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Vaping Associated with Increased Risk of Heart Failure, According to New Research


ACC.24: Data showed that individuals who used e-cigarettes were approximately 19% more likely to develop heart failure compared with those who had never vaped.

Vaping Associated with Increased Risk of Heart Failure, According to New Research / Image credit: ©Natalia/AdobeStock


Individuals who use e-cigarettes are significantly more likely to develop heart failure (HF) compared with those who have never used them, according to one of the largest prospective studies to date evaluating potential links between vaping and HF.1

Findings are being presented at the American College of Cardiology’s (ACC) Annual Scientific Sessions, April 6-8, 2024, in Atlanta, Georgia.

“More and more studies are linking e-cigarettes to harmful effects and finding that it might not be as safe as previously thought,” said presenting author Yakubu Bene-Alhasan, MD, a resident physician at MedStar Health in Baltimore, in an ACC press release. “The difference we saw was substantial. It’s worth considering the consequences to your health, especially with regard to heart health.”2

To examine the association between e-cigarette use and HF, researchers used data from surveys and electronic health records (EHR) in the All of Us Research Program, a large national study of US adults sponsored by the National Institutes of Health. Participants with a baseline EHR diagnosis of HF were excluded. Data on e-cigarette use was obtained from participants using the Population Assessment of Tobacco and Health-styled questions, according to the study abstract.1

“We determined the association between electronic nicotine products use and incident HF using Cox proportional hazards models adjusted for demographic and socioeconomic factors, diabetes mellitus, hypertension, hyperlipidemia, BMI and concomitant substance use (cigarette, cigar, hookah, smokeless cigarette and alcohol use),” wrote investigators.1

A total of 175 667 participants (mean age, 52 years; 60.5% women) were included in the cohort, of which 3242 developed HF within a median follow-up time of 45 months, according to the results.1

Compared to never users, researchers observed that ever users of e-cigarettes had an increased risk of incident HF (aHR -1.19, 95% CI 1.06-1.35) in the fully adjusted model.1

When researchers broke the data down by type of HF, they found that the increased risk associated with e-cigarette use was statistically significant for HF with preserved ejection fraction (aHR -1.21, 95% CI 1.01-1.47), but not for HF with reduced ejection fraction (aHR -1.11, 95% CI 0.90-1.37).There was no evidence that participants’ age, sex, or smoking status modified the relationship between e-cigarette use and HF.1

“More research is needed corroborate these findings, to enable clinicians provide the public with high quality information on the health implications of electronic nicotine product use and to guide policies,” concluded Bene-Alhasan and colleagues.1


  1. Bene-Alhasan Y, Mensah SO, Almaadawy O, et al. Electronic nicotine product use is associated with incident heart failure – the All of Us research program. Presented at: The American College of Cardiology Scientific Sessions; April 6-8, 2024; Atlanta, GA. Accessed April 2, 2024. https://accmedia.org/wp-content/uploads/2024/03/Bene-Alhasan_Nicotine_PRO_Abstract.pdf
  2. Study links e-cigarette use with higher risk of heart failure. News release. American College of Cardiology. April 2, 2024. Accessed April 2, 2024. https://accmedia.org/wp-content/uploads/2024/03/Bene-Alhasan_Nicotine_PRO_Release.pdf

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