Do E-Cigarettes Increase Risk of Future Cardiovascular Events?

A recent study found that otherwise healthy habitual e-cigarette users had increased cardiac sympathetic activity and oxidative stress compared with non-users.

The study included 42 healthy participants between 21 and 45 years of age (mean age 27.6), 23 of whom self-identified as habitual e-cigarette users and 19 of whom self-identified as non-e-cigarette users. None of the participants used traditional cigarettes.
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Researchers analyzed heart rate variability components for high-frequency component (an indicator of vagal activity), low-frequency component (an indicator of both vagal and sympathetic activity), and the ratio of low frequency to high frequency, which reflects cardiac sympathovagal balance.

Plasma was used to measure oxidative stress, and was assessed with 3 parameters: low-density lipoprotein oxidizability, high-density lipoprotein antioxidant/anti-inflammatory capacity, and paraoxonase-1 activity.

E-cigarette users had a significantly decreased high-frequency component compared to nonusers. In addition, the low-frequency component and the low frequency to high frequency ratio were significantly increased in e-cigarette users compared to nonusers, indicating sympathetic predominance.

Likewise, low-density lipoprotein oxidizability was significantly increased in e-cigarette users compared to nonusers, which is indicative of the susceptibility of apolipoprotein B-containing lipoproteins to oxidation and consistent with increased oxidative stress.

However, there were no significant differences between high-density antioxidant/anti-inflammatory capacity and paraoxonase-1 activity in e-cigarette users compared to nonusers.

“Habitual electronic cigarette use is associated with physiologic effects. Further research into potential adverse health effects of electronic cigarettes is warranted,” the researchers concluded.

—Melissa Weiss

Reference:

Moheimani RS, Bhetraratana M, Yin F, et al. Increased cardiac sympathetic activity and oxidative stress in habitual electronic cigarette users: implications for cardiovascular risk [published online February 1, 2017]. doi:10.1001/jamacardio.2016.5303.