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The Relationship Between Vaping and Heart Health – The Latest Research

Despite different reports, the evidence in favour of vaping as a harm reduction tool, even for cardiovascular health, is undeniable.

Diane Caruana

November 11, 2024

Research on vaping’s impact on cardiovascular health has consistently presented contrasting findings, with some studies suggesting potential risks while others indicating lower harm relative to smoking. A 2017 study published in JAMA Cardiology associated vaping with elevated heart attack risk due to increased inflammation and oxidative stress in blood vessels. Conversely, Public Health England’s reports indicate that vaping is likely 95% less harmful than smoking and may reduce cardiovascular risks for those transitioning from cigarettes. Tobacco harm reduction (THR) experts, amongst who are many medical professionals, have incessantly argued that while vaping may not be risk-free, it presents a harm-reduction approach, especially for those struggling to quit smoking entirely.

Researchers found that switching to vaping, whether partially or exclusively, reduced the risk of major adverse coronary events to levels similar to those who quit smoking entirely.

Recent studies, have once again led to different findings. A study published by the American College of Cardiology last April, suggested that vaping nicotine-containing e-cigarettes may raise the risk of heart failure by nearly 20%. Researchers tracked 175,667 participants over 45 months, and found that those who had used vapes containing nicotine had a 19% higher chance of developing heart failure compared to non-users. The risk was particularly pronounced for heart failure with preserved ejection fraction (HFpEF).

The current paper said that while vaping has been considered a safer alternative to smoking, recent research suggests that it may impair blood vessel function and negatively impact heart health. It added that while vape aerosols contain fewer chemicals than cigarettes, they still pose health risks due to substances like nicotine and heavy metals.

Regrettably, many experts in the field have long argued that these last two claims are based on misinformation not science. For starters nicotine is known to not be a harmful stimulant, at least not any more harmful than caffeine, and in some cases it is even lauded for its medicinal properties. Secondly, studies have shown that the presence of metals in vapes is so minimal, that it is insignificant to human health.

Meanwhile, a new study published in the Journal of the American Heart Association reported cardiovascular side effects linked to vapes, but noted that these effects differ from those caused by traditional cigarettes. Led by environmental health experts from UC Irvine, USC, and Huntington Medical Research Institutes, the study involved 117 healthy rats exposed to different types of air, including purified air, e-cigarette vapor (with and without nicotine), and cigarette smoke.

The research team reported that while vaping, especially among smokers and teenagers, has grown due to the belief that it is safer than smoking, this study suggested that nicotine-containing e-cigarettes negatively affect vascular function. More specifically they impair the heart’s ability to properly pump blood, disrupting the flow between the heart and arteries, unlike traditional cigarettes, which mainly impact left ventricle function.

Findings in favour of vaping from human studies

In contrast, a landmark study from South Korea, recently published in the European Heart Journal, reported that smokers with coronary artery disease (CAD) who switch to vaping, experience significantly fewer life-threatening cardiac events than those who continue smoking. This study tracked nearly 18,000 adult CAD patients, all of whom had undergone percutaneous coronary intervention (PCI) to improve heart blood flow. Researchers found that switching to vaping, whether partially or exclusively, reduced the risk of major adverse coronary events (MACE) to levels similar to those who quit smoking entirely.

After a 4.5-year follow-up, 17% of continued smokers suffered MACE, compared to 13.4% of those who quit and 10.8% of those who switched to vaping. Notably, exclusive vapers had the lowest risk at 9.6%, while dual users (both vaping and smoking) saw slightly higher risks.

The findings suggest that vaping can be a viable alternative for patients who struggle to quit smoking after heart procedures, offering meaningful harm reduction. Renowned cardiologist and THR researcher Dr. Konstantinos Farsalinos, remarked that this study could challenge misconceptions linking nicotine to heart disease, calling out flawed research that equates vaping with smoking in cardiovascular risk. He emphasized that this evidence-based perspective may encourage more healthcare providers to support vaping as a harm reduction tool for patients unable to quit smoking entirely.

Dr. Farsalinos has studied the effects of vaping on heart health extensiely. He is among those reserchers whose studies’ have shown that e-cigarettes produce far fewer harmful chemicals than cigarettes, potentially reducing heart disease risks for smokers who switch. He advocates for evidence-based regulation of vaping products, arguing that a balanced approach supports smoking cessation efforts and may improve public health outcomes without discouraging harm reduction strategies.