Vaping and Heart Health: What We Know

Nicotine, heart rate and blood pressure

Nicotine stimulates the sympathetic nervous system, part of the body's response to demands and stress. Short-term studies of nicotine-containing e-cigarettes report increases in heart rate and blood pressure. These immediate responses are one part of the cardiovascular picture described by the American Heart Association. [1]

A temporary increase is not the same outcome as a heart attack. At the same time, a product's effect on circulation is relevant even when the person using it feels well. Neither a sensation nor the absence of one is a reliable measure of cardiovascular risk.

What have researchers found in blood vessels?

The endothelium is the inner lining of blood vessels. It participates in controlling how vessels widen and how blood flows. A 2022 study compared people who regularly used e-cigarettes, people who smoked cigarettes and nonusers. It found impaired vessel function in the smoking and vaping groups, alongside laboratory evidence of changes affecting endothelial cells. [2]

The study examined vascular function and biological mechanisms; it did not follow participants to count future heart attacks. Its findings are a reason to investigate cardiovascular effects, not a formula for calculating an individual person's chances of disease. Results on a particular vascular measure also do not establish that the overall harms of vaping and smoking are identical.

Why long-term risk is harder to quantify

To estimate long-term outcomes, researchers need to distinguish people who only vape from those who also smoke, account for earlier smoking and other risk factors, and track exposure over time. The AHA statement identifies important gaps in that evidence. [1]

When reading a headline, look for three details: who was studied, what was actually measured and how long the follow-up lasted. A report about cells exposed to liquid, a measurement taken after a vaping session and a diagnosis recorded years later are not interchangeable.

A racing heart, anxiety and panic

A racing heart can also occur during a panic attack, together with symptoms such as trembling, dizziness and difficulty breathing. NIMH explains that medical evaluation may be needed to rule out an unrelated physical problem. Having a panic attack does not by itself mean someone has panic disorder. [4]

Nicotine's effects and panic symptoms can overlap, but that overlap does not establish the cause of a particular episode. Read more about vaping, anxiety and panic-like symptoms. Recurrent symptoms deserve a conversation with a clinician rather than repeated self-testing with a vape.

How does the comparison with smoking change things?

For a person who smokes cigarettes, switching completely to nicotine vaping reduces exposure to many toxins from burning tobacco. The NHS describes vaping as less harmful than smoking, while emphasizing that it is not risk-free. [3]

That is a different comparison from vaping versus using neither product. If you have stopped smoking, returning to cigarettes is not a way to address concerns about vaping. The vaping versus smoking guide explains complete switching and dual use in more detail.

When to seek medical attention

A tight or heavy chest, severe breathing difficulty or pain that spreads to the arm, back, neck or jaw warrants emergency care. Do not label these symptoms as anxiety without assessment. [5]

For an appointment about recurring palpitations, bring a clear account of when they happen, what products you use and any other symptoms. A record is useful context for a medical conversation. For the wider health picture, start with the overview of vaping's effects on the body.