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E-cigarettes linked to higher risk of heart failure, study finds

Using e-cigarettes significantly increases the likelihood of developing heart failure, according to one of the largest studies.
Using e-cigarettes significantly increases the likelihood of developing heart failure, according to one of the largest studies. (CREDIT: Creative Commons)

Using e-cigarettes significantly increases the likelihood of developing heart failure, according to one of the largest studies examining the potential connection between vaping and heart health. The study’s findings were presented at the American College of Cardiology’s Annual Scientific Session.

Heart failure, a condition affecting over 6 million adults in the U.S., occurs when the heart becomes too weak or stiff to pump blood effectively. This can lead to severe symptoms and frequent hospitalizations as individuals age.


Electronic nicotine products, such as e-cigarettes, deliver nicotine without combustion. Although initially considered a safer alternative to smoking, mounting research suggests potential negative health effects associated with their use.

Typical e-cigarette / vaping systems.
Typical e-cigarette / vaping systems. (CREDIT: US FDA)

Dr. Yakubu Bene-Alhasan, a resident physician at MedStar Health in Baltimore and the study’s lead author, highlighted the increasing evidence linking e-cigarettes to harmful effects. “The difference we saw was substantial. It’s worth considering the consequences to your health, especially with regard to heart health,” he noted.


The study, utilizing data from surveys and electronic health records in All of Us, a large national study by the National Institutes of Health, analyzed associations between e-cigarette use and new heart failure diagnoses in 175,667 participants. Of these, 3,242 developed heart failure over a median follow-up period of 45 months.

Results revealed that individuals who had ever used e-cigarettes were 19% more likely to develop heart failure compared to non-users.


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The analysis accounted for various demographic and socioeconomic factors, as well as other heart disease risk factors and substance use. Importantly, the study found no evidence that age, sex, or smoking status influenced the relationship between e-cigarettes and heart failure.

Further examination showed that the increased risk associated with e-cigarette use was particularly significant for heart failure with preserved ejection fraction (HFpEF), where the heart muscle becomes stiff, impairing blood flow.


E-cigarette / vaping studies

However, this association was not observed for heart failure with reduced ejection fraction (HFrEF), characterized by weakened heart muscle.

These findings corroborate previous studies in animals suggesting that e-cigarette use can impact the heart in ways relevant to heart failure. While human studies have also linked e-cigarette use to risk factors associated with heart failure, prior attempts to establish a direct connection have been inconclusive due to study limitations.

Dr. Bene-Alhasan emphasized the need for further investigation, particularly given the prevalence of e-cigarette use among young people. Estimates suggest that 5% to 10% of U.S. teens and adults use e-cigarettes, prompting concerns raised by the U.S. Surgeon General in 2018 about the health risks associated with nicotine addiction among youth.


Expressing the urgency for more research, Dr. Bene-Alhasan cautioned against relying on e-cigarettes as a smoking cessation tool, as many users continue vaping long after quitting smoking. The U.S. Centers for Disease Control and Prevention recommend a combination of counseling and medications for smoking cessation.

While the study’s prospective observational design allows for inference of a potential causal relationship between e-cigarette use and heart failure, Dr. Bene-Alhasan acknowledged its limitations. Nevertheless, with its large sample size and detailed data, the study represents one of the most comprehensive assessments of this relationship to date.


How does smoking affect your body?

According to the Cleveland Clinic, tobacco use harms every organ in your body. Smoking tobacco introduces not only nicotine but also more than 5,000 chemicals, including numerous carcinogens (cancer-causing chemicals), into your lungs, blood and organs.

The damage caused by smoking can shorten your lifespan significantly. In fact, smoking is the number one cause of preventable death in the United States.

Pregnant women who smoke put their unborn babies at risk, too. Possible effects on pregnancy include:

  • Ectopic pregnancy, a life-threatening condition when the embryo implants outside the uterus.

  • Miscarriages.

  • Stillbirths.

  • Birth defects, such as cleft palate.

  • Low birth weight.


What other conditions may be caused or worsened by tobacco?

In addition to its known cancer risks, the Cleveland Clinic states that smoking causes many other chronic (long-term) health problems that need ongoing care. Specific smoking-related problems that need treatment include:

  • Decreased HDL (good) cholesterol and increased blood pressure (increasing risks for heart attack and stroke).

  • Erectile dysfunction.

  • Lower oxygen to the heart and other tissues in the body (increasing risks for coronary artery disease, peripheral artery disease, and diabetes).

  • More frequent routine illnesses like colds, especially in children living with smokers.

  • Poorer lung function (ability to get enough oxygen) leading to COPD, asthma, bronchitis, or emphysema.


The study is titled, “Changing smoking habits and the occurrence of lung cancer in Sweden—a population analysis" is published in the European Journal of Public Health.

For more science news stories check out our New Discoveries section at The Brighter Side of News.


Note: Materials provided above by The Brighter Side of News. Content may be edited for style and length.


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