THE ILLUSION OF SAFETY: UNMASKING THE CARDIOVASCULAR RISKS OF ELETRONIC CIGARETTES

Resumo

E-cigarettes are popular alternatives to tobacco. Despite perceived safety, evidence indicates adverse cardiovascular effects, including endothelial dysfunction, arterial stiffness, oxidative stress, and increased myocardial infarction risk. Even nicotine-free versions demonstrate toxicity. This review synthesizes current evidence. Evaluate cardiovascular effects of e-cigarettes, including endothelial dysfunction and outcomes. This is a systematic literature review encompassing articles from 2022 to 2025 from the PubMed (ME DLINE) database. In total, from the 15 previously selected articles, 10 were chosen using the descriptors "E -Cigarettes”, “Cardiovascular" and "Endothelial Dysfunction". Meta -analyses, systematic reviews and cross sectional studies in English were included , addressing cardiovascular manifestations under the use of electronic cigarettes. The use of electronic cigarettes is associated with increased oxidative stress and endothelial dysfunction, contributing to the development of vascular lesions and, consequently, to a higher risk of cardiovascular diseases. The underlying biological mechanisms include increased inflammation and the production of reactive oxygen species, leading to the formation of toxic compounds and the progression of atherosclerosis. Furthermore, studies have demonstrated a 2.6- fold increase in the likelihood of myocardial infarction among individuals who use electronic cigarettes compared to those who have never used conventional cigarettes. However, although some clinical trials suggest a transient improvement in endothelial function in individuals who switch from conventional to electronic cigarettes, the heating of e -liquids (propylene glycol, glycerin, flavorings, and sometimes nicotine) promotes the formation of toxic substances, maintaining deleterious effects on vascular function in the long term.Thus, evidence demonstrates that e-cigarette use causes harms such as arterial stiffness, oxidative stress, increased risk of acute myocardial infarction, and endothelial dysfunction. Hence, a lthough trials indicate temporary improvement over conventional ones, other substances maintain long -term damage. Therefore, further studies, prevention, awareness, and lifestyle changes are necessary to mitigate such complications.