Impact of Electronic Cigarette use on Cardiovascular Health: Current Evidence, Causal Pathways, and Public Health Implications

Abstract

Electronic cigarette (e-cigarette) use is increasing in Europe and the USA. While mounting evidence exists regarding an array of associated adverse health effects, to date limited evidence exists regarding the health effects of e-cigarette use on cardiovascular (CV) disease (CVD). The present review summarizes the effects of e-cigarette use on CV health. A search strategy of in vivo experimental, observational studies (including population-based cohort studies), and interventional studies was conducted in PubMed, MEDLINE, and Web of Science (April 1, 2009–April 1, 2022). The main findings revealed that the influence of e-cigarette on health are attributed mainly to the individual and interactive effects of flavors and additives used in e-cigarette fluids, along with the extended heating. The above collectively stimulate prolonged sympathoexcitatory CV autonomic effects, such as increased heart rate and diastolic blood pressure (BP), as well as decreased oxygen saturation. Hence, e-cigarette users are at increased risk of developing atherosclerosis, hypertension, arrhythmia, myocardial infarction, and heart failure. Such risks are anticipated to increase, especially among the young who are increasingly adopting e-cigarette use particularly with flavored additives. Further investigations are urgently needed to evaluate the long-term effects of e-cigarette use, particularly among susceptible population groups such as youth.

Conhecimento de Acadêmicos de Odontologia sobre os Riscos do Cigarro Eletrônico para a Saúde Bucal

“…O CE apresenta riscos à saúde em virtude dos compostos tóxicos e metais pesados em seus líquidos e aerossóis que podem causar danos por inalação, exposição dérmica e ingestão oral 13 . O uso crônico pode levar à dependência, dispneia, dor no peito e ao aumento dos riscos de hipoxemia 14 e riscos cardiovasculares, como aterosclerose, hipertensão, arritmias, infarto do miocárdio e insuficiência cardíaca 15 , aumento do tônus simpático, rigidez vascular, disfunção endotelial 16 , surtos de lesões pulmonares e altos níveis de substâncias cancerígenas e tóxicas 17 , além do risco de lesões graves causando queimaduras, lacerações e hematomas na face do usuário 18 .…”

Public Health Concerns from Increased Use of Electronic Cigarette Use

“…The excellent review by Critselis and Panagiotakos summarizes the effects of the use of electronic cigarette (e-cigarette) on cardiovascular (CV) health and CV disease (CVD). 1 Detrimental effects of e-cigarette use include increased blood pressure, exposure to metals in e-liquids and vapours leading to arterial stiffness, as well as formaldehyde generation leading to increased risk of arrhythmia, atherosclerosis, myocardial infarction and heart failure. 1 Some additional comments may be of interest.…”

“…1 Detrimental effects of e-cigarette use include increased blood pressure, exposure to metals in e-liquids and vapours leading to arterial stiffness, as well as formaldehyde generation leading to increased risk of arrhythmia, atherosclerosis, myocardial infarction and heart failure. 1 Some additional comments may be of interest.…”