Vaping may pose a greater risk to blood pressure and vascular health than previously thought, according to a large-scale longitudinal study led by Johns Hopkins Medicine.
The research, published in Nicotine & Tobacco Research, evaluated health data from nearly 250,000 U.S. adults over four years to examine the effects of exclusive e-cigarette use on chronic disease outcomes.
One of the most significant findings was a measurable increase in the risk of developing hypertension among adults aged 30 to 70 who exclusively used e-cigarettes.
This association, though smaller than that seen in traditional cigarette users, was still clinically relevant and suggests that e-cigarette use may not be a heart-healthy alternative.
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E-Cigarettes and the Onset of High Blood Pressure
Hypertension, also known as high blood pressure, affects over 1 in 3 adults globally and is a major risk factor for heart attacks, strokes, and kidney failure.
In the study, 23,745 new cases of hypertension were identified during the follow-up period, with a portion of those emerging in people who vaped exclusively.
Although traditional cigarette use showed stronger correlations with blood pressure elevation, the data revealed that vaping is not without cardiovascular impact, much like the risks described in our overview of smoking and high blood pressure.
Researchers believe the nicotine and organic chemicals found in e-cigarette aerosols may contribute to vascular dysfunction and increased arterial stiffness over time.
Why This Study Matters for Hypertension Prevention
The study provides one of the first large-scale longitudinal data sets connecting e-cigarette use with new-onset hypertension in a real-world population.
It fills a critical gap in cardiometabolic research, which has traditionally focused on the well-documented risks of combustible cigarettes while overlooking vaping-specific outcomes.
Previous studies linked vaping to asthma and general respiratory decline, but this new analysis offers direct evidence of its potential role in early vascular disease.
Even without associations to heart failure or diabetes in the short term, the early sign of elevated blood pressure suggests a need for ongoing monitoring and consideration of blood pressure medications in clinical management.
How Vaping Compares to Traditional Smoking
The data confirms that traditional cigarette use continues to be a leading cause of hypertension, COPD, and cardiovascular disease.
Among dual users—those who both vape and smoke—the risk estimates were even higher than for exclusive smokers.
This layered risk profile demonstrates that while vaping may be marketed as a harm-reduction strategy, it does not eliminate the cardiovascular risks tied to tobacco consumption.
For individuals concerned with blood pressure management, avoiding both forms of nicotine exposure remains the safest path, as emphasized in our complete guide on understanding and managing hypertension.
Public Health Implications for Blood Pressure Awareness
According to CDC data, the use of e-cigarettes among U.S. adults rose from 3.7% in 2020 to 4.5% in 2021, with high usage among adolescents and young adults.
As the popularity of vaping grows, public health agencies and clinicians must adapt blood pressure screening protocols and awareness campaigns to include vape users.
Long-term studies are needed, but this initial evidence supports a more cautious stance on vaping in cardiovascular risk assessment models.
For now, anyone using e-cigarettes regularly should consider getting their blood pressure checked and discussing heart health with a qualified provider.
Robin Backlund is a dedicated journalist and a medical student who has written several articles and essays exposing the falseness and hollowness of online resources in the medical science niche.