was found

Nicotine vaping significantly increased heart rate during use compared to placebo (change of +5.0 ± 1.3 beats/min vs. +0.1 ± 0.8 beats/min, P < 0.01), returning to baseline during recovery. Mean arterial pressure increased in the nicotine condition and remained elevated during recovery (+6.5 ± 1.6 mmHg vs. +2.6 ± 1 mmHg during vaping; +4.6 ± 1.7 mmHg vs. +1.4 ± 1.4 mmHg during recovery; P < 0.05). Concurrently, MSNA decreased during nicotine inhalation and remained suppressed during recovery (-7.1 ± 1.6 bursts/min vs. +2.6 ± 2 bursts/min during vaping; -5.8 ± 1.7 bursts/min vs. +0.5 ± 1.4 bursts/min during recovery; P < 0.05).

Why it matters

This study provides physiological evidence that acute nicotine e-cigarette inhalation increases arterial blood pressure and triggers baroreflex-mediated sympathetic inhibition in healthy young nonsmokers, mirroring effects seen with combustible tobacco.

Limits

The study had a very small sample size (n = 15 for pressure, n = 10 for MSNA), included only young healthy nonsmokers, tested only a single brand and high nicotine concentration (59 mg/mL), and evaluated only brief 10-minute acute exposure rather than chronic use.

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