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It’s not just lung injury e-cigarette/vape users need to worry about, e-cigarette smokers were found to be worse off than conventional cigarette smokers in terms of coronary microvascular vascular function, according to a new study presented at the American Heart Association meeting in Philadelphia. 

Physiological changes between rest and hand grip exercise to stimulate stress showed both users had fairly similar myocardial blood volume right after a smoking session compared to non-smoking controls. However, the e-cig group did worse than traditional smokers in change in myocardial blood velocity and myocardial blood flow, both groups were worse that non-smoking control according to Florian Rader, MD, MSs, of the Smidt Heart Institute at Cedars-Sinai Medical Center, Los Angeles, and colleagues.

“The blunting of stress-induced increase of coronary blood flow associated with chronic e-cig use in humans is consistent with what is being seen in other vascular systems, in animals, and after acute use: endothelial dysfunction at the level of (or exceeding) that of combustible cigarette use,” commented Matthew Springer, PhD, of the University of California, San Francisco, who was not involved in the research.

“We are seeing an emerging story that regardless of whether vaping involves less risk of cancer and less tar in the lungs than traditional smoking, the cardiovascular effects are substantial and indicate a level of cardiovascular risk that one really wants to avoid,” wrote Springer in an email to MedPage Today.

Vaping related acute lung damage has already killed dozens, most of whom were under the age of 30 in which vitamin E acetate is a proposed common denominator between both nicotine e-cigs and THC vape users among the bronchoalveolar lavage samples from those who have fallen sick after e-cigarette/vape use. Devices rely on battery powered aerosolization at a high temperature to deliver a mix of small molecules that can cross the alveolar capillary barrier to enter into the circulation. 

“What makes e-cigarettes so harmful to the heart and lungs is not just nicotine,” said Rader in a press release. “It’s the completely unknown bucket of manufactured products used to form vapors that is likely causing the most harm. This is what we believe is underlying the current public health problem.”

“It’s very clear that e-cigarettes have a detrimental effect on myocardial endothelial function, even a worse effect than classical cigarettes,” commented Daniel Duprez, MD, PhD, of the University of Minnesota, Minneapolis. Endothelial dysfunction, in turn, can lead to increased blood pressure and mark the beginning of atherosclerotic disease, he told MedPage Today.

“This is just adding to the evidence that in terms of heart disease, e-cigarettes are just as bad as cigarettes and might be even worse. That’s the picture emerging for lung disease, too,” said Stanton Glantz, PhD, also of the University of California, San Francisco, who was not involved in the study.

30 healthy adults with an average age of 30 with normal tension and were not obese participated in this study, and underwent myocardial contrast echocardiography after overnight abstinence from smoking. 

“The gender ratio in the vaping group was similar to that in the smoking group, so the observation that the vapers had essentially no myocardial flow response to stress, compared with a blunted but still present response in smokers, is especially strong and implies that switching from smoking to vaping may involve increased risks in some aspects of cardiovascular health,” Springer emphasized.

The public may have been getting mixed messages that these recent 2,000 cases of vaping-related acute lung damage with a death toll of 39 seem to be mostly associated with THC products and associated ingredients, which can potentially lead to those vaping nicotine products feeling immune to all of the vaping risks, but this attitude and perception is wrong and can lead to further injury. 

“The public needs to hear about studies like this,” says Springer as there are other ways in which vaping nicotine e-cigarettes can lead to cardiovascular and pulmonary harm. 

For more perspective, just touch your walls or windows after using an e-cig/vaping, that greasy film left there is also being left on your insides. Not to mention all of the compounds are exposed to extreme heat to turn them into vapors which changes them into new and largely untested compounds. 

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