Vaping isn’t necessarily better for your heart health than smoking tobacco, a pair of new studies argue.

They report that use of e-cigarettes negatively affects risk factors for heart disease in ways similar to traditional tobacco cigarettes:

• Levels of bad cholesterol and triglycerides are elevated in people who use e-cigarettes, according to results from the first study.
• E-cigarette users also experience a decrease in blood flow to the heart muscle, the second study says.

Higher total cholesterol levels

“People are making the assumption if they switch from cigarettes to e-cigarettes, their risk will be substantially reduced of cardiovascular disease,” said Dr Rose Marie Robertson, deputy chief science and medical officer for the American Heart Association, and co-author of the first study. “That’s not necessarily the case.”

Both studies are to be presented at the American Heart Association’s annual meeting, in Philadelphia. Research presented at meetings is typically considered preliminary.

For the first study, researchers evaluated 476 healthy adults who took no daily heart medications to see how smoking might affect their cholesterol levels.

Of these participants, 285 were tobacco cigarette smokers, 45 were e-cigarette smokers, 52 were “dual users” who smoke and vape, and 94 were non-smokers.

All tobacco users – including vapers – had higher total cholesterol levels, as well as higher levels of triglycerides and “bad” LDL cholesterol, the study found.

Researchers said they found the same sort of cholesterol when they looked only at e-cigarette users.

Blood flow to the heart

The second study used advanced ultrasound techniques to track blood flow inside the body, according to lead researcher Dr Florian Rader. He’s co-director of the Clinic for Hypertrophic Cardiomyopathy and Aortopathies at Cedar-Sinai Medical Center’s Smidt Heart Institute in Los Angeles.

His team tracked the flow of blood to the hearts of 19 young adult smokers immediately before and after vaping or smoking.

Participants were asked to rest while their blood flow was tested, and then to perform a handgrip exercise intended to increase their heart rate, Rader said.

“In healthy individuals, blood flow increases to the heart because the heart’s working harder and it needs more oxygen. The body adjusts blood flow and delivers more oxygen to the heart,” Rader said. “This increase was blunted and even partially reversed in patients who are habitual e-cigarette smokers.”

Researchers added that blood flow to the heart was reduced at rest, even in the absence of stress, after a puff on an e-cigarette.

“It shows that cigarette and e-cigarette smoking seem to be equally bad in causing abnormalities of blood flow to the heart,” Rader said.

Can’t say which comes first

However, both sets of findings come from “very preliminary studies” that haven’t appeared in a peer-reviewed journal, said Dr Mary Ann McLaughlin, a cardiologist at Mount Sinai Hospital in New York City who reviewed the studies.

She noted that the blood flow study involved a “very small sample size”, while the cholesterol study couldn’t draw a direct cause-and-effect relationship.

“It’s an association, but you can’t say which is coming first,” cholesterol levels or e-cigarette use, McLaughlin said. “I could argue that people with high cholesterol may be more sedentary, may have poorer lifestyle choices, and may be more likely to smoke.”

The cholesterol researchers suspect the chemicals inhaled from e-cigarettes could be increasing oxidative stress in the body, said lead researcher Dr Sana Majid, a postdoctoral fellow in vascular biology at Boston University School of Medicine.

In turn, that increase in stress and inflammation could be altering people’s cholesterol levels, Majid said

‘A little disturbing’

Known e-cigarette chemicals also have been shown in the lab to be toxic to endothelial cells that line the inside of blood vessels, said Robertson. That could affect blood vessels’ ability to respond to increased demands from the heart.

She said these sorts of studies should have been done to test the safety of e-cigarettes long before they ever went on the market.

“It’s a little disturbing we’re now doing that experiment with the American public, rather than figuring it out before the products are so widely available and so widely used,” Robertson said.

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Gut health is extremely important, and ensuring that you take in the right fuel means that your system will work optimally.

If you put the wrong kind of food into your body, you could end up suffering from gas, heartburn, bloating, constipation or diarrhoea – to name just a few.

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Vaping caused a catastrophic reaction in Ewan Fisher’s lungs that meant he could not breathe.

An inquest hears the woman was able to get online prescriptions without her GP’s knowledge.

Christie Tolosky went to her family doctor’s office to get a prescription for a toothache. She collapsed and was dead within an hour, leaving doctors looking for clues about what happened to the otherwise healthy 24-year-old.

An autopsy revealed the answer. While planning the funeral, Barbara Tolosky, Christie’s mother and a registered nurse, saw the cause of death listed as arrhythmia, an irregular heart rhythm. That started a chain of events that led to three generations of the family being diagnosed with long QT syndrome, a disorder of the heart’s electrical system that can cause irregular and potentially fatal heartbeats.

She was on the floor

Christie had experienced fainting spells – the first in her high school cafeteria in upstate New York. She was taken to a hospital. Her blood sugar was low, and a follow-up visit confirmed hypoglycaemia, a condition caused by low blood sugar. She was told to follow a certain diet. There was no reason to check an otherwise healthy teen’s heart.

Christie’s second episode was in college. She told her mom she woke up with her alarm going off, and the next thing she knew, she was on the floor.

The final time was in the doctor’s office.

Within days of Christie’s death in June 2005, the family’s physician wanted the Toloskys to be checked to see if there was something genetic going on.

Long QT syndrome is a rare condition. It’s marked by the lower chambers of the heart taking too long to contract and release. The name comes from letters associated with the waves on an electrocardiogram: the problem is found when there’s too much time between the letters Q and T.

Long QT can be hereditary, usually affecting otherwise healthy children or young adults. Others can get it as a side effect of medication.

Another death in the family

Christie’s older brother, Nick, was fine. But mom Barbara and younger sister, Melissa, were both diagnosed with the condition.

At the time, Melissa was 22 and about to spend a year in Belgium for graduate school. After multiple consultations, she opted to get an implantable cardioverter defibrillator, or ICD, a device that tracks heart rate and can deliver an electric shock if needed to restore a normal heart rhythm.

Four months later, another death rocked the family: Barbara’s mother died. Two days later, Barbara felt her heart flutter and went to the hospital. While there, she had a cardiac arrest. She also now has an ICD.

By 2014, Melissa had moved back to the Albany area to be near her close-knit family and was working as a communications consultant. She and her husband, Braden Russom, were expecting their first child.

She found out about a foetal arrhythmia study that was recruiting pregnant women with long QT syndrome and enrolled. The couple flew to Wisconsin and met with the specialist overseeing the research. Melissa was hooked up to a machine that could separate the foetal heart rhythm from her own. Right away, they detected the 24-week-old foetus had long QT.

From that point, the doctor became part of the care team, and a crowd of medical staff was in the delivery room, providing extra peace of mind.

A ‘special heart’

They named the girl Cora. Her middle name is Christie.

Two years later, the couple was pregnant again. Their second child, Kate, had the same test and she too was diagnosed with long QT. She and her big sister take medicine called beta blockers to help regulate their hearts’ workload.

“The way that we tell them about it is that they have a special heart, and that’s why they have to take their medicine,” Melissa said.

In the years since Christie died, several of her aunts, cousins and their children – all on her mom’s side – also have been tested and diagnosed with long QT.

This extended family has learned that people can have it without showing any symptoms. Others may faint. Sometimes, an everyday circumstance can trigger an arrhythmia, such as being startled, experiencing intense emotion or working out. In fact, Barbara believes a lunch bell ringing at school may have triggered Christie’s first fainting episode, and her alarm clock may have caused the second.

Check it out

“For us, when we hear anyone has fainted, we always say, ‘Ask, ask, ask if it could be cardiac-related,'” Melissa said.

She volunteers for the American Heart Association, sharing with others what happened to her sister. The family also participates in their local AHA Heart Walk wearing T-shirts in Christie’s favourite colour, purple.

“To me, it’s getting anyone who potentially has a warning sign to get them to check it out,” Melissa said. “If they had found Christie had long QT, they could have treated her. It’s not like it’s a death sentence. It’s just that she didn’t know.”

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