Impact of Electronic Cigarette use on Cardiovascular Health: Current Evidence, Causal Pathways, and Public Health Implications.

Introduction:
This text provides a comprehensive review of the impact of electronic cigarette (e-cigarette) use on cardiovascular health, highlighting the current evidence, causal pathways, and public health implications. The review discusses the effects of e-cigarette use on various cardiovascular health parameters, including heart rate, blood pressure, oxygen saturation, and the risks of developing atherosclerosis, hypertension, arrhythmia, myocardial infarction, and heart failure. The text also explores the influence of e-cigarette components, such as flavors and additives, on cardiovascular health.

Key Points:

* E-cigarette use is associated with increased heart rate, diastolic blood pressure, and decreased oxygen saturation.
* The health impacts of e-cigarette use are mainly attributed to the individual and interactive effects of flavors and additives, along with extended heating.
* Prolonged sympathoexcitatory cardiovascular autonomic effects, such as increased heart rate and diastolic blood pressure, are linked to e-cigarette use.
* E-cigarette users are at an increased risk of developing atherosclerosis, hypertension, arrhythmia, myocardial infarction, and heart failure.
* The risks associated with e-cigarette use are expected to surge, particularly among youth who increasingly adopt e-cigarette use, particularly with flavored additives.
* Further research is needed to evaluate the long-term effects of e-cigarette use and passive smoking, especially among susceptible populations.
* E-cigarette flavors, particularly sweet and menthol flavors, have been shown to induce effects of highest toxicity and are not currently subject to regulation.

Main Message:
The text emphasizes the need for continued research on the impact of e-cigarette use on cardiovascular health, particularly in susceptible populations such as youth. The review highlights the importance of considering the influence of e-cigarette components, such as flavors and additives, on cardiovascular health. The main message is that, while e-cigarette use may be considered a harm reduction strategy for conventional tobacco smoking cessation, it is not without health risks. Therefore, non-tobacco smokers are recommended not to initiate electronic cigarette use. Furthermore, the long-term effects of e-cigarette exposure on health, particularly during pivotal developmental periods, remain to be elucidated and are not predictable based on currently available data.

Critselis E, Panagiotakos D. Impact of Electronic Cigarette use on Cardiovascular Health: Current Evidence, Causal Pathways, and Public Health Implications. Angiology. Published online March 13, 2023:33197231161905. doi:10.1177/00033197231161905