acute effects of electronic cigarettes on vascular endothelial function: a systematic review and meta-analysis of randomized controlled trials.

Introduction:
This text is a systematic review and meta-analysis of randomized controlled trials investigating the acute effects of electronic cigarettes on vascular endothelial function. The study aims to compare e-cigarettes with traditional tobacco and vaping without nicotine, focusing on three indicators of endothelial function: flow-mediated dilation (FMD), pulse wave velocity (PWV), and heart rate corrected augmentation index (aIx75). The review provides valuable insights into the potential cardiovascular risks associated with e-cigarette use.

Key Points:

* The study included eight randomized controlled trials with a total of 372 participants.
* Compared to vaping without nicotine, e-cigarettes significantly increase PWV and aIx75, but not FMD.
* When compared to traditional tobacco, e-cigarettes did not affect FMD or PWV, but reduced aIx75.
* Subgroup analyses revealed that population type may be a source of heterogeneity for PWV.
* Network meta-analysis showed that e-cigarettes had the strongest effect on FMD, while tobacco use showed the strongest effect on PWV and aIx75.
* The negative effects of e-cigarettes and tobacco on endothelial function were obvious, with no clear evidence that e-cigarettes are superior to conventional tobacco.
* The adverse effects of e-cigarettes on endothelial function may be related to the ingredients contained in e-cigarettes, such as heavy metals, organic solvents, or other unknown substances.

Main Message:
The study suggests that acute exposure to e-cigarettes affects endothelial function, arterial stiffness, and vascular smooth muscle tension, which may increase the risk of cardiovascular diseases such as acute coronary syndrome and atherosclerosis. The findings emphasize the importance of further research on the long-term toxicity and safety of e-cigarettes, as well as their impact on other organs. The study concludes that e-cigarettes cannot be used as an alternative to public health strategies for tobacco control and should not be considered cardiovascular safety products.

Meng XC, Guo XX, Peng ZY, Wang C, Liu R. acute effects of electronic cigarettes on vascular endothelial function: a systematic review and meta-analysis of randomized controlled trials. European journal of preventive cardiology. 2023;30(5):425-435. doi:10.1093/eurjpc/zwac248