From the Guidelines
Limited pure nicotine does not have sufficient cardioprotective effects to outweigh its risks and addictive properties, and therefore, it is not recommended as a therapeutic agent for cardiovascular protection. The most recent and highest quality study, published in 2023, suggests that while nicotine replacement therapy (NRT) is safe for use in patients with cardiovascular disease, its benefits for smoking cessation are outweighed by the risks of long-term dependence and potential cardiovascular harm associated with e-cigarettes 1. Research has shown that nicotine can potentially improve lipid profiles, reduce inflammation, and inhibit platelet aggregation, but these effects are not sufficient to translate into real-world clinical benefits, especially considering the risks of nicotine addiction and cardiovascular harm 1.
Some studies have suggested that nicotine may have some beneficial effects on cardiovascular health, such as promoting angiogenesis and improving endothelial function, but these effects are not well-established and are outweighed by the negative effects of nicotine on cardiovascular health, including increased blood pressure, heart rate, and myocardial oxygen demand 1.
The 2023 guidelines for the management of patients with chronic coronary disease recommend established approaches such as regular exercise, heart-healthy diets, blood pressure control, and medications like statins or aspirin for cardiovascular protection, rather than nicotine or NRT 1.
Key points to consider:
- Nicotine replacement therapy is safe for use in patients with cardiovascular disease, but its benefits for smoking cessation are limited by the risks of long-term dependence and potential cardiovascular harm associated with e-cigarettes.
- Nicotine's potential cardioprotective effects are outweighed by its risks and addictive properties.
- Established approaches like regular exercise, heart-healthy diets, blood pressure control, and medications like statins or aspirin remain the recommended strategies for cardiovascular protection.
In clinical practice, the focus should be on evidence-based strategies for cardiovascular protection, rather than relying on nicotine or NRT, which have limited benefits and significant risks 1.
From the Research
Cardioprotective Effects of Limited Pure Nicotine
- There is no direct evidence in the provided studies to suggest that limited pure nicotine has cardioprotective effects 2, 3, 4, 5, 6.
- The studies primarily focus on the effectiveness of nicotine replacement therapy (NRT), varenicline, and bupropion for smoking cessation, rather than the cardioprotective effects of nicotine itself 2, 3, 4, 5, 6.
- However, some studies mention that smoking cessation, which can be achieved through NRT, varenicline, or bupropion, reduces subsequent cardiovascular events and mortality 3, 4, 5.
- One study notes that quitting smoking improves mental health and reduces cardiovascular events and mortality in people living with cardiovascular disease 5.
- Nevertheless, the cardioprotective effects of limited pure nicotine are not explicitly addressed in the provided studies, and more research would be needed to determine its potential benefits or risks 2, 3, 4, 5, 6.