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