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E-cigarette use associated with increased risk of heart failure: Recent findings and implications

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The prevalence of e-cigarette use raises concerns about potential health implications, particularly in relation to cardiovascular health. Recent research presented at the American College of Cardiology's annual scientific meeting sheds light on the association between e-cigarette use and heart failure.  

Illustration of e-cigarette and heart
E-cigarette use has been linked to increased risk of heart failure

The rising popularity of e-cigarettes has sparked concerns regarding their potential health effects. 

Recent studies have suggested a link between e-cigarette use and adverse cardiovascular outcomes, including respiratory disease, heart attacks, and stroke. A new study presented at the annual scientific meeting of the American College of Cardiology sheds further light on this issue. Analysing data from the US National Institutes of Health's All of Us Research Program, researchers found that individuals who had ever used e-cigarettes faced a 19% higher risk of heart failure compared to non-users.   

This prospective study, the largest of its kind, underscores the need for continued research into the cardiovascular consequences of e-cigarette use. 

Since the outbreak of vaping-related lung injuries in 2019, concerns about the health risks associated with e-cigarette use have escalated. While earlier studies have highlighted respiratory complications, emerging evidence suggests a potential link between e-cigarettes and cardiovascular disease. This article reviews recent findings from a study investigating the association between e-cigarette use and heart failure, emphasising the need for comprehensive research to inform public health policies
and interventions. 

Methods:  

Researchers analysed health records from 175 667 adults participating in the US National Institutes of Health's All of Us Research Program. Participants were categorised based on e-cigarette use, and incidents of heart failure were documented over a median follow-up period of nearly four years. Statistical adjustments were made for confounding variables such as age, sex, and comorbidities associated with heart failure. 

Results: 

Among the study participants, individuals who reported ever using e-cigarettes exhibited a 19% increased risk of heart failure compared to non-users. This association persisted after accounting for known risk factors, highlighting a potentially independent effect of e-cigarette use on cardiovascular health. Notably, the risk was particularly elevated among individuals who also smoked traditional cigarettes, suggesting a synergistic effect of dual tobacco product use.  

Discussion: 

The findings from this study contribute to a growing body of evidence implicating e-cigarette use in adverse cardiovascular outcomes. While the precise mechanisms underlying this association remain unclear, several hypotheses have been proposed, including the direct impact of e-cigarette aerosols on cardiac function and the systemic effects of nicotine exposure. Additionally, the presence of harmful substances in e-cigarette formulations, such as nicotine and flavourings, may contribute to cardiovascular toxicity. 

Conclusion: 

The results of this study underscore the importance of continued surveillance and research into the health effects of e-cigarette use. Public health initiatives aimed at reducing e-cigarette uptake, particularly among youth, may help mitigate the long-term burden of cardiovascular disease associated with these products. Further investigation is warranted to elucidate the underlying mechanisms and inform evidence-based interventions aimed at reducing the adverse cardiovascular effects of e-cigarettes.  

Sources: Science Alert; Bene-alhasan, y, Mensah, S, Almaadawy, O. et al. Electronic nicotine product use is associated with incident heart failure – the all of us research program. J Am Coll Cardiol. 2024 Apr, 83 (13_Supplement) 695.https://doi.org/10.1016/S0735-1097(24)02685-8  

 

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