Electronic cigarettes (E-cigarettes) have grown in popularity as an alternative to traditional cigarettes especially among consumers who want to reduce the risk of morbidity and mortality associated with smoking. Nonetheless, a recent study showed that both E-cigarettes and traditional cigarettes cause an increase in oxidative stress and endothelial dysfunction, however this effect is less pronounced with E-cigarettes. Currently, there is a limited study that shows the impact of E-cigarette in the cardiovascular system. Therefore, data from the 2014 National Health Interview Survey (NHIS) was used to evaluate the effect of E-cigarettes on the cardiovascular system, specifically the effect on myocardial infarction (MI).
Methods:
Analysis of the 2014 National Health Interview Survey (NHIS) database was performed to examine the effect of E-cigarettes on MI. Initially, subjects were assigned to one of two groups: those with a history of MI and those without a history of MI. The t-test and chi-square test were subsequently applied to compare the different demographics and health characteristics between these two groups. A logistic regression model was then used to measure the association between E-cigarettes and history of MI. Data was adjusted for multiple risk factors for MI including age, gender, race, body mass index, income, the status of smoking cigarettes, and history of hypertension, diabetes, and hypercholesterolemia.
Results:
A total of 35,156 subjects were included in the final logistic model. [Summarize a number of baseline variables with respect to health and demographic characteristics] Analysis showed that increasing age (OR, 1.04; p <0.001), history of hypertension (OR, 2.72; p < 0.001), high cholesterol (OR, 2.19; p< 0.001), and diabetes (OR, 1.68; p< 0.001) are associated with an increased odd of myocardial infarction. With respect to smoking, increased frequency of smoking was associated with increasingly higher odds of MI when compared to patients who had never smoked: every day smokers (OR, 2.75 p<0.001), some day smokers (OR, 2.39; p<0.001), and former smokers (OR 1.80; p<0.001.) In contrast, females (OR, 0.49; p<0.001), Hispanics (OR, 0.62; p<0.001), and people with higher incomes (OR, 0.93 [95% CI, 0.90-0.96]; p<0.001) have lower odds of heart attack. With respect to Electronic cigarette use and MI, analysis revealed an odds ratio of 1.42 with p = 0.017.
Conclusions:
Our findings indicate that Electronic cigarette use, when adjusted for other risk factors, is associated with a 42 % increased odds of myocardial infarction. This increase in odds is consistent regardless of traditional cigarette smoking history. More studies are needed to further assess this risk.