| Summary: | Introduction
Acute exposure to e-cigarette aerosol has been shown to have
potentially deleterious effects on the cardiovascular system. However, the
cardiovascular effects of habitual e-cigarette use have not been fully elucidated.
Therefore, we aimed to assess the association of habitual e-cigarette use with
endothelial dysfunction and inflammation – subclinical markers known to be
associated with increased cardiovascular risk.
Methods
In this cross-sectional study, we analyzed data from 46 participants (23
exclusive e-cigarette users; 23 non-users) enrolled in the VAPORS-Endothelial
function study. E-cigarette users had used e-cigarettes for ≥6 consecutive months.
Non-users had used e-cigarettes <5 times and had a negative urine cotinine
test (<30 ng/mL). Flow-mediated dilation (FMD) and reactive hyperemia index
(RHI) were used to assess endothelial dysfunction, and we assayed high-sensitivity
C-reactive protein, interleukin-6, fibrinogen, p-selectin, and myeloperoxidase as
serum measures of inflammation. We used multivariable linear regression to assess
the association of e-cigarette use with the markers of endothelial dysfunction and
inflammation.
Results
Of the 46 participants with mean age of 24.3 ± 4.0 years, the majority were
males (78%), non-Hispanic (89%), and White (59%). Among non-users, 6 had
cotinine levels <10 ng/mL while 17 had levels 10–30 ng/mL. Conversely, among
e-cigarette users, the majority (14 of 23) had cotinine ≥500 ng/mL. At baseline,
the systolic blood pressure was higher among e-cigarette users than non-users
(p=0.011). The mean FMD was slightly lower among e-cigarette users (6.32%)
compared to non-users (6.53%). However, in the adjusted analysis, current
e-cigarette users did not differ significantly from non-users in their mean FMD
(Coefficient=2.05; 95% CI: -2.52–6.63) or RHI (Coefficient= -0.20; 95% CI:
-0.88–0.49). Similarly, the levels of inflammatory markers were generally low
and did not differ between e-cigarette users and non-users.
Conclusions
Our findings suggest that e-cigarette use may not be significantly
associated with endothelial dysfunction and systemic inflammation in relatively
young and healthy individuals. Longer term studies with larger sample sizes are
needed to validate these findings.
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