Abstract 3139: Evidence Of Vascular Endothelial Dysfunction In Habitual Hookah (i.e., Waterpipe) Users: Insights For Cardiovascular Disease Risk

Abstract

Introduction: Flavored hookah tobacco smoking among young adults continues to be a public health concern. While short-term exposure to flavored hookah tobacco smoking impairs vascular function, data on the long-term impact of habitual use are not clearly delineated. Research Question: Is habitual flavored hookah tobacco smoking associated with vascular endothelial dysfunction in young healthy adults? Goals: Investigate the impact of regular flavored hookah tobacco smoking on vascular endothelial function, as compared to regular cigarette smoking and never tobacco use, in young healthy adults. Methods: We assessed brachial artery flow-mediated dilation (FMD)—a well-established index of vascular endothelial function—in 22 exclusive chronic hookah smokers (25±1 years of age, 23% women; mean±SE), who reported smoking flavored hookah tobacco on average two times per week for 9±1 years, 22 exclusive cigarette smokers who reported 4±1 pack years, and 23 non-smokers. FMD and vascular endothelium-independent nitroglycerin-mediated vasodilation was assessed using high resolution ultrasound. Results: Whereas baseline brachial artery diameter was comparable between groups ( P =ns), brachial artery FMD was significantly lower in habitual hookah users and cigarette users as compared to never smokers (cigarette smokers: 5.22±0.42; hookah smokers: 6.43±0.50; non-smokers: 9.80±0.83; P <0.05). Endothelium-independent dilation of the brachial artery in response to sublingual nitroglycerin did not significantly differ between groups. Conclusions: Despite claims of safety advertised by the growing hookah tobacco industry, our findings provide evidence that, as compared to non-tobacco users, young and apparently healthy adults who regularly smoke flavored hookah tobacco exhibit reduced vascular endothelial function. These results suggest that flavored hookah tobacco smoking is not without harm and has potential harmful vascular effects, associated with increased cardiovascular disease risk.