E-cigarettes can double heart attack risk, researchers find

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Although electronic cigarettes are often considered a healthier alternative to smoking tobacco, one group of researchers found this smoking option can have an alarming impact on heart health.

Three researchers in the medical school, along with a professor of medicine at the University of California, San Francisco, released a study Feb. 24, which found that daily-users of e-cigarettes are nearly twice as likely to have a heart attack. Researchers said this finding shows that e-cigarettes are not a safe alternative to tobacco.

The heart attack risk is multiplied by five for daily dual users – people who use both regular and electronic cigarettes – according to the study. Regular cigarette users are at nearly triple the risk of having a heart attack.

Talal Alzahrani, the lead author of the study who is currently a cardiology fellow in international medicine programs at GW Hospital, said companies that sell e-cigarettes often promote the product as being harmless and similar to nicotine patches or gum, but these cigarettes actually contain more unnatural chemicals.

“A lot of people think they’re safe, and there is even a vast majority of physicians that think it’s safe, and that’s the biggest concern,” he said.

Alzahrani said all the data for the research came from the Centers for Disease Control’s national databases from between 2014 and 2016, including information about a patient’s smoking habits and their heart health. He said he began working in 2015 and added the 2016 statistics to his research after they were released.

About 70,000 subjects were used to conduct the research, he said. After the research was completed, Alzahrani, along with two colleagues from GW, contacted a professor from UCSF who had experience in the field to write and submit the paper.

Alzahrani said often e-cigarette studies don’t last long enough to generate concrete results because smoking for six weeks will not show an increase in heart attack risk. But if those subjects are tracked for a longer period of time, then researchers can see a rise in inflammation in the blood stream, which is thought to be a trigger for heart attacks, he said.

Ivan Pena, a second-year fellow in the medical school, said high school and college students are often exposed to electronic cigarettes because big tobacco companies focus on marketing these products to teenagers, especially by creating several flavored varieties.

“I think it’s important to highlight the possible dangers of things, like that when they’re relatively new and haven’t been well studied – especially when this is touted as a possible alternative to traditional smoking,” he said.

Pena said that with lung cancer already considered one of the top health risks of smoking regular cigarettes, tobacco companies need to show that these products don’t carry the same risks if they are going to be marketed as a healthier alternative – a claim this study does not support.

“If we’re going to offer electronic cigarettes or promote electronic cigarettes as an alternative, then we have to prove they cause them at a lesser rate or they don’t cause them at all,” he said.

Pena said it will take additional research to determine other health risks associated with e-cigarette use besides cardiovascular disease.

Stanton Glantz, a professor of medicine at UCSF who was involved in the study, said there also appears to be an elevated heart attack risk for non-daily users of e-cigarettes. It was deemed not “statistically significant,” meaning it might have appeared by chance based on who was being surveyed, but the study does suggest all users might have a higher risk.

“Based on what we know of the effects of ultrafine particles on cardiovascular system, I would expect there to be an increased risk on non-daily use,” he said. “It may just be that enough time hasn’t passed in order to actually demonstrate it.”

Glantz said when someone smokes an e-cigarette, ultra-fine particles combine with air to form aerosol. The chemicals are then inhaled by the smoker, increasing the risk of cardiovascular or lung disease.

He also said the team will look to conduct longitudinal studies that follow people over a longer period of time to get a more through idea of the health risks associated with these products.

“In terms of the adverse effects on your blood vessels, which are very important in terms of heart disease, they’re as bad as a cigarette,” he said.

This post was updated to reflect the following correction:
The Hatchet incorrectly reported Talal Alzahrani’s name. It is now fixed. We regret this error.

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