A previously unanticipated risk for cardiovascular disease: e-cigarettes!

E-cigarettes are becoming increasingly popular. Meanwhile, more research is being conducted on these devices, recently marketed as aids for quitting smoking . Most recently, JAMA Cardiology published a striking new study evaluating the relationship between electronic cigarettes and cardiovascular disease risk. The study showed that people using e-cigarettes may be putting their cardiovascular health at risk.

The cardiovascular system, also called our circulatory system, concerns the heart, blood vessels and blood circulation

As is known, an e-cigarette is an electronic device that imitates conventional smoking. Consisting of a cartridge, battery and atomizer, it vaporizes the liquid inside for use similar to a conventional cigarette. Its use has increased at an astonishing rate recently. We also see increasing use in our country despite sales being prohibited. In America, %3,7 of adults, approximately 9 million adults, use e-cigarettes, while among young people, between 2011-2015, over a short period of 4 years, the rate increased a full 4-foldand reached %16. Against this frightening numerical background, let us examine the study details:

Study

The research team hypothesized that regular e-cigarette users have increased oxidative stress and an imbalance in cardiac autonomic stimulation. Both are cardiovascular risk factors.

To investigate this, the team selected people aged between 21 and 45 who did not smoke conventional cigarettes or take any medication: 23 healthy e-cigarette users were compared with a control group of 19 healthy people with the same characteristics who had never used e-cigarettes.

The researchers recorded participants’ electrocardiograms (ECGs), checking heart rate both during quiet rest and during breathing, and divided them into 3 categories: high-frequency, low-frequency and very-low-frequency. They also performed blood analyses to test oxidative stress.

The low-frequency component increased, as did the ratio of low to high frequencies. In other words, the balance of the cardiac autonomic system in e-cigarette users shifted toward the sympathetic system.

The sympathetic system takes control of the cardiovascular system in situations such as emergencies; during danger, adrenaline levels rise, producing the “fight or flight” response.

Assessment of oxidative stress found an increase in the oxidizability of low-density lipoprotein (LDL, known as bad cholesterol).

Considering all findings together, compared with controls, e-cigarette users appeared more prone to both increased cardiac sympathetic activity and increased oxidative stress associated with tobacco.

In conclusion the physiological effects of e-cigarette use may seriously affect cardiovascular health in most users. In the research team’s own words: “Nicotine, the principal bioactive substance in e-cigarette vapor, may cause harm not identifiable through its breakdown products. Regular e-cigarette users experience physiological effects that increase cardiovascular risk.”