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Impact of electronic cigarettes on cardiac risk

Institution: University of California, Los Angeles
Investigator(s): Holly Middlekauff,
Award Cycle: 2014 (Cycle 23) Grant #: 23XT-0006H Award: $278,525
Subject Area: Regulatory Science/New Products
Award Type: Exploratory/Developmental Award
Abstracts

Initial Award Abstract

There is increasing recognition that the known adverse health consequences of exposure to cigarette smoke, including heart disease, are also shared by exposure to air pollution. Both cigarettes and air pollution are sources of toxic gases and fine particulate matter, and both increase adrenaline, a known trigger for heart attacks and sudden death. Both also increase inflammation, which leads to cholesterol build up in the arteries, called “atherosclerosis.” Relatively recently, a new source of emissions, the electronic(e)-cigarette, has been introduced, and is gaining unprecedented popularity, especially among young people. Although e-cigarettes are not cigarettes at all (no tobacco, no smoke), similar to tobacco cigarettes, they are a source of potentially toxic gases, small particles, and nicotine. It remains unknown if they too increase adrenaline, and inflammation, leading to increased risk of heart disease; these critical questions will be answered by the investigations in this proposal.

Our overall goal is to determine if e-cigarettes have adverse cardiovascular effects. To date, e-cigarettes regulation the Food and Drug Administration has been controversial; the controversy stems from the paucity of scientific study and knowledge regarding the health effects of e-cigarettes. In the absence of scientific evidence, e-cigarettes are being touted as a safe alternative to tobacco cigarettes, and are in fact increasingly being used by non-smokers, highlighting the need for rigorous scientific study. Study aims include: 1) To determine if e-cigarettes generate increased oxidative stress, which is known to be harmful, 2) To assess the level of adrenaline in e-cigarette users, since increased adrenaline can be a risk factor for heart disease, and 3) To determine if the stiffness of the blood vessels is increased by e-cigarettes, since stiff blood vessels can be an early marker for cardiovascular disease. Knowledge gained from these studies will inform e-cigarette regulations, and provide information to the general public regarding the effects of e-cigarettes use.

Publications

Does the Risk of Electronic Cigarettes Outweigh the Potential Benefits? No.
Periodical: Chest Index Medicus:
Authors: Middlekauff HR. ART
Yr: 2015 Vol: 143 Nbr: 3 Abs: Pg: 582-4

Rebuttal from Dr. Middlekauff
Periodical: Chest Index Medicus:
Authors: Middlekauff HR ART
Yr: 2015 Vol: 143 Nbr: 3 Abs: Pg: 585-6

Increased cardiac sympathetic activity and oxidative stress in habitual electronic cigarette users: Implications for Cardiovascular Risk
Periodical: JAMA Cardiology Index Medicus:
Authors: Moheimani RS, Bhetraratana M, Yin F, Peters KM, Gornbein J, Araujo JA, Middlekauff HR ART
Yr: 2017 Vol: 2 Nbr: 3 Abs: Pg: 278-284

Activation of the 'Splenocardiac Axis' by Electronic and Tobacco Cigarettes in Otherwise Healthy Young Adults
Periodical: Physiological Reports Index Medicus:
Authors: Boas Z, Gupta P, Moheimani RS, Bhetraratana M, Yin F, Peters KM, Gornbein J, Araujo JA, Cz ART
Yr: 2017 Vol: Nbr: Abs: Pg:

Sympathomimetic Effects of Acute E-Cigarette Use: Role of Nicotine and Non-Nicotine Particulates
Periodical: JAMA: Journal of the American Medical Association Index Medicus:
Authors: Moheimani RS, Bhetraratana M, Peters KM, Yang BK, Yin F, Gornbein J, Araujo JA, Middlekauf ART
Yr: 2017 Vol: Nbr: Abs: Pg:

Does the Risk of Electronic Cigarettes Outweigh the Potential Benefits? No.
Periodical: Chest Index Medicus:
Authors: Middlekauff HR. ART
Yr: 2015 Vol: 143 Nbr: 3 Abs: Pg: 582-4

Rebuttal from Dr. Middlekauff
Periodical: Chest Index Medicus:
Authors: Middlekauff HR ART
Yr: 2015 Vol: 143 Nbr: 3 Abs: Pg: 585-6

Increased cardiac sympathetic activity and oxidative stress in habitual electronic cigarette users: Implications for Cardiovascular Risk
Periodical: JAMA Cardiology Index Medicus:
Authors: Moheimani RS, Bhetraratana M, Yin F, Peters KM, Gornbein J, Araujo JA, Middlekauff HR ART
Yr: 2017 Vol: 2 Nbr: 3 Abs: Pg: 278-284

Activation of the 'Splenocardiac Axis' by Electronic and Tobacco Cigarettes in Otherwise Healthy Young Adults
Periodical: Physiological Reports Index Medicus:
Authors: Boas Z, Gupta P, Moheimani RS, Bhetraratana M, Yin F, Peters KM, Gornbein J, Araujo JA, Cz ART
Yr: 2017 Vol: Nbr: Abs: Pg:

Sympathomimetic Effects of Acute E-Cigarette Use: Role of Nicotine and Non-Nicotine Particulates
Periodical: JAMA: Journal of the American Medical Association Index Medicus:
Authors: Moheimani RS, Bhetraratana M, Peters KM, Yang BK, Yin F, Gornbein J, Araujo JA, Middlekauf ART
Yr: 2017 Vol: Nbr: Abs: Pg: