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Cardiovascular effects Combustible cigarette smoking is one of the strongest preventable risk factors for cardiovascular disease.[28] Though the association between e-cigarette use and cardiovascular outcomes is largely unclear at this point, new data suggest that e-cigarettes are associated with cardiovascular morbidity [Table 2], though it is likely less than that of combustible cigarette smoking.[29] This section highlights the potential associations between e-cigarette use and cardiovascular disease, hypertension, endothelial health, and myocardial function