A new study found that e-cigarettes may cause heart disease about as much as regular cigarettes do, virtually debunking the myth that e-cigs are safer.

The Journal of the American Heart Association published the study that looked at more than 400 men and women between the ages of 21 to 45 years old who had no diagnosis of heart disease and had no risk factors for heart disease. Among the participants were 94 nonsmokers, 285 cigarette smokers, 36 e-cigarette vapers and 52 people who used e-cigs and regular cigarettes.

Jessica L. Fetterman, Ph.D., assistant professor of medicine at Boston University School of Medicine, spoke with the American Association for the Advancement of Science about the study that she led.

“We studied measures of blood vessel function in e-cigarette and dual users who had been using e-cigarettes for at least three months. Most studies to-date have looked at the impact of acute use of e-cigarettes on blood vessel function measured right before and after use, whereas our study evaluated blood vessel function in chronic e-cigarette use among young, healthy adults,” Fetterman said.

Evidence that E-cigarettes Cause Heart Disease

The researchers determined that former smokers of regular cigarettes who changed to using e-cigarettes and those who used both devices had arteries that were stiffening as much as arteries observed in traditional cigarette smokers.

Fetterman explained that when the arteries become stiff, smaller blood vessels and capillaries can become damaged, putting stress on the heart that can develop into heart disease.

The study also determined that the endothelial cells that constitute the lining of the blood vessels are damaged just as much by e-cigs as they are by regular cigarettes.

Fetterman said damaged endothelial cells in e-cigarette vapers and dual users produced less heart-protecting compounds such as nitric acid. The damaged cells also produced “more reactive oxygen species, which cause damage to the parts of cells such as DNA and proteins.”

She said the study found no evidence that e-cigarettes cause heart disease to any lesser degree than regular cigarettes.

Fetterman also was the lead author of a study published in medical journal Arteriosclerosis, Thrombosis, and Vascular Biology that found flavorings added to e-cigarettes and regular cigarettes contain chemicals that also damage blood vessel cells.

The study found chemicals used in vanilla and clove flavors cause blood vessel inflammation similar to that seen in people with diabetes or high blood pressure.

EVALI Study Finds Commonalities in Severe Cases

Last fall, the U.S. saw the onset of a new vaping-associated lung injury that was nicknamed EVALI. Researchers found that EVALI patients who already suffered from chronic diseases or mental health conditions had worse cases of EVALI that led to hospitalization or death, according to the study published in The New England Journal of Medicine.

Healio Pulmonology contacted researcher Angela K. Werner, PhD, MPH, who is a health scientist with the Environmental Public Health Tracking Program at the National Center for Environmental Health, a division of the Centers for Disease Control and Prevention (CDC).

Werner said the people who appeared more likely to suffer the most severe cases of EVALI included those who were older, non-Hispanic white, current or former smokers, had a history of a chronic disease, and a history of mental health issues. More than half of the lethal cases of EVALI occurred in obese patients.

She also noted that health authorities have determined most of the EVALI patients had reported using THC-containing vaping products obtained from friends or dealers. Authorities have linked most EVALI cases with the use of vitamin E acetate in these homemade marijuana vaping juices, which could explain the lung damage observed.

Even though the number of cases of EVALI has been declining, at least 2,807 people have been hospitalized and 68 patients have died, according to the CDC’s latest report, which was issued on Feb. 18, 2020.