Study Links Vaping With Reduced Cardiovascular Function

A pair of new analyses found that adults who regularly used electronic nicotine delivery devices have concerning changes in heart and blood vessel function with significantly worse results on exercise stress testing vs those who do not use nicotine products.

The Cardiac and LUng E-cig Smoking (CLUES) study evaluated outcomes among individuals who vape, those who smoke combustible cigarettes, and those did not use any nicotine products.

The study was conducted by researchers at the University of Wisconsin between March 2019 and March 2022. The study was designed to analyze the short-term effects of vaping and cigarette smoking in regular nicotine users compared with their similar matched peers who did not use nicotine in any form.

Among 395 study participants, 164 reported exclusive use of electronic cigarettes for an average of 4.1 years, whereas 80% reported using the most recent generation of vaping devices. Further, 117 individuals reported exclusively smoking combustible cigarettes for an average of 23 years, whereas 114 adults reported never smoking or vaping and currently had negative urine tests for nicotine use.

In the first study, investigators evaluated blood pressure, heart rate and heart rate variability, and the diameter of the brachial artery in the arm prior to and up to 15 minutes following vaping or smoking. The investigators then compared the before-and-after measures to measurements recorded 10 to 15 minutes apart among the cohort who reported never vaping or smoking.

The researchers found greater increases in heart rate among nicotine users. Among individuals who vaped or smoked cigarettes, the results showed an approximately 4 beat per minute jump in heart rate after vaping or smoking, whereas individuals who did not use nicotine had no changes in heart rate.

The results also showed greater increases in systolic and diastolic blood pressure. Among those who vaped or smoked, increases in blood pressure were observed from approximately 122/72 mm Hg to approximately 127/77 mm Hg after vaping or smoking. There was no change in blood pressure observed among those who had never used nicotine products had no change in blood pressure.

“Immediately after vaping or smoking, there were worrisome changes in blood pressure, heart rate, heart rate variability and blood vessel tone (constriction),” lead study author Matthew C. Tattersall, DO, MS, assistant professor of medicine at the University of Wisconsin School of Medicine and Public Health and associate director of preventive cardiology at UW Health in Madison, Wisconsin, said in a press release. “These findings suggest worse cardiovascular disease risk factors right after vaping or smoking, and activation of the sympathetic nervous system may play a role in the adverse responses seen immediately after using e-cigarettes and after exercise testing 90 minutes later.”

The second analysis used the same cohorts of participants to compare how the results of exercise stress testing, which is used to calculate cardiovascular disease outcomes. The treadmill stress tests were conducted approximately 90 minutes after nicotine users had either vaped or smoked, and 90 minutes after the no nicotine use group had rested.

Compared with the cohort who did not use nicotine, those who smoked or vaped regularly were found to have had reduced ability to exercise as distinguished by lower peak METS; showed a lower cardiac workload while exercising at their maximum level; had reduced heart rate reserve, which indicates worse fitness; and experienced slower heart rate recovery following completion of the exercise test.

“People who vaped clearly performed worse on all four exercise parameters compared to their peers who did not use nicotine, even after adjusting for age, sex and race/ethnicity,” said lead author of the study, Christina M. Hughey, MD, a fellow in cardiovascular medicine at UW Health, the integrated health systems of the University of Wisconsin-Madison, in a press release. “The exercise performance of those who vaped was not significantly different than people who used combustible cigarettes, even though they had vaped for fewer years than the people who smoked and were much younger.”

REFERENCE

People who vape had worrisome changes in cardiovascular function, even as young adults. October 31, 2022. Accessed November 1, 2022. American Heart Association. https://newsroom.heart.org/news/people-who-vape-had-worrisome-changes-in-cardiovascular-function-even-as-young-adults?preview=64cf