AAAR 35th Annual Conference October 17 - October 21, 2016 Oregon Convention Center Portland, Oregon, USA
Abstract View
Electronic Cigarettes and Cardiovascular Disease Risk
DANIEL CONKLIN, Aruni Bhatnagar, American Heart Association
Abstract Number: 144 Working Group: Electronic Cigarettes - Health Effects
Abstract Electronic cigarettes (e-cigarettes) are new modes of nicotine delivery in which nicotine is transferred from the liquid to the vapor phase by heating nicotine in solution. Although these devices do not generate many of the harmful or potentially harmful constituents (HPHCs), generated by combustion in conventional cigarette smoke, the cardiovascular effects of e-cigarettes are unknown and their efficacy in promoting and sustaining cessation remains unclear. Currently, e-cigarettes are being marketed as cleaner and safer alternative to smoking that could help smokers quit smoking. Nevertheless, e-cigarette aerosols contain appreciable levels of carbonyls such as acrolein, formaldehyde and acetaldehyde, which within the concentration range reported in e-cigarettes, exert significant cardiovascular toxicity. Exposure to these aldehydes has been shown to be associated with increases in blood coagulation, mean arterial blood pressure, nasal inflammation and airway irritation. Moreover, even by itself, nicotine is a sympathomimetic drug that elicits hemodynamic and metabolic changes such as increases in blood pressure and coronary resistance and deterioration of arterial compliance; changes that could accelerate cardiovascular disease and trigger acute cardiovascular events. In agreement with this view, the use of e-cigarettes has been found to be associated with increases in heart rate, and systolic blood pressure. With some devices, the effects were similar in magnitude to those observed with conventional cigarettes.The dose-response relationship between smoking and cardiovascular mortality is non-linear, suggesting that reduction in HPHC concentrations in e-cigarette aerosols may not result in proportional harm reduction and decreased HPHC exposure may be off-set by increased use by individuals who believe that e-cigarettes are safer than conventional cigarettes. Thus, taken together, current evidence suggests that despite reduction in the content of several combustion products, e-cigarette use is associated with significant hemodynamic and metabolic changes that could induce significant cardiovascular injury.