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Vaping's Veiled Menace: Unraveling the Cardiovascular Dangers of E-cigarettes

Written by Andrew Le, MD

UpdatedMay 29, 2024

Electronic cigarettes (e-cigarettes), gaining popularity in Europe and the USA, have become the subject of thorough investigation due to their potential health implications—particularly concerning cardiovascular diseases (CVD). In a detailed review by Elena Critselis and Demosthenes Panagiotakos, the cardiovascular effects of e-cigarette usage are scrutinized, revealing how the compounds in e-cigarette fluids alongside the heating mechanism can have harmful impacts on the heart and blood vessels.

This informative article summarizes the significant points of their study, initially published in Angiology, Vol. 75(5), 2024. For those interested in diving deeper into this research, the full study can be accessed at and holds the DOI: 10.1177/00033197231161905.

The review explores various studies, assessed for methodological quality, that suggest e-cigarette users might face an increased risk of atherosclerosis, hypertension, and heart failure due to the prolonged activation of sympathetic cardiovascular effects—like heightened heart rates and diastolic blood pressure, and decreased oxygen saturation. The addition of flavors and additives, especially those favored by younger users, might exacerbate these risks. Moreover, long-term investigations are needed to understand the full scope of consequences, particularly among adolescents and young adults who are the most likely to use flavored e-cigarettes.

It is inferred that the in vivo exposure to the vapor of e-cigarettes activates inflammatory and pro-inflammatory mediators. They concluded that e-cigarette users, even without using traditional tobacco products, might face a fourfold increased likelihood of myocardial infarction. Additionally, passive exposure to e-cigarette vapors—which can contain nicotine, metals, and other substances—might also pose significant risks, although the extent of these risks and their long-term implications remain unsettled.

The potential causal pathways for the damaging effects of e-cigarettes on cardiovascular health include disturbances in endothelial function, oxidative stress, and augmentation of blood pressure and heart rate. These factors mirror the impact of conventional smoking, suggesting a possible parallel in the associated risks between both smoking practices.

The review emphasizes the need for more long-term research to evaluate the effects of both active and passive e-cigarette use on cardiovascular health. The current evidence cautions against assuming e-cigarettes are safe and suggests particular vigilance regarding their use by non-smokers and young people.

Finally, this article serves as a reminder that the health implications of e-cigarettes are an urgent public health concern, with the potential for far-reaching consequences on the population’s cardiovascular health.

Please note: This is a news article summarizing the given research document. It is intended to communicate the findings of the researchers and should not substitute medical advice.

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Critselis, E., & Panagiotakos, D. (2024). Impact of Electronic Cigarette use on Cardiovascular Health: Current Evidence, Causal Pathways, and Public Health Implications. Angiology, 75(5), 417-424.