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A new study out of Greece has renewed concerns over the effect using electronic cigarettes may have on cardiovascular health. In a paper published by the Journal of the American College of Cardiology, Charalambos Vlachopoulos, MD and his colleagues at Athens Medical School say vaping could stiffen the body's largest artery, while increasing blood pressure.
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Despite its small sample size, only 24 smokers "free of cardiovascular risk factors" were studied, Vlachopoulos expects the results to initiate further research into the consequences of vaping for heart health. To conduct their analysis, the cardiologists broke their 24 subjects into one of four groups:
They used pulse wave technology, measuring the velocity at which blood flows through the arteries, to gauge the immediate effect smoking and vaping had on aortic stiffness. In general, a more limber, and thus healthier, aorta allows blood to flow at a slower rate. Stiff arteries, on the other hand, cause increases in the speed of blood flow, leading to jumps in the cardiovascular system's pulse wave velocity.
In healthy individuals, pulse wave velocity varies widely, but remains within a safe range above 5 m/s and below 15 m/s. Vaping for just five minutes, however, caused an immediate surge in pulse wave velocity. The effect of 30 minutes of vaping was even more pronounced, and it lasted longer, too.
Traditional cigarettes had a similar, albeit more intensified, effect. Just five minutes of smoking increased pulse wave velocity by around 0.44 m/s, even more than the 0.36 m/s increase observed after 30 minutes of vaping. Blood pressures also rose, although no more than the increase caused by traditional cigarettes.
Aortas stiffen with age, and many physicians consider the stiffening of an aorta to be the first sign of structural deterioration in the cardiovascular system. We can now probably add e-cigarettes to the roster of products that increase aortic stiffness, although it should be reiterated that traditional cigarettes do the same, and to a greater degree. Along with increased blood pressure, an inflexible aorta is a critical predictor of long-term cardiovascular problems, along with mortality over-all.
Traditional cigarettes have long been associated with cardiovascular disease, but experts believe nicotine is the cause. Since e-cigarettes themselves are usually used to deliver nicotine, it's only reasonable to assume that the devices would present their own heart risks. However, the first study to investigate the effects of vaping on heart health contradicted these assumptions in a surprising way.
In 2012, Dr. Konstantinos Farsalinos and colleagues in Kallithea, Greece looked at the immediate consequences of smoking and using e-cigarettes for heart muscle function. While "smoking one tobacco cigarette led to acute, significant impairment of four parameters of left ventricular function[,] electronic cigarettes had no acute adverse effects," according to Medscape. Tobacco cigarettes also led to spikes in blood pressure and heart rate, but e-cigarettes only caused a slight elevation in diastolic blood pressure, the arterial pressure between heart beats.
The newer results have called these early findings into question, bringing our evidence back in line with what we already know about nicotine exposure. Both e-cig users and smokers saw significant increases in blood pressure to the same degree. But it also adds a new data-point, because Farsalinos' 2012 study didn't measure pulse wave velocity.
Other findings have supplied even more detail to the picture, providing insight on the mechanism by which nicotine damages arteries directly. A 2013 study on rats suggests that the chemical, delivered both in e-cigarettes and traditional cigarettes, pushes cells to develop "invadosomes," tiny cellular drills that puncture and degrade the walls of arteries. This process was also observed in human vascular cells.
In part, the results imply that nicotine exposure, no matter the source, could cause atherosclerosis, a deadly condition in which blood vessels become clogged with plaque. Lead author Chi-Ming Hai, Professor of Medical Science at Brown University, says that while e-cigs may not expose users to all of the carcinogenic substances found in tobacco smoke, the new devices could still present the same risk for heart disease.
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Thanks to our friends at Sahn Law, Charleston SC lip and fall lawyers, for their contributions to this post.
