Effect of shisha vs. cigarette smoking on endothelial function by brachial artery duplex ultrasonography: an observational study.

Objective: In this study, we sought to investigate the effect of shisha smoking on endothelial function compared to cigarettes, using brachial artery ultrasound (BAUS) imaging in asymptomatic young adults with no other cardiovascular risk factors. Methods: This is an observational case-control study where 30 young shisha smokers, 30 cigarette smokers and 10 healthy, non-smokers, age-matched subjects between 25-35 years old with no cardiovascular risk factors were recruited from all around Egypt. Flow-mediated dilation was assessed using brachial artery duplex ultrasonography. Results: FMD% was significantly impaired among shisha smokers compared to cigarette smokers and non-smokers cigarettes (7.9 +/- 3.8% vs. 12 +/- 3.4% and 21.5 +/- 2.5% respectively p<0.001). Conclusion: Shisha smoking has a more hazardous effect on brachial artery endothelial-dependent flow mediated vasodilation compared to cigarette.