The cardiovascular consequences of electronic cigarette smoking: a narrative review

Expert Rev Cardiovasc Ther. 2023 Jul-Dec;21(10):651-661. doi: 10.1080/14779072.2023.2264179. Epub 2023 Oct 26.

Abstract

Introduction: E-cigarettes have emerged as a popular alternative to traditional tobacco smoking in recent years. Despite their growing popularity, concerns have arisen regarding the cardiovascular implications of e-cigarette use.

Areas covered: This narrative review aims to highlight the latest evidence on the impact of e-cigarettes on cardiovascular health.

Expert opinion: Numerous studies have demonstrated that e-cigarette use can lead to acute adverse cardiovascular effects. Inhalation of e-cigarette aerosols exposes users to a wide range of potentially harmful substances that have been implicated in critical pathophysiologic pathways of cardiovascular disease, namely endothelial dysfunction, oxidative stress, inflammation, sympathetic overdrive, and arterial stiffness. While long-term epidemiological studies specifically focusing on the cardiovascular effects of e-cigarettes are still relatively scarce, early evidence suggests a potential association between e-cigarette use and an increased risk of adverse cardiovascular events. However, it is essential to recognize that e-cigarettes are relatively new products, and the full extent of their long-term cardiovascular impact has not been fully elucidated. In the meantime, promoting tobacco cessation strategies that are evidence-based and regulated, along with rigorous monitoring of e-cigarette use patterns and associated health outcomes, are essential steps in safeguarding cardiovascular health in the face of this emerging public health challenge.

Keywords: Electronic cigarette; cardiovascular disease; inflammation; smoking; sympathetic nervous system.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Cardiovascular System*
  • Electronic Nicotine Delivery Systems*
  • Heart
  • Humans
  • Smoking / adverse effects
  • Smoking / epidemiology