Abstract
BACKGROUND: Smoking, including conventional and electronic cigarettes (e-cigarettes), is a major contributor to cardiovascular morbidity and mortality. Indonesia, with 69.1 million smokers, experiences a high burden of smoking-related diseases. This study aims to evaluate the impact of conventional and e-cigarette exposure on atherosclerosis in Rattus norvegicus (Wistar rats). METHODS: Twenty-one male Wistar rats were randomized into three groups: control, conventional cigarette exposure, and e-cigarette exposure. Both smoking groups received equivalent nicotine doses for 30 min daily, five days a week, for 12 weeks. Aortic and iliac artery intima-media thickness (IMT) was measured, and plasma levels of tumor necrosis factor-alpha (TNF-α) and monocyte chemoattractant protein-1 (MCP-1) were analyzed using ELISA. Histopathological changes were also examined. RESULTS: Cigarette exposure significantly increased IMT in the aorta (control: 67.22 ± 3.07 µm; conventional: 100.89 ± 25.60 µm; e-cigarette: 83.75 ± 7.45 µm; p < 0.05) and iliac arteries (control: 68.50 ± 5.6 µm; conventional: 90.49 ± 25.02 µm; e-cigarette: 90.68 ± 12.26 µm; p = 0.031). MCP-1 levels were significantly elevated in the conventional group (205.77 ± 22.18 pg/mL; p = 0.003), while TNF-α levels increased in both groups but without statistical significance. Histopathology revealed fatty streaks and elastic fiber disruption in both exposure groups, with no significant differences observed (p > 0.05). CONCLUSIONS: Both conventional and e-cigarettes promote atherosclerosis, as evidenced by increased arterial thickness and inflammatory markers. The cardiovascular risks associated with e-cigarettes are comparable to those of conventional cigarettes, highlighting the need for stricter regulation and public awareness.