The Acute Effects of Water-Pipe Smoking on the Cardiorespiratory System

Hakim, Fahed; Hellou, Elias; Goldbart, Aviv; Katz, Ralph; Bentur, Yedidia; Bentur, Lea

doi:10.1378/chest.10-1833

Cited by 105 publications

(113 citation statements)

References 32 publications

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“…Our data show that nose-only exposure to WPS for 1 mo causes a significant increase in SBP. Our finding corroborates those of recent clinical studies (1,13,34), which reported an increase in blood pressure and heart rate after exposure to WPS in healthy subjects. These hemodynamic changes were suggested to be mediated by nicotine, which activates the sympathetic nervous system with a subse- Fig.…”

Section: Discussionsupporting

confidence: 93%

“…Al-Kubati et al (1) demonstrated that WPS induced a high increase in heart rate, systolic blood pressure (SBP), diastolic blood pressure, and mean blood pressure and markedly impaired baroreflex sensitivity in healthy normotensive subjects. More recently, Hakim et al (13) reported that one session of WPS resulted in significant increases in carboxyhemoglobin concentrations, SBP, diastolic blood pressure, heart rate, and respiratory rate. Clinical studies have reported difficulties in studying the isolated effects of WPS because most of the smokers are also current or past cigarette smokers.…”

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confidence: 99%

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Cardiovascular effects of nose-only water-pipe smoking exposure in mice

Nemmar

Yuvaraju

Beegam

et al. 2013

American Journal of Physiology-Heart and Circulatory Physiology

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pipe smoking (WPS) is a major type of smoking in Middle Eastern countries and is increasing in popularity in Western countries and is perceived as relatively safe. However, data on the adverse cardiovascular effects of WPS are scarce. Here, we assessed the cardiovascular effects of nose-only exposure to mainstream WPS generated by commercially available honey-flavored "moasel" tobacco in BALB/c mice. The duration of the session was 30 min/day for 1 mo. Control mice were exposed to air. WPS caused a significant increase of systolic blood pressure (SBP) in vivo (ϩ13 mmHg) and plasma concentrations of IL-6 (ϩ30%) but not that of TNF-␣. Heart concentrations of IL-6 (ϩ184%) and TNF-␣ (ϩ54%) were significantly increased by WPS. Concentrations of ROS (ϩ95%) and lipid peroxidation (ϩ27%) were significantly increased, whereas those of GSH were decreased (Ϫ21%). WPS significantly shortened the thrombotic occlusion time in pial arterioles (Ϫ46%) and venules (40%). Plasma von Willebrand factor concentrations were significantly increased (ϩ14%) by WPS. Erythrocyte numbers (ϩ15%) and hematocrit (ϩ17%) were significantly increased. Blood samples taken from mice exposed to WPS and exposed to ADP showed significant platelet aggregation compared with air-exposed mice. WPS caused a significant shortening of activated partial thromboplastin time (Ϫ45%) and prothrombin time (Ϫ13%). We conclude that 1-mo nose-only exposure to WPS increased SBP and caused cardiac inflammation, oxidative stress, and prothrombotic events. Our findings provide plausible elucidation that WPS is injurious to the cardiovascular system.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

Cardiovascular effects of nose-only water-pipe smoking exposure in mice

Nemmar

Yuvaraju

Beegam

et al. 2013

American Journal of Physiology-Heart and Circulatory Physiology

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“…10,[25][26][27][28][29][30][31] An example of an acute effect is that a single 30-min session of narghile smoking (10 g of double apple-flavored tabamel) by 45 volunteers induced a significant increase in SBP (from 120 Ϯ 12 to 132 Ϯ 18 mm Hg), DBP (from 75 Ϯ 8 to 83 Ϯ 13 mm Hg), and heart rate (from 80 Ϯ 10 to 96 Ϯ 17 beats/min). 31 An example of a chronic effect is that the resting heart rate and resting SBP of the 22 ENS with a Ͼ 5 narghile-year history were significantly higher than those of the HNS group (93 Ϯ 4 vs 78 Ϯ 4 beats/min and 141 Ϯ 4 vs 131 Ϯ 3 mm Hg, respectively). 10 Thirty-four percent of the ENS had a chronotropic insufficiency, and the ENS group with an abnormal 6MWD had a significantly higher resting heart rate, resting SBP, and resting DBP compared with the ENS group with a normal 6MWD (42 Ϯ 6 vs 39 Ϯ 5% predicted, 133 Ϯ 10 vs 124 Ϯ 12 mm Hg, and 85 Ϯ 9 vs 78 Ϯ 10 mm Hg, respectively).…”

Section: Effects Of Resting Spirometric Datamentioning

confidence: 99%

“…In addition, studies have demonstrated acute (immediate) effects of narghile smoke in the form of increased heart rate, breathing frequency, expired carbon monoxide, SBP, or DBP and a decline in lung function. [25][26][27][28][29][30][31] However, most of these studies have evaluated only changes in basic spirometric and/or cardiac measures at rest.…”

Section: Introductionmentioning

confidence: 99%

Investigation of Exclusive Narghile Smokers: Deficiency and Incapacity Measured by Spirometry and 6-Minute Walk Test

et al. 2014

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BACKGROUND: Studies on the submaximal aerobic capacity of exclusive narghile smokers (ENS) seem necessary in view of effective prevention of cardiorespiratory diseases. The goal of the study was to assess, by 6-min walk test (6MWT) data, the submaximal aerobic capacity of ENS, to identify factors influencing their 6-min walk distance (6MWD), and to compare their data with those of a healthy non-smoker (HNS) group. METHODS: Seventy 20 -60-y-old male ENS were included. Narghile use (narghile-years) and anthropometric, clinical, spirometric, and 6MWT data were collected. Univariate and multivariate analyses were used to identify factors influencing 6MWD. Data of a subgroup of 40 -60-y-old ENS (n ‫؍‬ 25) were compared with those of an age-matched HNS group (n ‫؍‬ 53). RESULTS: The median (first to third quartile) for age and narghile use were 32 (26 -43) and 17 (8 -32) narghile-years, respectively. The profile of ENS performing the 6MWT was as follows: at the end of the 6MWT, 34% and 9% had a low heart rate (< 60% of maximum predicted) and high dyspnea scores (> 5/10, visual analog scale), respectively; 3% had an oxyhemoglobin saturation decrease of > 5 points during the test; and 20% had an abnormal 6MWD (less than the lower limit of the normal range). The factors that significantly influenced the 6MWD, explaining 38% of its variability,

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“…6 In one human volunteer study, carboxyhemoglobin levels exceeded 20% after 30 minutes in 3 of 45 subjects ''instructed to smoke at their own regular pace and pattern.'' 7 In another study performed in a hookah café, patrons inhaled on average 130 6 21 L of smoke containing 150 6 26 mg of carbon monoxide in 1 hour. To put this dose of carbon monoxide in perspective, only about 600 mg of carbon monoxide is needed to bind half of all the hemoglobin in an adult.…”

mentioning

confidence: 99%