E-Cigs Linked To Adverse Cardiac Effects

MedicalResearch.com Interview with:

Holly R. Middlekauff, MD Professor UCLA Division of Cardiology David Geffen School of Medicine UCLA

Dr. Holly Middlekauff

Holly R. Middlekauff, MD
UCLA Division of Cardiology
David Geffen School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: E-cigarettes are the fastest rising tobacco product in the US today, but almost nothing is known about their cardiovascular effects. Rather than wait decades for epidemiological data in e-cigarette users to become available, we reasoned that investigations into the known mechanisms by which tobacco cigarettes increase heart disease would provide insights into the health risks of e-cigarettes.

We focused on 2 critical mechanisms:
1) cardiac adrenaline activity, and
2) oxidative stress, measured in chronic e-cigarrete users compared to matched, healthy controls.

The major findings were that, compared to healthy controls, e-cig users had increased cardiac adrenaline activity (measured by a technique called “heart rate variability”). Furthermore, compared to healthy controls, the e-cig users had increased susceptibility to oxidative stress.

MedicalResearch.com: What should readers take away from your report?

Response: E-cigarettes have real, measurable, adverse physiologic effects. We should get the word out that to our patients, and to the public, that: “If you don’t already smoke tobacco cigarettes, don’t start using e-cigarettes – they are not harmless!”

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Important remaining questions for future research are:
1) Are e-cigarettes are as harmful as tobacco cigarettes?
2) What component(s) of the e-cigarette aerosol is responsible for these adverse effects – the inhaled nicotine? humectants? the flavorings?

We don’t yet have the answers to these questions, but we are working on them.

MedicalResearch.com: Is there anything else you would like to add?

Response: No disclosures. Thank you very much for your interest in our work

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


Moheimani RS, Bhetraratana M, Yin F, Peters KM, Gornbein J, Araujo JA, Middlekauff HR. Increased Cardiac Sympathetic Activity and Oxidative Stress in Habitual Electronic Cigarette UsersImplications for Cardiovascular Risk. JAMA Cardiol. Published online February 01, 2017. doi:10.1001/jamacardio.2016.5303

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on February 1, 2017 by Marie Benz MD FAAD