Differential Effects of E-Cigarette on Microvascular Endothelial Function, Arterial Stiffness and Oxidative Stress: A Randomized Crossover Trial

Propylene glycol and glycerol are electronic cigarettes vehicles allowing liquid vaporization and nicotine transport. The respective effects of these different constituents on the cardiovascular system are unknown. We assessed the differential effects of vehicles (propylene glycol and glycerol) and nicotine on microcirculatory function, arterial stiffness, hemodynamic parameters and oxidative stress. Twenty-five tobacco smokers were exposed to vaping with and without nicotine, and sham vaping, in a randomized, single blind, 3-period crossover design study. Neither sham-vaping nor vaping in the absence of nicotine resulted in modifications of cardiovascular parameters or oxidative stress. In contrast, vaping with nicotine: 1) impaired acetylcholine mediated vasodilation (mean ± standard error mean) (area under curve, perfusion unit (PU), 3385 ± 27PU to 2271 ± 27PU, p < 0.0001 ); 2) increased indices of arterial stiffness, namely augmentation index corrected for heart rhythm (−3.5 ± 1.5% to 1.9 ± 2.3%; p = 0.013 ) and pulse wave velocity (4.9 ± 0.1 m.s −1 to 5.3 ± 0 .1 m.s −1 ; p < 0.0001 ); 3) increased systolic and diastolic blood pressures as well as heart rate (all p < 0.0001 ) and finally; 4) raised plasma myeloperoxidase (median [interquartile range]) (13.6 ng.ml −1 [10–17.7] to 18.9 ng.ml −1 [12.2–54.4], p = 0.005 ). Our findings demonstrated that high temperature e-cigarette vehicle vaporization does not alter micro- and macro-vascular function, and oxidative stress, and that these effects are solely attributable to nicotine.