Electronic Cigarette Use and the Risk of Cardiovascular Diseases

Abstract

Electronic cigarettes or e-cigarettes are the most frequently used tobacco product among adolescents. Despite the widespread use of e-cigarettes and the known detrimental cardiac consequences of nicotine, the effects of e-cigarettes on the cardiovascular system are not well-known. Several in vitro and in vivo studies delineating the mechanisms of the impact of e-cigarettes on the cardiovascular system have been published. These include mechanisms associated with nicotine or other components of the aerosol or thermal degradation products of e-cigarettes. The increased hyperlipidemia, sympathetic dominance, endothelial dysfunction, DNA damage, and macrophage activation are prominent effects of e-cigarettes. Additionally, oxidative stress and inflammation are unifying mechanisms at many levels of the cardiovascular impairment induced by e-cigarette exposure. This review outlines the contribution of e-cigarettes in the development of cardiovascular diseases and their molecular underpinnings.

The Health Effects of Real-World Dual Use of Electronic and Conventional Cigarettes versus the Health Effects of Exclusive Smoking of Conventional Cigarettes: A Systematic Review

“…If DUs do not reduce the number of CPD but use ECs as a supplement, the combination of CCs and ECs might potentially be even more harmful for health than ESCC, as known and unknown [ 85 ] harmful substances and transformation products formed by heating of ECs [ 86 ] are added on top of the harmful substances in tobacco smoke. The long-term effects of EC use on human health will take a long time to be fully elucidated, but concern has been raised [ 87 , 88 , 89 , 90 , 91 ]. Although several studies have found an increased risk of disease in EC users [ 48 , 66 , 87 , 92 , 92 , 93 , 94 , 95 ] and shown that, e.g., the cardiovascular [ 96 ] and pulmonary harm from ECs is biologically plausible [ 88 ], at present the risk in the human population is uncertain [ 81 , 97 ].…”

How Electronic Cigarette Affects the Vascular System

“…Our study is in line with previous study about impact of electronic cigarettes on vascular damage as a risk factor of cardiovascular disease. Even though using an electronic cigarette is apparently safer than conventional cigarettes, previous research demonstrated that the molecular changes on the cardiovascular system clearly leads to oxidative stress and inflammation [ 41 ]. More studies about the impact of electronic cigarette smoking on the vascular system will describe the mechanism with more details.…”

Electronic Cigarette and Atherosclerosis: A Comprehensive Literature Review of Latest Evidences

“…An estimated 0.5-15.4 mg of nicotine are generated in the e-cigarette vapor for every 300 puffs [ 38 ]. The chronic exposure to e-cigarettes containing nicotine leads to atherosclerotic plaque formation, proved by a study in rats that found no atherosclerosis plaque formed on rats exposed to the e-cigarette with 0% nicotine [ 39 ]. The mechanism by which nicotine induces atherosclerosis appears to be caused by the FFA release from adipocytes, disrupting endothelial integrity [ 40 ].…”