USA: Study Links Waterpipe Tobacco Smoking to Increased Cardiovascular Risk

A recent study published in the journal CHEST has discovered an association between habitual waterpipe tobacco smoking (WPS) and an increased augmentation index (AI) in apparently healthy young individuals from the community.

The augmentation index is a predictor of cardiovascular risk, and one session of WPS acutely increased heart rate (HR) and aortic and brachial blood pressure (BP).

The study was conducted considering the popularity of waterpipe tobacco smoking among young adults globally, which exposes users to toxicants. Hassan A. Chami, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA, and colleagues assessed whether WPS is associated with impaired measures of arterial function and whether WPS acutely impairs these measures in young adults.

For this purpose, the researchers assessed brachial and aortic BP, heart rate, carotid-femoral pulse wave velocity (CFPWV), and HR-adjusted augmentation index (AI) in 62 waterpipe smokers and 34 never-smokers who were recruited from the community (mean age 22.5±3.0 years and 48% were females).

The researchers obtained measurements before and after an outdoor WPS session among smokers and among controls comprising non-smokers who did not smoke. A comparison of measurements was done after versus before exposure among smokers and non-smokers after adjusting for possible confounders using linear regression.

Findings

• Waterpipe smokers and non-smokers had similar demographic characteristics.
• BP and HR increased acutely after WPS:
  • Brachial systolic BP by 4.13 mmHg
  • Aortic systolic BP by 2.31 mmHg
  • Brachial diastolic BP by 3.69 mmHg
  • Aortic diastolic BP by 3.03 mmHg
  • HR by 7.75 beats/minute
• AI was significantly higher in waterpipe smokers compared to non-smokers (9.02% versus 3.06%), including after adjusting for body-mass index and family history of cardiovascular diseases (β=6.12) and when assessing habitual WPS extent (waterpipes smoked/day smoking duration) in waterpipe-years (β=2.51/waterpipe-year).
• CFPWV was similar in smokers and non-smokers, and AI and CFPWV did not change acutely after WPS.

"In apparently healthy young individuals from the community, routine waterpipe tobacco smoking is associated with increased AI, a predictor of cardiovascular risk, and one WPS session acutely increased HR and brachial and aortic blood pressure," the researchers concluded.