JACC. Advances · 2026
E-Cigarette Use and Early Cardiovascular Risk in Young Adults: The VapeScan Study.
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Anderson William A, Levitan Samuel B, Sangapalaarachchi Dona N, Lolacono Nancy J, Ilievski Vesna, McGraw Katlyn E, Hilpert Markus, Jiang Enoch, Gao Siyue, Liu Justin, Frangaj Brulinda, Patel Heli J, Robson Philip M, Fayad Zahi A, Shea Steven J, Oelsner Elizabeth C, Shimbo Daichi, Navas-Acien Ana
Аннотация
BACKGROUND: Electronic cigarette use, vaping, is common among young adults. The cardiovascular (CV) risk remains unknown.
OBJECTIVES: This study evaluated the association of long-term vaping with markers of CV risk in young adults.
METHODS: We recruited 372 CV disease-free participants aged 18 to 49 years into 4 groups: vaping/never smoking, vaping/former smoking, vaping/current smoking (dual use), or never vaping/never smoking and measured systolic and diastolic blood pressure (SBP/DBP), endothelial function (Framingham reactive hyperemia index), and coronary artery calcification (CAC) (spatially weighted CAC score). We used multivariable-adjusted linear and log-linear regression to model associations of vaping with markers of CV risk.
RESULTS: The median (Q1-Q3) age was 26 (21-33) years, and 50.5% were males. The median (Q1-Q3) years of vaping was 4 (2-6) years. After adjustment for age, gender, education, and body mass index, least squares mean differences (95% CI) for SBP/DBP in mm Hg were 4.79 (1.83-7.75)/2.88 (0.54-5.21), 1.60 (-1.65 to 4.85)/1.44 (-1.12 to 4.00), 1.10 (-1.86 to 4.06)/1.48 (-0.86 to 3.82), respectively, comparing vaping/never smoking, vaping/former smoking, and dual use to never vaping/never smoking. The corresponding least squares mean differences (95% CI) of SBP/DBP for greater than 100 vs fewer than 36 e-cigarette puffs/day were 4.84 (0.94-8.74)/3.57 (0.74-6.41) mm Hg. There was no association between vaping categories and Framingham reactive hyperemia index. For spatially weighted CAC score, there was an inverse association for the 3 vaping categories vs never vaping/never smoking.
CONCLUSIONS: Long-term vaping in young adults was associated with higher blood pressure, with evidence of a dose-response by vaping intensity. Vaping alone or vaping plus smoking provided no risk reduction for hypertension compared to never vaping or smoking.
OBJECTIVES: This study evaluated the association of long-term vaping with markers of CV risk in young adults.
METHODS: We recruited 372 CV disease-free participants aged 18 to 49 years into 4 groups: vaping/never smoking, vaping/former smoking, vaping/current smoking (dual use), or never vaping/never smoking and measured systolic and diastolic blood pressure (SBP/DBP), endothelial function (Framingham reactive hyperemia index), and coronary artery calcification (CAC) (spatially weighted CAC score). We used multivariable-adjusted linear and log-linear regression to model associations of vaping with markers of CV risk.
RESULTS: The median (Q1-Q3) age was 26 (21-33) years, and 50.5% were males. The median (Q1-Q3) years of vaping was 4 (2-6) years. After adjustment for age, gender, education, and body mass index, least squares mean differences (95% CI) for SBP/DBP in mm Hg were 4.79 (1.83-7.75)/2.88 (0.54-5.21), 1.60 (-1.65 to 4.85)/1.44 (-1.12 to 4.00), 1.10 (-1.86 to 4.06)/1.48 (-0.86 to 3.82), respectively, comparing vaping/never smoking, vaping/former smoking, and dual use to never vaping/never smoking. The corresponding least squares mean differences (95% CI) of SBP/DBP for greater than 100 vs fewer than 36 e-cigarette puffs/day were 4.84 (0.94-8.74)/3.57 (0.74-6.41) mm Hg. There was no association between vaping categories and Framingham reactive hyperemia index. For spatially weighted CAC score, there was an inverse association for the 3 vaping categories vs never vaping/never smoking.
CONCLUSIONS: Long-term vaping in young adults was associated with higher blood pressure, with evidence of a dose-response by vaping intensity. Vaping alone or vaping plus smoking provided no risk reduction for hypertension compared to never vaping or smoking.