Search Results (1,116)

Background/Objectives: High blood pressure remains a primary modifiable risk factor for cardiovascular disease. Nicotinamide mononucleotide (NMN) has emerged as a promising supplement; however, its efficacy with respect to blood pressure in humans is unclear. This meta-analysis systematically evaluated the effects of various NMN supplements on resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults with elevated blood pressure. Methods: A systematic literature search was conducted to identify eligible randomized controlled trials (RCTs) using the databases PubMed/MEDLINE, Scopus, Web of Science, and EBSCO from their inception to 13 December 2025. R software was used to combine the data from the included original trials using a common-effects model. Subgroup analyses were performed based on age, baseline body mass index, geographical location, intervention duration, NMN dosage, and baseline blood pressure. Results: A total of 349 participants from 10 RCTs with 11 intervention arms were included. Compared with the placebo, NMN supplementation was associated with a statistically significant but modest reduction in resting DBP (WMD, −2.15 mmHg; 95% CI: −3.68 to −0.61). In contrast, the reduction in resting SBP was not statistically significant. Notably, subgroup analyses revealed that NMN supplementation resulted in a significant reduction in SBP specifically among participants aged 60 years and older (WMD: −3.94 mmHg; 95% CI: −7.06 to −0.82). Conclusions: Our findings provide preliminary and suggestive evidence that NMN supplementation may be associated with a small reduction in resting DBP and a modest beneficial effect on resting SBP in adults aged 60 years and older. However, the potential of NMN as a viable candidate for early-stage blood pressure management requires confirmation through long-term, large-scale, high-quality RCTs in future clinical studies. Full article

Background: The ISCHEMIA trial demonstrated no overall prognostic benefit of an initial invasive strategy over optimal medical therapy (OMT) in patients with chronic coronary syndrome (CCS) and moderate-to-severe ischemia. However, managing patients with stable angina and low systolic blood pressure (SBP) remains challenging due to limited tolerance to vasodilatory anti-anginal drugs and the uncertain role of revascularization in improving long-term outcomes for this subgroup. Objectives: This study aimed to estimate the treatment effect of an initial invasive strategy (INV) compared with conservative medical therapy (CON) on long-term clinical outcomes and quality of life in patients with stable angina, particularly those with low baseline systolic blood pressure (≤120 mmHg). Methods: We conducted a post hoc analysis of 3544 patients with stable angina from the ISCHEMIA trial, divided into an initial invasive strategy or a conservative approach. The primary endpoint was a 3-year composite of cardiovascular death, myocardial infarction, hospitalization for unstable angina or heart failure, or resuscitated cardiac arrest. Health-related quality of life was assessed using the Seattle Angina Questionnaire (SAQ). In the subgroup, patients were stratified by baseline SBP, diastolic blood pressure (DBP) and heart rate; the Cox model was adjusted for the covariates. Results: Baseline characteristics were generally comparable between the two groups. Over 3 years of follow-up, no significant difference in primary endpoint events was observed between the INV and CON group in the overall cohort (HR = 0.94, 95%CI 0.77–1.14, p = 0.53), and the INV group had the higher SAQ score. Among patients with low baseline SBP (≤120 mmHg), after adjusting for clinical factors using Cox regression, randomized treatment assignment to the INV approach significantly reduced adverse cardiovascular events compared with conservative therapy (HR = 0.58, 95%CI 0.38 to 0.89). Conclusions: In patients with stable angina, an invasive strategy improved long-term quality of life. Among those with low baseline SBP (≤120 mmHg) and limited tolerance to vasodilatory anti-anginal drugs, invasive management reduced 3-year adverse events, supporting tailored revascularization strategies for these patients; a larger cohort is needed for validation. However, this subgroup-specific causal contrast derives from a post hoc exploratory analysis and should be interpreted cautiously; prospective randomized studies are needed to further validate these findings. Full article

Background and Objectives: Despite extensive research into its vascular mechanisms, the relationship between tinnitus and morning blood pressure surge (MBPS) remains unexplored. This study aims to investigate the association between tinnitus and MBPS in hypertensive patients. Materials and Methods: The study included 266 hypertensive patients, 86 with tinnitus and 180 without. Office blood pressure (BP) measurements, 24 h ambulatory BP monitoring (ABPM), echocardiographic findings, and laboratory parameters were analyzed. Tinnitus severity was assessed using the Tinnitus Handicap Inventory (THI). MBPS was calculated as the difference between the average systolic BP (SBP) in the first two hours after waking and the lowest three SBP values measured during sleep. Statistical analyses included regression models, ROC curve analysis, and the Boruta feature selection method. Results: MBPS was significantly higher in the tinnitus group compared to the non-tinnitus group (35 ± 9 vs. 26 ± 11 mm Hg, p < 0.001). Office BP and ABPM were significantly lower in the tinnitus group, while DBP showed no differences. The regression analysis identified MBPS (OR = 1.15, 95% CI: 1.08–1.23, p < 0.001), SBP (OR = 1.09, 95% CI: 1.03–1.15, p = 0.004), age (OR = 0.89, 95% CI: 0.82–0.96, p = 0.003), and smoking status (OR = 3.54, 95% CI: 1.09–11.61, p = 0.037) as independent predictors of tinnitus. The ROC analysis demonstrated that MBPS >28 mm Hg predicted tinnitus with 73.3% sensitivity and 68.3% specificity (AUC = 0.742, 95% CI: 0.685–0.793, p < 0.001). The comparative analysis showed that MBPS had a superior predictive accuracy for tinnitus compared to other BP parameters (p < 0.001). The 5-fold cross-validated ROC analysis further validated the moderate discriminatory power of MBPS, with an average AUC of 0.735 (95% CI: 0.672–0.798). Conclusions: This study demonstrates a significant association between tinnitus and MBPS in hypertensive patients. MBPS may serve as a useful indicator for identifying patients at risk of tinnitus, highlighting the importance of circadian BP monitoring in clinical practice. Full article

Background: Vitamin D has been associated with blood pressure across the life course in observational studies, although effect sizes are generally modest and findings are not fully consistent. We examined the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and multiple blood pressure indices in a community-based cohort of young adults. Methods: We conducted a cross-sectional analysis within the Young Taiwanese Adults (YOTA) cohort, restricting the sample to adults aged 18–45 years with complete serum 25(OH)D and blood pressure data. Serum 25(OH)D was modeled as a continuous variable and additionally examined using predefined concentration categories. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were assessed using standardized protocols. Multivariable linear regression models evaluated associations, with sequential adjustment for demographic, anthropometric, cardiometabolic, and lifestyle covariates. Restricted cubic spline models assessed potential nonlinearity. Results: Among 923 participants, higher serum 25(OH)D concentrations were modestly and linearly associated with lower SBP, DBP, and MAP after multivariable adjustment. Each 10 ng/mL increase in serum 25(OH)D was associated with a 1.07 mmHg lower SBP, a 1.19 mmHg lower DBP, and a 1.22 mmHg lower MAP. Associations remained consistent in sensitivity and subgroup analyses. Conclusions: In young adults, higher serum 25(OH)D concentrations were modestly associated with lower blood pressure indices. These findings confirm prior observational evidence of modest inverse associations between serum 25-hydroxyvitamin D concentrations and blood pressure and extend these observations to a relatively healthy young adult population. Prospective studies are required to clarify temporality and clinical relevance. Full article

Phthalates (PAEs), non-phthalate plasticizers (NPPs) and bisphenols (BPs) were monitored by fully validated GC-MS and HPLC-MS/MS protocols in honeys from diverse Algerian coastal and non-coastal areas. Experimental results showed that no honey was free of these compounds. A higher PAE contamination was evident in coastal honeys, while NPPs were more abundant in non-coastal samples. The revealed PAEs were: dimethyl phthalate (DMP, 28.12–277.14 µg/kg), diethyl phthalate (DEP, 18.20–404.70 µg/kg), dibutyl phthalate (DBP, 29.58–889.71 µg/kg) and bis(2-ethylhexyl) phthalate (DEHP, 20.66–523.16 µg/kg), while bis(2-ethylhexyl) terephthalate (DEHT, 8.95–206.12 µg/kg) and diethyl adipate (DEA, 10.36–97.51 µg/kg) were the NPPs determined. The EU—not Algeria—classifies DBP and DEHP as very high concern substances. Nonetheless, these PAEs were the most abundant and frequently detected contaminants. Even certain honeys showed DEHP outliers compared to the range provided above (1256.53 µg/kg). Coastal and non-coastal honeys were contaminated by bisphenol A (BPA, 2.64–12.73 µg/kg), thus, raising compliance concerns for export in the EU. In fact, the assessment of dietary exposure and toxicological risk derived from the consumption of these honeys highlighted that, while the exposure to plasticizers was within the safety limits, the exposure to BPA raised toxicological concern. Hopefully, these findings will support the constant monitoring of beekeeping activities and products and encourage the adoption of good practices with a view to guide the advancement of the sector and better safeguard consumers. Full article

Background: Hypertension is a multifactorial condition influenced by physiological, behavioral, and psychosocial factors. Muscle strength, physical activity, sleep quality, and perceived stress may contribute to blood pressure variability, although their relative influence remains unclear. This study examined associations between systolic blood pressure (SBP) and demographic, anthropometric, neuromuscular, behavioral, and psychosocial variables in adults with primary hypertension, with secondary analyses for diastolic blood pressure (DBP) and sex differences. Methods: A cross-sectional study was conducted in 391 adults with hypertension (165 men, 226 women). Predictors included age, body mass index, lower-limb muscle strength, physical activity (GPAQ), sleep quality (PSQI), and perceived stress. Associations were analyzed using correlation analyses and sex-stratified multivariable regression models. Results: In men, SBP correlated positively with age and negatively with lower-limb strength. In women, SBP showed associations with physical activity and perceived stress. Regression analyses indicated that sleep quality and perceived stress were independently associated with SBP in women (adjusted R² = 0.13), whereas hamstring strength was associated with DBP in men with low explanatory capacity (R² = 0.05). Moderate-to-high collinearity was observed among strength variables. Conclusions: Blood pressure variability was associated with neuromuscular and psychosocial factors with sex-specific patterns; however, the modest explained variance suggests these factors act as complementary rather than primary determinants. Longitudinal studies are needed to clarify causal relationships. Full article

Inorganic nitrate (NO₃⁻) has demonstrated therapeutic efficacy in several populations characterised by cardiovascular risk. However, it is unknown whether increasing nitric oxide (NO) bioavailability affects vascular and cardiovascular responses in men with androgenic–anabolic steroid (AAS) abuse. Objective: To investigate the effects of dietary NO₃⁻ on cardiovascular, autonomic, and strength performance in men with AAS abuse. Methods: In this double-blind, randomised, placebo-controlled crossover trial, participants consumed beetroot juice (12.8 mmol [800 mg] NO₃⁻) or a placebo (0.3 mmol NO₃⁻). After two hours, assessments included saliva collection, endothelial function, heart rate, and systolic (SBP) and diastolic (DBP) blood pressure at rest, during, and after an isometric handgrip test. Results: Thirteen resistance-trained males [mean (standard deviation) age: 31 (9) y; body mass index (BMI): 30 (4) kg/m²; SBP: 132 (3) mmHg; DBP: 70 (2) mmHg] completed the protocol. NO₃⁻-rich juice significantly increased salivary NO₃⁻ (40.6 μM, p < 0.001) and nitrite (NO₂⁻) (3.1 μM, p = 0.002) versus placebo. Flow-mediated dilation was greater with NO₃⁻ both at pre-exercise (2.37%, p = 0.02) and post-exercise (2.57%, p = 0.01). No between-group differences were observed in isometric strength (0.02 kgf, p = 0.99) or systolic/diastolic blood pressure across conditions. Conclusions: Dietary NO₃⁻ enhanced salivary NO₂⁻ and NO₃⁻ concentrations and modestly improved endothelial function but did not reduce the elevated blood pressure or alter cardiac autonomic responses associated with AAS abuse. Full article

Plastic pollutants, including phthalates, bisphenol A (BPA), per- and polyfluoroalkyl substances (PFAS), and microplastics (MPs), are increasingly recognized as emerging environmental cofactors that intersect with infectious disease dynamics. These compounds, once considered inert, can alter immune function, reshape host–pathogen interactions, and directly influence viral survival and transmission. In this review, we compile current evidence on the chemistry, environmental occurrence, and biological activity of major plastic-associated pollutants with emphasis on their role in viral infections. Phthalates such as di(2-ethylhexyl) phthalate (DEHP) and its metabolite MEHP modulate innate immune signaling and have been shown to exacerbate infections, including Dengue and Coxsackievirus B3. Other DEHP-like phthalates, such as dibutyl phthalate (DBP), exhibit consistent infection-enhancing effects, while high molecular weight or cyclical phthalates such as polyvinyl acetate phthalate (PVAP) display conflicting results in their modulation of viral infections. BPA, widely detected in human tissues, acts through endocrine and immune disruption, worsening viral myocarditis, and altering influenza outcomes. PFAS, persistent “forever chemicals,” reshape adaptive immune responses and are associated with increased susceptibility, viral persistence, or severity of infection of herpesvirus (HCMV, EBV, HSV-1), hepatitis virus, and influenza infection. Microplastics represent a distinct risk by acting as physical carriers for viruses and bacteria, stabilizing viral RNA, enhancing host cell uptake, and skewing immune responses. Together, these pollutants extend beyond toxicology into virology, providing novel insights into how environmental exposures converge with viral pathogenesis. We highlight mechanistic advances and critical knowledge gaps and propose future directions for integrating environmental health and infectious disease research. Full article

Hospital wastewater (HWW) carries a high and variable burden of pathogenic microorganisms, along with a diverse spectrum of emerging contaminants, such as pharmaceutically active compounds (PhACs) and antimicrobial resistance (AMR) determinants, posing significant challenges to conventional municipal treatment systems. The COVID-19 pandemic intensified the global use of disinfection technologies for infection control, inadvertently leading to the generation and release of novel classes of disinfection by-products (DBPs) and transformation products (TPs). These emerging by-products, alongside the persistent release of pharmaceuticals and AMR elements, have exposed critical limitations in conventional and advanced disinfection processes when applied to such complex matrices. This review synthesizes recent literature on disinfection-oriented advanced treatment strategies and other contaminants of emerging concern in hospital effluents worldwide. The discussed technologies include chlorine-based disinfection (e.g., free chlorine and chlorine dioxide), ozonation, ultraviolet irradiation (UV), electrochemical disinfection (ECD), nanomaterial-enabled disinfection, and combined multi-barrier schemes. While real-time monitoring of key compounds in HWW is increasingly feasible, critical bottlenecks remain: culture-based indicators may underestimate viable but non-culturable populations, molecular assays quantify genes without directly reflecting infectivity or transfer potential, and complex matrices hinder methodological harmonization. Future efforts should prioritize risk-based multi-barrier design, activity-informed monitoring, and intelligent process control to achieve robust co-mitigation of pathogens, PhACs, and AMR while minimizing disinfection by-products (DBPs) and life-cycle energy consumption. Full article

Psychological stress arises when perceived situational demands exceed an individual’s available coping resources. Beyond individual differences and broader contextual factors, an individual’s emotional connection to a group (i.e., social identity) may shape stress appraisals and physiological reactivity. Across two laboratory experiments with 180 college students, we examined whether making social identity salient influences acute stress responses under different competitive frames, comparing intragroup versus intergroup competition. In Experiment 1, participants in the social-identity condition showed numerically lower cardiovascular reactivity than those in the personal-identity condition, but between-condition differences were not statistically significant. In Experiment 2, the Identity × Competition interaction was statistically significant for heart-rate (HR) reactivity, indicating that the effect of identity salience differed across competition frames; however, this interaction did not generalize to systolic/diastolic blood pressure (SBP/DBP) or subjective stress. We also observed higher HR reactivity in intragroup than intergroup competition in this protocol, which we interpret cautiously given the limited consistency across outcomes. Overall, the findings suggest that any identity-related modulation of acute stress responding may be context-dependent and modality-specific, underscoring the importance of competitive framing when evaluating the stress-related consequences of social identity. Full article

Background: The Dietary Approaches to Stop Hypertension (DASH) diet effectively lowers blood pressure and improves blood lipid profiles. However, it remains unclear how the DASH diet contributes to gut microbiota and how the gut microbes affect these processes. This study aimed to examine the associations of DASH diet adherence with blood pressure and lipid levels, and to explore whether the gut microbiota mediated these relationships. Methods: A total of 879 Chinese aged over 18 years were recruited. DASH diet adherence was evaluated by a food frequency questionnaire. Blood pressure and lipid measurements were obtained during physical examinations. The gut microbiota was analysed via 16S rRNA sequencing. Results: Greater DASH diet adherence was correlated with lower diastolic blood pressure (DBP; sβ = −0.180 and p = 0.027) and low-density lipoprotein cholesterol (LDL-C; sβ = −0.268 and p = 0.002). Five bacterial genera were associated with the DASH diet (q-value < 0.15). Among them, Bifidobacterium was inversely linked to both DBP and LDL-C (p < 0.050). Two species (Bifidobacterium kashiwanohense and Bifidobacterium longum) were detected within the Bifidobacterium genus. Both of them explained the associations of the DASH diet with DBP and/or LDL-C (average causal mediation effect = −0.027 to −0.018; p < 0.050; proportion mediated = 8.22% to 9.04%). Conclusions: This study found favourable correlations of the DASH diet with both DBP and LDL-C. Bifidobacterium partially explained these relationships. These results may offer valuable insights into managing blood pressure and lipid levels through dietary and gut microbiota modulation. Full article

Background: Human immunodeficiency virus (HIV) and antiretroviral therapy (ART) are known to be involved in cardiovascular disease development. They act alongside systemic risk factors, which interact with both macrovascular and microvascular vessels to accelerate vascular damage. Therefore, the aim of this study was to investigate the cardiovascular risk factors and their relationship with retinal microvascular function in HIV-positive pregnant women on ART in Mthatha, South Africa. Methods: A cross-sectional study was carried out among 78 pregnant women (25 HIV-positive and 53 HIV-negative) in Mthatha, South Africa. Blood pressure (BP) parameters, including systolic BP (SBP), diastolic BP (DBP), and heart rate (HR), were measured, and mean arterial pressure (MAP) was calculated. Lipid profile parameters and fasting blood glucose were assessed. Markers for kidney function, such as albuminuria, were determined. Vascular biomarkers including asymmetric dimethyl arginine (ADMA) and human endothelial specific molecule-1 were quantified. Non-invasive vascular function parameters such as flow-mediated slowing (FMS), carotid-femoral pulse wave velocity (cfPWV), ankle-brachial index, central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), arteriolar venular ratio (AVR), uterine artery pulsatile index (UtA PI) were determined. Results: Diastolic BP, MAP, cfPWV, ADMA, low density lipoprotein (LDL-c) and UtA PI were higher in the HIV-positive group (p ≤ 0.05) compared to the HIV-negative group. The prevalence of prehypertension/hypertension was higher in the HIV-positive group (p ≤ 0.05). DBP, MAP, and cfPWV correlated positively with CRVE in the HIV-positive group (p ≤ 0.05), while AVR negatively correlated with the urinary creatinine (uCr) in the same group (p ≤ 0.05). Linear regression results demonstrated that DBP, cfPWV, ABI, and LDL-c were predictors of reduced AVR in the HIV-positive group. Conclusions: Increased cardiovascular risk was observed in HIV-positive pregnant women on ART. Further, increased cardiovascular risk such as hypertension and endothelial dysfunction due to ART predicted retinal microvascular dysfunction in the HIV-positive population. This implies a potential mechanistic link between macrovascular dysfunction due to cardiovascular risk factors and retinal microvascular impairment, highlighting the importance of assessing cardiovascular risk early and preserving overall vascular health in HIV-positive population. Full article

Solar energy, as a clean and renewable resource, plays a pivotal role in advancing sustainable energy technologies. The efficiency of front-side silver paste is critical for the photovoltaic performance of Tunnel Oxide Passivated Contact (TOPCon) solar cells. In this study, we comprehensively investigated how the composition of organic vehicles in conductive pastes influences both printing rheological properties and electrical performance. Through rheological characterization, contact angle measurements, and Three-Interval Thixotropy Tests (3ITT), we examined the effects of varying solvent, binder, and thixotropic agent ratios on paste properties. The optimized formulation—a solvent mixture of lauryl alcohol ester (TE), butyl carbitol (DGME), butyl carbitol acetate (BCA), and dibutyl phthalate (DBP) in a 3:4:2:1 ratio, with ethyl cellulose (EC) STD10 as the binder and a polyamide wax (PAW)–hydrogenated castor oil (HCO) thixotropic agent at a 3:1 mass ratio—demonstrated superior viscosity control and rapid structural recovery. Printed grid lines achieved a height-to-width ratio (H/W) of 0.35 and a sheet resistance (Rs) of 1.43 Ω/□. These findings reveal direct relationships between organic vehicle composition, paste rheology, and functional performance, providing practical guidance for the design and optimization of high-performance conductive pastes for c-Si solar cells. This work establishes a foundation for improving both the efficiency and reliability of next-generation silver paste formulations in photovoltaic applications. Full article

Background/Objectives: Laparoscopic sleeve gastrectomy (LSG) treats severe obesity, but data on its effects on 24 h blood pressure (BP) patterns, blood pressure variability (BPV), and cardiac autonomic nervous system (CANS) in obese patients without hypertension or diabetes are limited. We evaluated these parameters before and after LSG. Methods: 78 patients with severe obesity (BMI ≥ 40 kg/m²) without hypertension or diabetes who underwent LSG between January 2016 and December 2019 were included in the study. Patients underwent ambulatory blood pressure monitoring (ABPM), ambulatory electrocardiographic monitoring, and laboratory tests before and six months after surgery. Results: Preoperative ABPM was characterized by a significant proportion of masked hypertension (43.5%), high 24 h BP (mean SBP 138.9 ± 5.5 mmHg, DBP 81.1 ± 4.9 mmHg), high BP load (39% SBP, 38% DBP), and a non-dipper pattern (67.9%). After LSG, significant improvements were observed in mean 24 h SBP, DBP (p < 0.001), BPV, BP load, and non-dipper patterns. HRV parameters (SDANN, RMSSD) increased significantly (p < 0.001) and HRT parameters improved: TO became more negative from −0.54 ± 1.73 to −2.53 ± 1.97, TS increased from 5.98 ± 3.49 to 9.87 ± 4.28 ms/RR (p < 0.001). We found a strong association between decreased body mass index and BP changes. Changes in glucose, HbA1c, and HOMA-IR predicted CANS improvement (β = 0.24–0.38; R² = 20.8–29.7%). Conclusions: Six months after LSG, significant improvements in BP, BPV, and CANS were observed. BP reduction was primarily associated with weight loss, while glucose control was associated with autonomic improvements. LSG was associated with early improvements in surrogate cardiovascular risk markers through combined weight-dependent and metabolic-hormonal mechanisms. Full article

Background/Objectives: Heated tobacco products (HTPs) are a gateway to nicotine addiction for non-smokers, especially young people. The short- and long-term health effects of using heated tobacco products are not yet fully understood. The study aimed to assess the effect of heated tobacco use on blood pressure and heart rate in young, healthy individuals aged 18–30. The study also assessed exposure to tobacco smoke by measuring salivary cotinine concentration. Methods: The case–control study was conducted in 2022–2025 among 200 healthy individuals aged 18–30 years: 70 I-Quit-Ordinary-Smoking users (IQOS), 65 daily traditional cigarette smokers (DS), and 65 non-smokers (NS). The research tool was a questionnaire containing information on the use of tobacco products. The participants completed a questionnaire and then underwent blood pressure measurements, anthropometric measurements, and saliva collection for cotinine levels. Results: The average age of initiation of IQOS use was 18.5 years, and smoking had continued for an average of 2.3 years. The average age of initiation of smoking traditional cigarettes was 16.3 years, and smoking had continued for 4.4 years. There were no statistically significant differences in median values between systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the IQOS, DS, and NS groups (p > 0.05). High SBP values ≥ 140 mm Hg were observed in 10% of the IQOS users, 18.5% of the daily smokers of conventional cigarettes, and 12.3% of the non-smokers. High DBP values ≥ 90 mm Hg were observed in 11.4% of IQOS, 7.7% of DS, and 7.7% of NS. The cigarette smokers demonstrated significantly higher median cotinine levels compared to the IQOS users and non-smokers: 153.7 vs. 64.3 vs. 0.5 ng/mL (p < 0.01). Salivary cotinine levels were positively correlated (ρ = 0.38; p < 0.01) with the daily number of heated tobacco sticks among IQOS users (weak correlation), as well as among DS (ρ = 0.42; p < 0.01) with a higher daily number of cigarettes (moderate correlation). Conclusions: Long-term studies are needed to determine the health effects of heated tobacco products among young people in Poland. Furthermore, the potential impact of HTP aerosols on passive smokers should be examined. Further studies should consider the use of salivary cotinine as a biomarker. Full article