E-cigarette use associated with higher risk of heart failure: study

People who use e-cigarettes are significantly more likely to develop heart failure compared with those who have never used them, a US study has found.

Using data from surveys and electronic health records in All of Us, a large national study of US adults run by the National Institutes of Health, researchers analysed associations between e-cigarette use and new diagnoses of heart failure in 175,667 study participants, with an average age of 52 years and 60.5 per cent female.

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 per cennt more likely to develop heart failure compared with people who had never used e-cigarettes.

“More and more studies are linking e-cigarettes to harmful effects and finding that it might not be as safe as previously thought,” said Yakubu Bene-Alhasan, a resident physician at MedStar Health in Baltimore and the study’s lead author.

“The difference we saw was substantial. It’s worth considering the consequences to your health, especially with regard to heart health.”

The findings of the study, one of the largest prospective studies to date investigating possible links between vaping and heart failure, will be presented at the American College of Cardiology’s annual scientific session, taking place on 6-8 April in Atlanta.

Researchers said 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, which Bene-Alhasan said 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.

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.

“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 it 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.”

Researchers said 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.