In a recent systematic review and meta-analysis published in the journal BMC Public Health, researchers investigated the association between electronic cigarette (e-cigarette) use and the risk of myocardial infarction (MI) and stroke, according to NewsMedical. The study pooled data from 12 observational studies involving large population samples to examine whether vaping is linked to cardiovascular outcomes while accounting for conventional cigarette smoking.

Analyses showed that e-cigarette users had 53% higher odds of MI compared with non-users. Notably, among former cigarette smokers who currently use e-cigarettes, the odds of a heart attack were more than doubled. These findings raise concerns about the cardiovascular safety of e-cigarettes and indicate that they should not be assumed to be risk-free alternatives.

For decades, cigarette smoking has been recognized as a major risk factor for coronary artery disease, hypertension, and stroke. In response, the tobacco industry introduced electronic nicotine delivery systems (ENDS), commonly referred to as e-cigarettes or “vapes,” and promoted them as harm-reduction tools to aid smoking cessation.

These devices aerosolize nicotine-containing liquids that typically include propylene glycol, vegetable glycerin, and flavoring agents. When heated, propylene glycol can generate aldehydes and other reactive compounds that are known contributors to cardiovascular disease.

Despite rapid global uptake, the cardiovascular safety of e-cigarettes remains controversial. Human studies have produced conflicting results, with some suggesting lower risk for exclusive vapers, while others were limited by cross-sectional designs, residual confounding by smoking history, or potential industry-related conflicts of interest.

As a result, a comprehensive analysis that carefully accounts for conventional cigarette smoking is needed to clarify the independent cardiovascular risks associated with vaping.

The present study addressed this gap using a systematic review and meta-analysis (SRMA) conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Conventional cigarette smoking was treated as a key confounder and subgroup variable.