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The adolescent cardiovascular systemcharacterized by active vascular remodeling and an immature endotheliumis especially vulnerable to the oxidative stress and inflammation induced by e-cigarette aerosols ( Nicotine and other chemical components of vaporized e-liquids can impair endothelial function, increase arterial stiffness, and elevate blood pressurerecognized early markers of cardiovascular disease ( Given the prognostic value of elevated blood pressure and arterial stiffness as predictors of cardiovascular morbidity and mortality, these findings raise serious concerns about the potential lifelong cardiovascular consequences of vaping initiation during adolescence