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Researchers are learning more about the effects of e-cigarette use. Getty Images
  • Recent research shows that e-cigarettes can affect not just the lungs, but also the heart, brain, and blood vessels.
  • A new study found a single vaping episode caused a number of changes in the cardiovascular health of 20 healthy cigarette smokers.
  • Additionally, the Centers for Disease Control and Prevention is investigating the outbreak of lung disease linked to vaping that has led to 42 deaths.

With the number of vaping-related lung injuries in the United States topping 2,000, much of the focus has been on the effects of e-cigarettes on the lungs.

But recent research shows that vaping may also harm the heart, brain, and blood vessels. And it could even damage the heart more — or faster — than traditional combustible cigarettes.

In a study released earlier this week, researchers from the University Medical Centre Mainz in Germany found that a single vaping episode caused a number of changes in the cardiovascular health of 20 healthy cigarette smokers.

The participants’ heart rate increased, their arteries stiffened, and the inner lining of the arteries, or endothelium, showed signs of not working properly.

This was after the smokers inhaled two puffs per minute for just 20 minutes.

The researchers also saw a similar disruption of the endothelium in mice exposed to e-cigarette vapor six times a day for 20 minutes for up to 5 days. This included damage to the blood vessels in the brain.

The endothelium is involved in causing the arteries to contract and relax, which helps keep blood pressure constant. It also releases chemicals that keep cells and clotting proteins from sticking to the inner lining of the blood vessels.

Dysfunction of the endothelium is linked to heart disease, stroke, vascular disease, and many other conditions. Stiffening of the arteries is also a risk factor for stroke and dementia.

The study was published in the European Heart Journal.

In another recent study, researchers from the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles found that e-cigarettes may be as harmful to the heart as combustible cigarettes — if not more harmful.

Researchers measured blood flow to the heart in 20 healthy young adults who were regular users of e-cigarettes or combustible cigarettes — 10 of each.

They looked at the participants’ coronary vascular function before and after they vaped or smoked cigarettes. This was done both at rest and while doing a simple hand exercise, which simulated physical stress.

In cigarette smokers, blood flow to the heart increased slightly after they inhaled and decreased while doing the hand exercise. In vapers, blood flow decreased both after inhalation and during the stress test.

Researchers said in a news release this suggests e-cigarette use interferes with the regulation of blood flow to the heart.

“For e-cigarette smokers, I would say this provides another cautionary note, and it’s also justification for larger research studies,” study co-author Dr. Florian Rader, a cardiologist and hypertension specialist at the Smidt Heart Institute, said in a statement.

The study was presented Nov. 11 at the American Heart Association’s annual meeting in Philadelphia. The results haven’t been published yet in a peer-reviewed journal, so they should be viewed with some caution.

Dr. Mangala Narasimhan, regional director of critical care medicine at Northwell Health in New Hyde Park, New York, says given the small size of the new studies, the results aren’t conclusive.

But she says they’re still “very worrisome.” “There seems to be some cardiac dysfunction that goes along with e-cigarettes,” she said.

More research, including longer-term studies, need to be done to confirm these results.

However, these add to a growing number of studies showing the potential harms of vaping, not just for the lungs but also the cardiovascular system.

Smoking cigarettes has long been known to damage the heart, possibly more than many people realize.

A 2014 report from the Office of the Surgeon General found that approximately 1 of every 4 deaths from cardiovascular disease is due to cigarette smoking.

But “with e-cigarettes, it seems to be a much quicker thing that’s happening,” Narasimhan said. “There’s a toxin [in e-cigarette vapor] that seems to be affecting the way the blood flows to the heart,” as seen in the Cedars-Sinai study.

E-cigarettes have only been in widespread use for a little over a decade. It may take years to know whether long-term vaping leads to more deaths from heart attack, stroke, coronary heart disease, or other conditions.

More immediate is the damage that can happen to the lungs from vaping.

As of Nov. 13, 2019, there have been 2,172 vaping-related lung injury cases and 42 deaths in the United States, according to the Centers for Disease Control and Prevention (CDC).

Many who have gotten sick reported using vape liquids containing THC. But some people said they used only nicotine-containing vaping products.

The CDC has also identified vitamin E acetate as a “potential toxin of concern.” But the agency said there’s not enough evidence to rule out other chemicals in vaping products as possible culprits.

Much is still unknown, but a couple of recent cases highlight the potential for severe lung damage from vaping.

This week, a Michigan teen received a double lung transplant due to an “enormous amount of inflammation and scarring” in the lungs caused by vaping.

There was also a recent case of a U.K. teen who developed a potentially life-threatening lung inflammation known as hypersensitivity pneumonitis.

While these cases are toward the extreme end of what can happen, they’re not altogether unusual.

“We’ve taken care of 40 vaping patients already,” said Narasimhan, many of whom were otherwise completely healthy and not heavy vapers.

“These patients have gotten very sick — enough that they need to be in a hospital on life support,” she said.