Abstract
Purpose: This study aimed to analyze and summarize the effects that waterpipe (WP) smoke has on the cardiopulmonary system through a systematic review and meta-analysis. Methods: We searched MEDLINE, Embase, Wiley Cochrane Library, Centre for Reviews and Dissemination, CINAHL Plus, and grey literature in March 2017. Our inclusion criteria for the studies were a comparison of WP smokers before and after waterpipe smoking (WPS) or to non-smokers. Results: Using a random effects meta-analysis, a WPS session was associated with an elevation in systolic blood pressure (SBP) by 6.45 mmHg (95% CI 3.87 to 9.04; p < 0.0001), diastolic blood pressure (DBP) by 3.71 mmHg (95% CI 2.34 to 5.08; p < 0.0001), mean arterial pressure by 5.54 mmHg (95% CI 3.33 to 7.76; p < 0.0001), heart rate by 7.03 bpm (95% CI 4.60 to 9.46; p < 0.0001), carboxyl hemoglobin (COHb) by 4.11% (95% CI 3.38 to 4.84; p < 0.0001), and expired carbon monoxide (CO) by 22.53 ppm (95% CI 15.99 to 29.08; p < 0.0001). Conclusion: WPS exposure is associated with significant acute increases in cardiopulmonary hemodynamic parameters, along with COHb and expired CO. These findings parallel the acute effects seen with cigarette smoking.
Highlights
According to the 2010 Global Burden of Disease Study, cardiopulmonary diseases are responsible for the top 5 causes of death worldwide[1]
waterpipe smoking (WPS) exposure is associated with significant acute increases in cardiopulmonary hemodynamic parameters, along with carboxyl hemoglobin (COHb) and expired carbon monoxide (CO)
A pooled analysis of the results revealed an association between a WPS session and an increase in mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of 6.45 millimeters of mercury (mmHg) and 3.71 mmHg, respectively (Figure 2)
Summary
According to the 2010 Global Burden of Disease Study, cardiopulmonary diseases are responsible for the top 5 causes of death worldwide[1]. Within the United States (U.S), mortality data from 2015 shows cardiovascular disease (CVD) ranked as the leading cause of death in the U.S.,2 with about 80% of CVD being preventable,[3] and chronic lower respiratory diseases ranked third[2]. One of the greatest risk factors for developing cardiopulmonary disease is cigarette smoking,[5] but with major public health efforts since 1965, the prevalence of cigarette smoking has been declining[6]. In the United States, 8% of adolescents 13 -17 years old and 20% of high-school seniors
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