E-cigarettes and cigarettes worsen peripheral and central hemodynamics as well as arterial stiffness: A randomized, double-blinded pilot study

Vasc Med. 2018 Oct;23(5):419-425. doi: 10.1177/1358863X18779694. Epub 2018 Jul 9.


The introduction of electronic cigarettes has led to widespread discussion on the cardiovascular risks compared to conventional smoking. We therefore conducted a randomized cross-over study of the acute use of three tobacco products, including a control group using a nicotine-free liquid. Fifteen active smokers were studied during and after smoking either a cigarette or an electronic cigarette with or without nicotine (eGo-T CE4 vaporizer). Subjects were blinded to the nicotine content of the electronic cigarette and were followed up for 2 hours after smoking a cigarette or vaping an electronic cigarette. Peripheral and central blood pressures as well as parameters of arterial stiffness were measured by a Mobil-O-Graph® device. The peripheral systolic blood pressure rose significantly for approximately 45 minutes after vaping nicotine-containing liquid ( p<0.05) and for approximately 15 minutes after smoking a conventional cigarette ( p<0.01), whereas nicotine-free liquids did not lead to significant changes during the first hour of follow-up. Likewise, heart rate remained elevated approximately 45 minutes after vaping an electronic cigarette with nicotine-containing liquid and over the first 30 minutes after smoking a cigarette in contrast to controls. Elevation of pulse wave velocity was independent from mean arterial pressure as well as heart rate in the electronic cigarette and cigarette groups. In this first of its kind trial, we observed changes in peripheral and central blood pressure and also in pulse wave velocity after smoking a cigarette as well as after vaping a nicotine-containing electronic cigarette. These findings may be associated with an increased long-term cardiovascular risk.

Keywords: arterial stiffness; cigarette; electronic cigarette (e-cigarette); pulse wave velocity; risk stratification; smoking; vaping.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cigarette Smoking / adverse effects*
  • Cross-Over Studies
  • Disease Progression
  • Double-Blind Method
  • Electronic Nicotine Delivery Systems*
  • Female
  • Germany
  • Hemodynamics*
  • Humans
  • Male
  • Nicotine / administration & dosage
  • Nicotine / adverse effects*
  • Nicotinic Agonists / administration & dosage
  • Nicotinic Agonists / adverse effects*
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / etiology*
  • Peripheral Arterial Disease / physiopathology
  • Pilot Projects
  • Pulse Wave Analysis
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Vaping / adverse effects*
  • Vascular Stiffness*
  • Young Adult


  • Nicotinic Agonists
  • Nicotine