Cardiovascular autonomic effects of electronic cigarette use: a systematic review

Garcia, Phoebe D.; Gornbein, Jeffrey; Middlekauff, Holly R.

doi:10.1007/s10286-020-00683-4

Cited by 41 publications

(43 citation statements)

References 53 publications

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“…Although it is reassuring that acute EC vaping did not acutely impair FMD, it would be dangerous and premature to conclude that ECs do not lead to atherosclerosis. However, there is increasing scientific literature (13,14,21) that supports the notion that ECs, although not harmless, may be less harmful than TC smoking for cardiovascular risk.…”

Section: Study Limitationsmentioning

confidence: 99%

Differential effects of tobacco cigarettes and electronic cigarettes on endothelial function in healthy young people

Haptonstall

Choroomi

Moheimani

et al. 2020

American Journal of Physiology-Heart and Circulatory Physiology

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Tobacco cigarette(TC) smoking has never been lower in the US, but EC vaping has reached epidemic proportions amongst our youth. Endothelial dysfunction, as measured by flow mediated vasodilation(FMD) is a predictor of future atherosclerosis and adverse cardiovascular events, and is impaired in TC smokers, but whether FMD is also reduced in EC vapers is uncertain. The aim of this study in otherwise healthy young people was to compare the effects of acute and chronic TC smoking and EC vaping on FMD. FMD was compared in 47 non-smokers(NS), 49 chronic EC-vapers and 40 chronic TC-smokers at baseline, and then after EC-vapers(n=31) and non-smokers(n= 47) acutely used an EC-with-nicotine(ECN), EC-without-nicotine(EC0), and nicotine inhaler(NI) at ~4week intervals, and after TC-smokers(n=33) acutely smoked a TC, compared to sham-control. Baseline FMD was not different among the groups (NS:7.7±4.5%∆ vs EC:6.6±3.6%∆ vs TC:7.9±3.7%∆, p=0.35), even when compared by group and sex. Acute TC smoking vs control impaired FMD(FMD pre/post smoking: -2.52±0.92%∆ vs 0.65±0.93%∆, p=0.02). Although the increase in plasma nicotine was similar, acute EC vaping did not impair FMD. In otherwise healthy young people who regularly smoke TCs or ECs, impaired FMD was not present. However, FMD was significantly impaired after smoking one TC, but not after vaping an equivalent "dose"(estimated plasma nicotine) of an EC, consistent with the notion that non-nicotine constituents in TC smoke mediate the impairment. Although it is reassuring that acute EC-vaping did not acutely impair FMD, it would be dangerous and premature to conclude that ECs do not lead to atherosclerosis.

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Section: Study Limitationsmentioning

confidence: 99%

Differential effects of tobacco cigarettes and electronic cigarettes on endothelial function in healthy young people

Haptonstall

Choroomi

Moheimani

et al. 2020

American Journal of Physiology-Heart and Circulatory Physiology

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“…Garcia and colleagues performed a systematic review and meta-analysis on the effects of EVC on blood pressure (BP), heart rate (HR), and heart rate variability (HRV), pooling data from 19 studies, and using largely explicit and valid methods [23]. They concluded that EVC are associated with acute increases in systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR, and changes in HRV typical of sympathetic prevalence over vagal activity, even if mostly explained by nicotine exposure.…”

Section: Recent Findingsmentioning

confidence: 99%

Vaping Cardiovascular Health Risks: an Updated Umbrella Review

Peruzzi

Biondi‐Zoccai

Carnevale

et al. 2020

Curr Emerg Hosp Med Rep

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Purpose of Review Modified risk products (MRP) such as electronic vaping cigarettes (EVC) and heat-not-burn cigarettes (HNBC) are alternatives to traditional combustion cigarettes (TCC) with an expanding consumer base. Yet, their cardiovascular health risks are still unclear. We aimed to summarize the evidence base on this topic by conducting an updated umbrella review. Recent Findings We identified 7 systematic reviews, totaling 183 studies and reports, ranging from in vitro and in animal studies to clinical studies in apparently healthy volunteers and patients at risk of cardiovascular disease. Overall, acute EVC use was associated with several toxic effects at molecular, cellular, tissue, organ, and system level. In addition, EVC impacted adversely on blood pressure (BP) management, caused tachycardia, and worsened arterial stiffness. Finally, EVC use was associated with an increased risk of adverse clinical events, including atrial fibrillation and myocardial infarction, even if the causal link is still debated. Most reviews highlighted that the detrimental impact of EVC was of lesser magnitude of that of TCC. In addition, the differential impact of liquids and nicotine was not clearly disentangled. Finally, no review included studies on HNBC. Summary The present umbrella review suggests that EVC, and likely HNBC, despite clearly causing an increase in overall cardiovascular risk, may represent a temporary lesser evil than TCC in a risk-reduction or risk-modification strategy, aiming for eventual abstinence from all tobacco or nicotine products. Keywords Cardiovascular disease. Electronic cigarette. Electronic vaping cigarette. Heat-not-burn cigarette. Smoking Giving up smoking is the easiest thing in the world. I know because I've done it thousands of times.

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“…Tobacco cigarette smoking is recognized as the most important modifiable risk factor for cardiovascular disease and it exerts its adverse events, at least partly, through an increase in sympathetic nerve activity [ 18 ]. In healthy smokers, smoking of the first TC of the day triggered a significant acute increase in systolic blood pressure by 7%, in diastolic blood pressure by 10%, and in the heart rate by 25% [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Electronic cigarette vaping also seems to produce acute cardiovascular effects. A meta-analysis compared the acute TCs and ECs cardiovascular effects and found that EC vaping resulted in an acute increase in the heart rate and systemic blood pressure, but to a lesser extent than TC smoking [ 18 ]. The authors attributed the sympathoexcitatory effects of ECs to the nicotine contained in the EC aerosol [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…In situations of acute stress response, like the immediate post-smoking period, that are characterized by an acute increase in heart rate and systemic blood pressure [ 18 , 19 ] and acute increase in perfusion pressure, the choroidal sympathetic innervation results in immediate, compensatory vasoconstriction and increase in vascular resistance. Consequently, the mean blood flow in choroidal circulation is maintained constant, protecting the eye against over-perfusion [ 22 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

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The Acute Effects of Electronic Cigarette Vaping and Tobacco Cigarette Smoking on Choroidal Thickness in Young, Healthy, Habitual, Dual Smokers

Makri

Pallikari

Kagkelaris

et al. 2020

Toxics

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The present study aims to evaluate and compare the acute effects of tobacco cigarettes (TC) smoking and electronic cigarette (EC) vaping on foveal and choroidal thickness (CT) in young, healthy, dual smokers. Participants underwent four trials: 5 min TC; 5 min EC; 30 min EC; and 60 min nothing (sham trial). Scans before and immediately after each trial were obtained using spectral domain optical coherence tomography with the enhanced depth imaging mode. Changes in central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), and CT at fourother points, 500 μm and 1000 μm temporally and nasally to the fovea, were measured. Forty-seven participants (33 male, 14 female; mean age 24.85 ± 1.57 years) were included. They smoked 13.53 ± 5.27 TCs/day for 6 ± 2.3 years and vaped ECs for the past 2.4 ± 1.08 years. We did not observe any statistically significant change in SFCT, CFT, and CT of the other points after any of the fourtrials. The acute changes in CFT and CT after EC vaping or TC smoking did not differ significantly compared to the sham trial. Smoking and vaping does not seem to result in statistically significant acute alterations in foveal and CT in young, dual smokers.

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Cardiovascular autonomic effects of electronic cigarette use: a systematic review

Cited by 41 publications

References 53 publications

Differential effects of tobacco cigarettes and electronic cigarettes on endothelial function in healthy young people

Differential effects of tobacco cigarettes and electronic cigarettes on endothelial function in healthy young people

Vaping Cardiovascular Health Risks: an Updated Umbrella Review

The Acute Effects of Electronic Cigarette Vaping and Tobacco Cigarette Smoking on Choroidal Thickness in Young, Healthy, Habitual, Dual Smokers

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