E-cigarettes and arterial health: A review of the link between vaping and atherosclerosis progression

Table 1 Comparison of e-cigarettes and traditional cigarettes

Category	E-cigarettes	Traditional cigarettes
Key components	Nicotine, flavorings, metal particles, glycerol, propylene glycol	Nicotine, tar, carbon monoxide, formaldehyde, ammonia, benzene
Toxic compounds	Acrolein, acetaldehyde (formed through thermal decomposition)	> 7000 chemicals, including tar and carbon monoxide, many of which are highly toxic
Immediate cardiovascular effects	Increases in heart rate and blood pressure due to nicotine; causes DNA damage, endothelial dysfunction, and oxidative stress	Immediate increases in heart rate and blood pressure; vasoconstriction, reduced blood flow to the heart, blood clots, and arrhythmias
Long-term cardiovascular effects	Aortic stiffness, proinflammatory phenotypes, hyperlipidemia, endothelial dysfunction, increased risk of myocardial infarction, heart failure, and mortality	Coronary artery disease, heart attacks, hypertension, strokes; arterial damage, reduced oxygen delivery to the heart muscle
Mechanism of cardiovascular harm	Nicotine causes macrophage activation and release of FFAs and adipokines, promoting inflammatory responses and oxidative stress	Nicotine stimulates catecholamine release, increasing heart rate and blood pressure; carbon monoxide reduces oxygen delivery to the heart muscle
Impact of dual use	Increases overall nicotine exposure and exposure to a broader spectrum of toxic substances, compounding adverse effects; 36% increased risk of CVD	Similar risks compounded by additional exposure to harmful chemicals when combined with e-cigarette use
Additional risks	Potential exposure to metal particles and other contaminants from e-cigarette devices	Exposure to tar and numerous carcinogenic substances not present in e-cigarettes

CVD: Cardiovascular disease; FFAs: Free fatty acids.