In the Journals

Hookah smoking stiffens arteries similar to cigarettes

Hookah smoking may cause an acute increase in arterial stiffness in young adults that is similar to the effects of smoking cigarettes, according to a study published in The American Journal of Cardiology.

“This study shows that hookah smoking causes an acute adverse increase in large artery stiffness as demonstrated by increased pulse wave velocity and aortic augmentation index,” Mary Rezk-Hanna, PhD, assistant professor at the UCLA School of Nursing, who was a PhD candidate at Smidt Heart Institute, Cedars Sinai Medical Center, at the time of the study, and colleagues wrote. “Although hookah smoking is effectively marketed to young adults as a safer socially desirable alternative to tobacco cigarettes, the objective measures of vascular stiffness after smoking hookah are quite comparable to what has been previously reported with cigarette smoking in young adults.”

For the study, researchers recruited 48 adults aged 18 to 34 years who had smoked hookah at least 12 times within the past 12 months, who had never tried cigarettes, and who were in generally good health with no history of diabetes, dyslipidemia, hypertension or illegal drug use (35% women; mean age, 25 years; mean BMI, 24.6 kg/m2; 35% white).

All participants did not smoke hookah or consume caffeine or alcohol for 12 hours before the study, nor did they engage in physical exercise for 24 hours beforehand.

Researchers conducted baseline measurements after participants sat in a quiet, temperature-controlled environment for 15 minutes (mean baseline heart rate, 64 bpm; mean brachial BP, 115 mm Hg/68 mm Hg; mean carotid-femoral pulse wave velocity, 7.59 m/s-1; mean aortic augmentation index, 13.68%).

Participants were then instructed to smoke hookah for 30 minutes, using a standard charcoal-heated waterpipe prepared with 12.5 g flavored hookah tobacco that had been heated by two natural charcoal cubes.

After hookah smoking, researchers found that heart rate increased from baseline by 16 bpm (P < .001), mean brachial BP increased by 6 mm Hg (P < .001), carotid-femoral pulse wave velocity increased from 7.59 m/s-1 to 8.25 m/s-1 (P < .001) and aortic augmentation index increased from 13.68% to 19.12% (P = .034).

In addition, plasma nicotine and exhaled carbon monoxide levels were greater after smoking hookah (increasing by 5.8 ng/mL and 25.44 ppm, respectively; P < .05).

“Our present data document that hookah smoking poses a potent adverse effect on large artery stiffness and wave reflection comparable to that previously reported with cigarette and other tobacco products,” the researchers wrote. “These results provide preliminary objective evidence to inform regulatory and policy activities countering claims that hookah smoking is a safer tobacco alternative. It is not. Further studies on the long-term cardiovascular effects of hookah smoking are warranted.” by Melissa J. Webb

Disclosures: The authors report no relevant financial disclosures.

Hookah smoking may cause an acute increase in arterial stiffness in young adults that is similar to the effects of smoking cigarettes, according to a study published in The American Journal of Cardiology.

“This study shows that hookah smoking causes an acute adverse increase in large artery stiffness as demonstrated by increased pulse wave velocity and aortic augmentation index,” Mary Rezk-Hanna, PhD, assistant professor at the UCLA School of Nursing, who was a PhD candidate at Smidt Heart Institute, Cedars Sinai Medical Center, at the time of the study, and colleagues wrote. “Although hookah smoking is effectively marketed to young adults as a safer socially desirable alternative to tobacco cigarettes, the objective measures of vascular stiffness after smoking hookah are quite comparable to what has been previously reported with cigarette smoking in young adults.”

For the study, researchers recruited 48 adults aged 18 to 34 years who had smoked hookah at least 12 times within the past 12 months, who had never tried cigarettes, and who were in generally good health with no history of diabetes, dyslipidemia, hypertension or illegal drug use (35% women; mean age, 25 years; mean BMI, 24.6 kg/m2; 35% white).

All participants did not smoke hookah or consume caffeine or alcohol for 12 hours before the study, nor did they engage in physical exercise for 24 hours beforehand.

Researchers conducted baseline measurements after participants sat in a quiet, temperature-controlled environment for 15 minutes (mean baseline heart rate, 64 bpm; mean brachial BP, 115 mm Hg/68 mm Hg; mean carotid-femoral pulse wave velocity, 7.59 m/s-1; mean aortic augmentation index, 13.68%).

Participants were then instructed to smoke hookah for 30 minutes, using a standard charcoal-heated waterpipe prepared with 12.5 g flavored hookah tobacco that had been heated by two natural charcoal cubes.

After hookah smoking, researchers found that heart rate increased from baseline by 16 bpm (P < .001), mean brachial BP increased by 6 mm Hg (P < .001), carotid-femoral pulse wave velocity increased from 7.59 m/s-1 to 8.25 m/s-1 (P < .001) and aortic augmentation index increased from 13.68% to 19.12% (P = .034).

In addition, plasma nicotine and exhaled carbon monoxide levels were greater after smoking hookah (increasing by 5.8 ng/mL and 25.44 ppm, respectively; P < .05).

“Our present data document that hookah smoking poses a potent adverse effect on large artery stiffness and wave reflection comparable to that previously reported with cigarette and other tobacco products,” the researchers wrote. “These results provide preliminary objective evidence to inform regulatory and policy activities countering claims that hookah smoking is a safer tobacco alternative. It is not. Further studies on the long-term cardiovascular effects of hookah smoking are warranted.” by Melissa J. Webb

Disclosures: The authors report no relevant financial disclosures.