Background: E-cigarettes are a consumer product designed to deliver nicotine by heating a liquid produced from tobacco. Usage in the US is growing rapidly and is common among combustible cigarette users (dual use). The impact of E-cigarettes on cardiovascular disease is unknown. Aim: A cross-sectional examination of e-cigarette use with self-reported cardiovascular disease, according to smoking status, using the nationally representative health survey - the Behavioral Risk Factor Surveillance System (BRFSS) 2016 Methods: We included 404,332 BRFSS 2016 participants with information on the history of CVD and e-cigarette use. E-cigarette use was categorized as never (reference), occasional, and daily with daily +occasional e-cigarette users considered current e-cigarette users. The association of e-cigarette use and CVD (defined as self-reported coronary heart disease, myocardial infarction, or stroke) was assessed using multivariable logistic regression models stratified by smoking status (never, former, current [occasional or daily]), adjusted for age, sex and race. Results: Of the total population, there were 15,240 e-cigarette users and 85,402 with CVD. Compared to those who never used e-cigarettes, current e-cigarette users had significantly higher odds of having CVD among current smoker groups (occasional smoker: Odds Ratio (OR)= 1.36 (95% CI= 1.06 - 1.76); daily smoker: OR=1.34 (1.12 - 1.62)). Daily use of e-cigarettes among occasional smokers was significantly associated with higher odds of having CVD (OR=1.64 (1.05 - 2.57)). (Table) There was no association between e-cigarette use and CVD among never and former smokers. Strengths and Limitations: Because of large sample size, we were powered to stratify e-cigarette use by smoking status. However, BRFSSS does contain directly measured risk factors or pack-years of smoking. Conclusions: Dual use of e-cigarette and combustible cigarettes is a new pattern of tobacco product use that may be associated with more CVD.