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Vaping has often been recommended to individuals as a “healthier” alternative to smoking and may assist people in their journey to quit smoking. However, one may want to reconsider this notion based on some new research that has come to light indicating that vaping raises people’s odds of experiencing heart failure.

Heart Failure: A New Reason to Avoid Vaping

Recent findings have found that people who use e-cigarettes are significantly more likely to develop heart failure compared to those who have never used them previously. The study is one of the largest prospective studies to date investigating possible links between vaping and heart failure, and its findings are being presented at the American College of Cardiology’s Annual Scientific Session.

Heart failure is a condition that affects more than 6 million U.S. adults, in which the heart becomes too stiff or too weak to pump blood as effectively as it should. It can often lead to debilitating symptoms and frequent hospitalizations as people age.

Studies link e-cigarettes to harmful effects

Electronic nicotine products, which include e-cigarettes, vape pens, hookah pens, personal vaporizers and mods, e-cigars, e-pipes, and e-hookahs, deliver nicotine in an aerosol form without combustion. Since their introduction in the U.S. in the late 2000s, electronic nicotine products have typically been portrayed as a safer alternative to smoking. Yet, a growing body of research has led us to think otherwise, and for good reason.

“More and more studies are linking e-cigarettes to harmful effects and finding that it might not be as safe as previously thought...It’s worth considering the consequences to your health, especially with regard to heart health.” – Yakubu Bene-Alhasan, MD, a resident physician at MedStar Health in Baltimore and the study’s lead author.

For the study, researchers used data from surveys and electronic health records from All of Us, a large national study of U.S. adults run by the National Institutes of Health. They analyzed associations between e-cigarette use and new diagnoses of heart failure in 175,667 study participants (an average age of 52 years and 60.5% females). Of this sample, 3,242 participants developed heart failure within a median follow-up time of 45 months.

The results showed that people who used e-cigarettes at any point were 19% more likely to develop heart failure compared with people who had never used e-cigarettes. In calculating this difference, researchers accounted for a variety of demographic and socioeconomic factors, other heart disease risk factors, and participants’ past and current use of other substances, including alcohol and tobacco products. The researchers also found no evidence that participants’ age, sex, or smoking status modified the relationship between e-cigarettes and heart failure.

A specific type of heart failure was noted

The effect seemed specific to a particular kind of heart failure – heart failure with preserved ejection fraction (HFpEF). With this condition, the heart muscle stiffens, preventing the heart from filling with blood as it should between contractions. The authors note that rates of HFpEF have risen in recent years, which has led to an increased focus on determining risk factors and improving treatment options for this type of heart failure.

The findings align with previous studies conducted in animals, which signaled e-cigarette use can affect the heart in ways that are relevant to the heart changes involved in heart failure. Other studies in humans have also shown links between e-cigarette use and some risk factors associated with developing heart failure.

However, previous studies attempting to assess the direct connection between e-cigarette use and heart failure have been inconclusive. According to Bene-Alhasan, this is due to the inherent limitations of the cross-sectional study designs, smaller sample sizes, and the smaller number of heart failure events seen in previous research.

The relationship between vaping and heart health

Researchers said the new study findings point to a need for additional investigations of the potential impacts of vaping on heart health, especially considering the prevalence of e-cigarette use among younger people. Surveys indicate that about 5% to 10% of U.S. teens and adults use e-cigarettes. In 2018, the U.S. Surgeon General called youth e-cigarette use an epidemic and warned about the health risks associated with nicotine addiction.

“I think this research is long overdue, especially considering how much e-cigarettes have gained traction,” Bene-Alhasan said,

“We don’t want to wait too long to find out eventually that [vaping] might be harmful, and by that time a lot of harm might already have been done. With more research, we will get to uncover a lot more about the potential health consequences and improve the information out to the public.”

Bene-Alhasan also expressed that e-cigarettes are not recommended as a tool to quit smoking, since many people may continue vaping long after they quit smoking. The U.S. Centers for Disease Control and Prevention recommends a combination of counseling and medications as the best strategy for quitting smoking.

That said, the researchers do admit that the study’s prospective observational design allows them to infer, but not conclusively determine, a causal relationship between e-cigarette use and heart failure. However, with its large sample size and detailed data on substance use and health information, Bene-Alhasan said the study is one of the most comprehensive studies to assess this relationship to date.


MAIN IMAGE CREDIT: Oleggg/Shutterstock
Tamlyn Bingle

Tamlyn Bingle

With an ever growing interest and appetite for sustainability, Tamlyn Bingle is an ambitious writer, her objective is to always share knowledgeable and insightful information in the written space. Tamlyn also enjoys living a healthy and active lifestyle, appreciative of nature and all creatures great and small.


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