Exclusive vape users did not show a statistically significant increase in cardiovascular disease (CVD) risk compared with non-users, according to new research analysing biomarker data from more than 6,400 adults.

The study, published in the Journal of the Louisiana Public Health Association, examined participants in the US Population Assessment of Tobacco and Health (PATH) Study and found that while vape users had slightly higher odds of developing CVD, the difference was not significant.

By contrast, cigarette smokers had 11 per cent higher odds of cardiovascular disease than non-users, with researchers identifying inflammation biomarkers as key mediators of the increased risk.

Biomarker differences highlight smoking risk

The research assessed 59 biomarkers linked to tobacco exposure and potential harm, focusing particularly on two inflammation markers – high-sensitivity C-reactive protein (hsCRP) and soluble intercellular adhesion molecule-1 (sICAM-1).

These biomarkers significantly explained the relationship between smoking and cardiovascular disease, accounting for up to 82.7 per cent and 20.7 per cent of the effect respectively.

Density charts showed cigarette smokers had higher levels of both hsCRP and sICAM-1 compared with non-users and e-cigarette users, reinforcing the link between smoking and inflammation-related cardiovascular risk.

Researchers said this supports growing evidence that smoking drives inflammation and endothelial damage, increasing the likelihood of heart attack, stroke and other cardiovascular conditions.

No significant difference for vaping

In contrast, the study found no meaningful difference between exclusive vape users and non-users in terms of cardiovascular disease occurrence or biomarker-mediated risk.

The authors said this aligns with previous research showing no significant differences in cardiovascular events or inflammation biomarker levels between vapers and non-users.

They concluded: “There were no significant differences found in cardiovascular disease occurrence for exclusive e-cigarette users compared to nonusers of any tobacco product.”

Researchers said the findings improve understanding of how smoking affects cardiovascular health and how biomarkers could help identify high-risk individuals.

The authors added that combining multiple biomarkers could improve early detection of smoking-related cardiovascular risk and support prevention strategies.