How Does Nicotine Affect the Heart?

Cigarette smoking remains a major cause of preventable disease and death among adults in the United States. Smoking also accounts for one of every four deaths from cardiovascular diseases⁽¹⁾.

Tobacco products, like cigarettes, smokeless tobacco, and e-cigarettes usually contain the highly addictive compound, nicotine, which may increase heart rate and blood pressure and narrow the arteries⁽²⁾.

Given these adverse effects, more people are looking for the best interventional radiology (IR) treatments for heart diseases and other alternative treatments. IR procedures include angioplasty (which decongests blood vessels), carotid stenting (which increases blood flow in the brain), and endovascular therapy (which prevents a ruptured aneurysm).

How Does Nicotine Increase Heart Rate?

According to a study published in Cardiovascular Drugs and Therapy, nicotine may increase heart rate, contractility, and blood pressure⁽³⁾. These effects are mainly due to the stimulation of catecholamine release.

Catecholamines are neurotransmitters important in stress responses. High catecholamine levels may cause high blood pressure.

Nicotine may also contribute to the hardening of the arterial walls, leading to a heart attack⁽⁴⁾.

How Does Nicotine in Vaping and Combustibles Affect the Heart Differently?

A growing number of e-cigarette or vape users is evident because of the popular belief that vaping has minimal risks and, therefore, is a healthy alternative to tobacco consumption⁽⁵⁾.

However, the effects of vaping remain a subject of debate. Current research suggests that e-cigarettes may be just as harmful as regular tobacco products.

A 2019 study revealed that e-cigarette users were 34% more likely to have a heart attack, 25% more likely to develop coronary artery disease, and 55% more likely to suffer from anxiety or depression⁽⁶⁾.

A 2020 study published in the European Heart Journal also noted e-cigarettes’ potential to induce adverse cardiovascular, pulmonary, and cerebrovascular effects⁽⁷⁾.

Moreover, the Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), and state health authorities are investigating the outbreak of a lung injury associated with the use of e-cigarettes⁽⁸⁾.

Patient reports and product sample testing show that tetrahydrocannabinol (THC)-containing e-cigarettes or vaping products are linked to most EVALI (e-cigarette or vaping product use-associated lung injury) cases and play a significant role in the outbreak.

Inhaling vapor oils and chemical byproducts also carry unknown risks. While some e-cigarettes are labeled nicotine-free, they may still contain nicotine⁽⁹⁾.

Aside from nicotine, the e-cigarette aerosol that users breathe from the vaping device and exhale may also contain harmful substances that damage the lungs.

According to the CDC, e-cigarette aerosol generally has fewer toxic chemicals than the deadly combination of 7,000 chemicals in smoke from regular cigarettes.

However, e-cigarettes are not harmless. They may contain potentially harmful substances, including nicotine, heavy metals, and cancer-causing chemicals.

Secondhand Smoke

Secondhand smoke poses adverse effects on nonsmokers. It interferes with the heart, blood, and vascular system’s normal functioning, increasing the risk of having a heart attack⁽¹⁰⁾.

Even brief exposure to secondhand smoke may damage the lining of blood vessels and make blood platelets stickier.

Those who have heart diseases face a higher risk of experiencing adverse effects from breathing secondhand smoke.

The only way to prevent secondhand smoke is to make homes, vehicles, workplaces, and public spaces smoke-free.

Whether regular cigarettes or e-cigarettes are used, both contain harmful toxins, including nicotine, leading to different heart diseases.

The best way to protect everyone’s health is to avoid or quit smoking.

References:

1. Centers for Disease Control and Prevention. (2020, Nov.16). Current Cigarette Smoking Among Adults in the United States. Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm#:~:text=Cigarette%20smoking%20remains%20the%20leading,about%201%20in%205%20deaths.&text=In%202019%2C%20nearly%2014%20of,14.0%25)%20currently*%20smoked%20cigarettes.
2. Haass, M., & Kübler, W. (1997). Nicotine and sympathetic neurotransmission. Cardiovascular drugs and therapy, 10(6), 657–665. doi.org/10.1007/BF00053022. https://pubmed.ncbi.nlm.nih.gov/9110108/#:~:text=These%20nicotine-induced%20cardiovascular%20effects,endings%20and%20the%20adrenal%20medulla
3. Haass, M., & Kübler, W. (1997). Nicotine and sympathetic neurotransmission. Op Cit.
4. Centers for Disease Control and Prevention (US), National Center for Chronic Disease Prevention and Health Promotion (US), & Office on Smoking and Health (US). (2010). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Centers for Disease Control and Prevention (US). https://www.ncbi.nlm.nih.gov/books/NBK53017/
5. Qasim, H., Karim, Z. A., Rivera, J. O., Khasawneh, F. T., & Alshbool, F. Z. (2017). Impact of Electronic Cigarettes on the Cardiovascular System. Journal of the American Heart Association, 6(9), e006353. doi.org/10.1161/JAHA.117.006353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634286/
6. American College of Cardiology. (2019, March 7). E-cigarettes linked to heart attacks, coronary artery disease and depression: Data reveal toll of vaping; researchers say switching to e-cigarettes doesn't eliminate health risks. ScienceDaily. Retrieved November 23, 2020 from www.sciencedaily.com/releases/2019/03/190307103111.htm
7. Kuntic, M., Oelze, M., Steven, S., Kröller-Schön, S., Stamm, P., Kalinovic, S., Frenis, K., Vujacic-Mirski, K., Bayo Jimenez, M. T., Kvandova, M., Filippou, K., Al Zuabi, A., Brückl, V., Hahad, O., Daub, S., Varveri, F., Gori, T., Huesmann, R., Hoffmann, T., Schmidt, F. P., … Münzel, T. (2020). Short-term e-cigarette vapour exposure causes vascular oxidative stress and dysfunction: evidence for a close connection to brain damage and a key role of the phagocytic NADPH oxidase (NOX-2). European heart journal, 41(26), 2472–2483. doi.org/10.1093/eurheartj/ehz772. https://pubmed.ncbi.nlm.nih.gov/31715629/
8. Centers for Disease Control and Prevention. (2020, Feb. 25). Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products. Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
9. Centers for Disease Control and Prevention. (2020, Nov. 16). About Electronic Cigarettes (E-Cigarettes). Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html
10. Centers for Disease Control and Prevention. (2020, Feb. 27). Health Effects of Secondhand Smoke. Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/health_effects/index.htm#:~:text=Breathing%20secondhand%20smoke%20interferes%20with,blood%20platelets%20to%20become%20stickier.