The association between electronic cigarettes, sleep duration, and the adverse cardiovascular outcomes: Findings from behavioral risk factor surveillance system, 2020

Abstract

The joint effect of electronic cigarette smoking and insufficient sleep duration on cardiovascular disease (CVD) was unclear. This cross-sectional study aimed to evaluate the association between electronic cigarettes, sleep duration, and risk of CVD among American adults. The participants who completed the survey from the behavioral risk factor surveillance system in 2020 were included in this study. The status of electronic cigarette smoking was divided into never, former, and current use. The duration of sleep was categorized into insufficient (<6 h), appropriate (6–9 h), and excessive (>9 h) groups. The CVD group was defined as a patient having any of the following conditions: heart attack, coronary heart disease, or stroke according to self-report. The multivariate logistic regression model was adopted to determine the association between electronic cigarettes, sleep duration, and the risk of CVD. Sensitivity analyses were performed to assess the joint effects on the risk of CVD subtypes, including heart attack, coronary heart disease, and strokes, respectively. Subgroup analyses were performed to estimate the joint effects within the stratum of the age group. The total number of participants included in the present study was 253,561. Of which, 22,908 patients had CVD. In total, 61,293 participants had previously or currently used electronic cigarettes and 37,429 participants had inappropriate sleep duration. Former electronic cigarette users had a 10.8% increased risk of having CVD (OR = 1.108, 95% CI: 1.001–1.227) compared to users who never had electronic cigarettes. Insufficient and excessive sleep durations are associated with increased risks of CVD (OR = 1.592, 95% CI: 1.460–1.735; OR = 1.523, 95% CI: 1.320–1.758). The participants with current vaping status and lack of sleep had a 159.6% increased risk of CVD (OR = 2.596, 95% CI: 1.810–3.723). Sensitivity analyses found similar joint effects of current vaping and insufficient sleep on the risk of heart attack, coronary heart attack, and stroke. The subgroup analyses across each age stratum found that the middle-aged group is most vulnerable to the joint effect of current vaping and insufficient sleep. This study found that both current vaping and inappropriate sleep duration were associated with CVD. Additionally, there was a significant joint effect of current vaping and insufficient sleep on the risk of CVD, especially for middle-aged participants.

Characterization and Summarization of the Impact of Electronic Cigarettes on the Cardiovascular System: A Systematic Review and Meta-Analysis

“…In addition, some of the chemicals in e-cigarette aerosol can damage the endothelium [ 7 ], leading to a buildup of atherosclerotic plaque, which can block or reduce blood flow [ 8 ]. This can cause serious cardiovascular problems, including arrhythmias [ 9 ], stroke [ 10 ], and MI [ 11 ]. To sum up, e-cigarettes pose a significant risk to cardiovascular health, leading to long-term complications.…”

Association between electronic nicotine delivery systems use and risk of stroke: a meta-analysis of 1,024,401 participants

“…Our search yielded 296 unique records, of which 19 articles underwent full-text screening. Only 6 studies (4 cross-sectional and 2 pro-spective cohort studies) matched our criteria and were included in this meta-analysis [3][4][5][6][7][8]. A total of 1,024,401 participants were included in our analysis, consisting of 54,888 current ENDS users, 111,754 former users, and 857,759 non-users.…”