Central and Peripheral Hemodynamics in Young Water-Pipe Users and the Acute Effects of Water-Pipe Use

Background Tobacco use via water pipe (commonly referred to as water-pipe smoking [WPS]) is popular among young adults globally and exposes users to toxicants. Research Question Is WPS associated with impaired measures of arterial function and does WPS acutely impair these measures in young adults? Study Design and Methods We assessed heart rate (HR), brachial and aortic BP, HR-adjusted augmentation index (AI), and carotid-femoral pulse wave velocity (CFPWV) in 62 water-pipe users and 34 never users recruited from the community (mean age, 22.5 ± 3.0 years; 48% female). Measurements were obtained before and after an outdoor session of WPS among users and among control nonusers. Measurements were compared after vs before exposure and between users and nonusers, adjusting for possible confounders using linear regression. Results Water-pipe users and nonusers had similar demographic characteristics. BP and HR increased acutely after WPS (brachial systolic BP, by 4.13 mm Hg [95% CI, 1.91-6.36 mm Hg]; aortic systolic BP, by 2.31 mm Hg [95% CI, 0.28-4.33 mm Hg]; brachial diastolic BP, by 3.69 mm Hg [95% CI, 1.62-5.77 mm Hg]; aortic diastolic BP, by 3.03 mm Hg [95% CI, 0.74-5.33 mm Hg]; and HR, by 7.75 beats/min [95% CI, 5.46-10.04 beats/min]), but not in control nonusers. AI was significantly higher in water-pipe users compared with nonusers (9.02% vs 3.06%; P = .03), including after adjusting for BMI and family history of cardiovascular disease (β = 6.12; 95% CI, 0.55-11.69; P = .03) and when assessing habitual tobacco use via water-pipe extent (water pipes used/day × water-pipe use duration) in water-pipe-years (β = 2.51/water-pipe-year; 95% CI, 0.10-4.92/water-pipe-year; P = .04). However, CFPWV was similar in users and nonusers, and AI and CFPWV did not change acutely after WPS. Interpretation In apparently healthy young individuals from the community, habitual WPS was associated with increased AI, a predictor of cardiovascular risk, and one WPS session acutely increased HR and brachial and aortic BP. Tobacco use via water pipe (commonly referred to as water-pipe smoking [WPS]) is popular among young adults globally and exposes users to toxicants. Is WPS associated with impaired measures of arterial function and does WPS acutely impair these measures in young adults? We assessed heart rate (HR), brachial and aortic BP, HR-adjusted augmentation index (AI), and carotid-femoral pulse wave velocity (CFPWV) in 62 water-pipe users and 34 never users recruited from the community (mean age, 22.5 ± 3.0 years; 48% female). Measurements were obtained before and after an outdoor session of WPS among users and among control nonusers. Measurements were compared after vs before exposure and between users and nonusers, adjusting for possible confounders using linear regression. Water-pipe users and nonusers had similar demographic characteristics. BP and HR increased acutely after WPS (brachial systolic BP, by 4.13 mm Hg [95% CI, 1.91-6.36 mm Hg]; aortic systolic BP, by 2.31 mm Hg [95% CI, 0.28-4.33 mm Hg]; brachial diastolic BP, by 3.69 mm Hg [95% CI, 1.62-5.77 mm Hg]; aortic diastolic BP, by 3.03 mm Hg [95% CI, 0.74-5.33 mm Hg]; and HR, by 7.75 beats/min [95% CI, 5.46-10.04 beats/min]), but not in control nonusers. AI was significantly higher in water-pipe users compared with nonusers (9.02% vs 3.06%; P = .03), including after adjusting for BMI and family history of cardiovascular disease (β = 6.12; 95% CI, 0.55-11.69; P = .03) and when assessing habitual tobacco use via water-pipe extent (water pipes used/day × water-pipe use duration) in water-pipe-years (β = 2.51/water-pipe-year; 95% CI, 0.10-4.92/water-pipe-year; P = .04). However, CFPWV was similar in users and nonusers, and AI and CFPWV did not change acutely after WPS. In apparently healthy young individuals from the community, habitual WPS was associated with increased AI, a predictor of cardiovascular risk, and one WPS session acutely increased HR and brachial and aortic BP.