"This is really a warning shot that people should not be complacent and think that these e-cigarettes are completely safe", said Dr. Joseph Wu, director of Stanford University's cardiovascular institute. According to researchers, cigarette smoking causes one of every three deaths that result from cardiovascular disease.
The researchers investigated the effect of six different popular e-liquid flavors - fruit, tobacco, sweet tobacco with caramel and vanilla, sweet butterscotch, cinnamon, and menthol - with nicotine levels of 0, 6, and 18 milligrams per milliliter on endothelial cells derived from human iPS cells.
The e-liquid flavoured with caramel and vanilla also disrupted growth, but not as severely.
"We're seeing more and more evidence that e-cigarettes do have a relationship with increased chance of having a heart attack", Dr. Lawrence Phillips, an assistant professor of medicine and director of outpatient cardiology at NYU Langone Health, previously told CNN. She said, "The remarkable thing was there were very strong effects, both in terms of the specific mechanisms they looked at and that the effects were not very different between cells from e-cigarette smokers and cigarette smokers".
E-cigarettes are largely considered safer than traditional cigarettes, but a new study suggests use of the devices - as well as the flavors, regardless of nicotine content - may pose a new risk for heart disease.
They investigated the effect of e-liquids - also known as vape juice - on cells that line the interior of blood vessels, called endothelial cells.
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The cells also were less able to help form new blood vessels or participate in wound healing, the findings showed.
The use of e-cigarettes has rocketed since their introduction about a decade ago, particularly among young people.
Induced pluripotent stem cells (iPSC) are generated from adult cells that are reprogrammed to enable the development of an unlimited source of any type of human cell needed, which allows researchers to model diseases in a dish. "Eventually, they want to stop using e-cigarettes the same way a traditional smoker wants to quit smoking cigarettes", said Marc Steinberg, lead author of the study. A minority of e-cigarettes do not contain nicotine.
"People have this notion that e-cigs are safe".
"And now we know that e-cigarettes are likely to have other significantly toxic effects on vascular function as well". Doing so allowed them to closely observe the effect of the flavorings with and without nicotine on the cells' biology and function.
While the researchers tested six liquids in the new study, experts say there are thousands of unique flavors being sold online.
Researchers from the University of Arizona College of Medicine, the University of Illinois College of Medicine, the University of California-San Francisco and the University of Louisville School of Medicine also contributed to the study.