Cardiovascular health effects of vaping e-cigarettes: a systematic review and meta-analysis

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dc.contributor.authorKundu, Anasuaen
dc.contributor.authorFeore, Annaen
dc.contributor.authorSanchez, Sheralden
dc.contributor.authorAbu- Zarour, Nadaen
dc.contributor.authorSutton, Meganen
dc.contributor.authorSachdeva, Kyranen
dc.contributor.authorSeth, Siddharthen
dc.contributor.authorSchwartz, Roberten
dc.contributor.authorChaiton, Michaelen
dc.contributor.funderCentre for Addiction and Mental Health, Toronto, Canadaen
dc.date.accessioned2025-03-18T14:50:04Z
dc.date.available2025-03-18T14:50:04Z
dc.date.issued2025-01-24en
dc.description.abstractBackground There is substantial interest in the cardiovascular effects of e-cigarette use, highlighting the need to update our knowledge on the subject. We conducted this review to analyse whether e-cigarette use increases cardiovascular health risks and how these risks vary among different populations. Methods We searched six databases and included peer- reviewed human, animal, cell/in vitro original studies but excluded qualitative studies, which were published between July 2021 and December 2023. Three types of e-cigarette exposure were examined: acute, short-to-medium term and long term. Different risk of bias tools were used for assessing the quality of the included human studies and we conducted meta- analysis when possible. Results We included 63 studies in the main analysis, 12 studies in the meta-analysis and 32 studies in the sociodemographic factor- based subgroup analysis. Over half of the human studies had low risk of bias. Acute exposure to e-cigarette was associated with increased heart rate (HR) (mean difference (MD) 11.329, p<0.01) and blood pressure (BP) (MD 12.856, p<0.01 for systolic; MD 7.676, p<0.01 for diastolic) compared with non- use. While HR was lower after acute exposure to e- cigarettes compared with cigarettes (MD −5.415, p<0.01), no significant difference in systolic or diastolic BP was observed. Non- smoker current vapers had no significant differences in resting HR and BP compared with non- users but lower resting HR (MD −2.608, p<0.01) and diastolic BP (MD −3.226, p<0.01) compared with non-vaper current smokers. Despite some association between e- cigarette and endothelial dysfunction, short- to- medium- term transition from cigarettes to e-cigarettes may improve blood flow and BP, particularly among females and younger individuals. There is lack of evidence supporting any association of e-cigarette use with cardiovascular diseases and cardiac dysfunction or remodelling. Conclusions This review highlighted several important cardiovascular impacts of e-cigarette use compared with non-use and cigarette smoking. However, the evidence is still limited and requires future research.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid325030en
dc.identifier.citationKundu, A., Feore, A., Sanchez, S., Abu-Zarour, N., Sutton, M., Sachdeva, K., Seth, S., Schwartz, R. and Chaiton, M. (2025) ‘Cardiovascular health effects of vaping e-cigarettes: a systematic review and meta-analysis’, Heart, 325030 (10pp). https://doi.org/10.1136/heartjnl-2024-325030en
dc.identifier.doihttps://doi.org/10.1136/heartjnl-2024-325030en
dc.identifier.eissn1468-201Xen
dc.identifier.endpage10en
dc.identifier.issn1355-6037en
dc.identifier.journaltitleHearten
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/17179
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.rights© 2025, the Authors (or their employer(s)). No commercial re- use.en
dc.subjectCardiovascular health effectsen
dc.subjectVaping e-cigarettesen
dc.subjectE-cigarette exposureen
dc.titleCardiovascular health effects of vaping e-cigarettes: a systematic review and meta-analysisen
dc.typeArticle (peer-reviewed)en
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