Young adults using e-cigarettes exhibited arterial stiffness and blood vessel damage similar with those who smoke traditional cigarettes, according to a cross-sectional study published on April 29 in the Journal of the American Heart Association.

As part of the Cardiovascular Injury due to Tobacco Use study, Jessica L. Fetterman, PhD, and colleagues studied more than 400 men and women, ages 21 to 45 years, who had not been diagnosed with heart disease or heart disease risk factors and were former traditional cigarette smokers. Study participants included 94 nonsmokers, 285 cigarette smokers, 36 e-cigarette users and 52 dual users who smoked combustible cigarettes and used e-cigarettes. Combustible cigarette smokers and dual users were older than nonsmokers and e-cigarette users, while e-cigarette users were more likely to be younger, male and white.

Former smokers who switched to e-cigarettes and dual users had an augmentation index similar with traditional cigarette users, indicating their arteries were just as stiff, researchers found. Furthermore, endothelial cells appeared to be equally as damaged, producing less nitric oxide suggestive of impaired eNOS signaling, whether the participants used e-cigarettes, combustible cigarettes or both.

"In conclusion, our study provides new insights into the effects of tobacco product use on measures of vascular function in young, healthy adult individuals without cardiovascular disease risk factors," write the authors. They note the most recent nationally representative sample shows the majority of adult e-cigarette users are either former (36.5%) or current (22.1%) combustible cigarette smokers, emphasizing the importance of understanding cardiovascular health measures in these groups.

While most e-cigarette users switch to them because they think they are healthier, this study reveals there is no evidence that using e-cigarettes reduces the cardiovascular injury associated with the use of combustible tobacco products. Longitudinal studies are needed to evaluate the long-term risks of sustained e-cigarette use.

Clinical Topics: Cardiovascular Care Team, Congenital Heart Disease and Pediatric Cardiology, Prevention, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Smoking

Keywords: ACC Advocacy, Young Adult, Middle Aged, Electronic Nicotine Delivery Systems, Tobacco, Tobacco Use, Tobacco Products, Smoke, Cross-Sectional Studies, Nitric Oxide, American Heart Association, Vascular Stiffness, Endothelial Cells, Cardiovascular Diseases, Risk Factors

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