A number of studies have associated e-cigarette use with a higher risk of having a heart attack and developing coronary artery disease. However, many harm reduction researchers have long been pointing out that these studies were flawed as they indicated a correlation not a causation.

The relationshipbetween e-cig use and an elevated risk for MI or CHD were inconsistent.

A US study titled “E-Cigarettes Linked to Heart Attacks, Coronary Artery Disease and Depression”, published last April, used data from the National Health Interview Survey (NHIS), a survey conducted by the National Center for Health Statistics (NCHS) and concluded that “adults who report puffing e-cigarettes, or vaping, are significantly more likely to have a heart attack, coronary artery disease and depression compared with those who don’t use them or any tobacco products.”

Similarly, a study and conference abstract released a month earlier had concluded that “Daily e-cigarette use, adjusted for smoking conventional cigarettes as well as other risk factors, is associated with increased risk of myocardial infarction.”

In response to these claims, renowned cardiologist and anti-smoking researcher Dr. Konstantinos Farsalinos, had pointed out that the above conclusions were wrong and “constitute epidemiological malpractice and misinformation.” He had explained that being cross-sectional surveys, meaning that they asked participants whether they suffer from heart disease and whether they use e-cigarettes, such studies provide no information as to whether the participants initiated e-cigarette use before or after the development of the disease, and/or for how long.

The current study cross examines data from the NHIS

In an attempt to determine whether such a link exists, together with a team including award winning researcher Dr. Riccardo Polosa, last month Dr. Farsalinos conducted another study re-examining data from the NHIS, and the ‘Sample Adult Public Use Files’ of 2016 (n = 33,028) and 2017 (n = 26,742).

These two surveys were examined separately and pooled, considering demographics, e-cigarette use, smoking and risk factors for CHD (hypertension, hypercholesterolemia, and diabetes) as independent variables.

The results indicated an association between MI and some days (not daily) e-cig use in the 2017 survey (OR: 2.11, 95% CI: 1.14–3.88, p = 0.017). No statistically significant association was observed in the pooled analysis (daily e-cigarette use: OR: 1.35, 95% CI: 0.80–2.27, p = 0.267).

For CHD, an association was observed with daily e-cigarette use in the 2016 survey (OR: 1.89, 95% CI: 1.01–3.53, p = 0.047). But once again, from the pooled analysis, no association was found between any pattern of e-cigarette use and CHD.

While smoking was consistently associated with MI and CHD, vaping was not

On the other hand, in both single-year and pooled analyses, both MI and CHD were strongly associated with all patterns of smoking, hypertension, hypercholesterolemia, diabetes, and age.

In light of these findings, the researchers concluded that while the associations between established risk factors, including smoking, and both heart conditions were remarkably consistent, the relationships between e-cigarette use and an elevated risk for MI or CHD were inconsistent. To this effect, Farsalinos, Polosa and their team, recommend longitudinal studies in order to explore the effects of e-cigarette use on cardiovascular disease, further.

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