Acute effects of waterpipe smoking on blood pressure and heart rate: a real-life trial

Background: Waterpipe smoking is becoming a popular way of tobacco use in the world. Its acute effects on the cardiovascular system are not well investigated.Materials and methods: This is a trial designed to evaluate the acute effects of waterpipe smoking on blood pressure (BP) and heart rate (HR) in healthy adults. Individuals who ordered waterpipe in 6 Lebanese restaurants were enrolled (cases) and were compared to controls who consisted of subjects who were sitting at the same table of smokers but who did not smoke (passive smokers) and of subjects who were sitting in nonsmoking sections (nonsmokers). BP and HR were measured immediately before and 15min after smoking or at baseline and 15min later in controls.Results: A total of 194 subjects were enrolled: 101 waterpipe smokers, 51 passive smokers, and 42 nonsmokers. Systolic and diastolic BP and HR significantly increased after 15min of smoking in cases (mean 3.1mm Hg (95% CI 0.8-5.5; p=0.009) for systolic BP, 2.1mm Hg (95% CI 0-4.2; p=0.053) for diastolic BP, and 6.3 beats/minute (95% CI 4.3-8.3; p<0.001) for HR, but did not change in controls.Conclusions: Waterpipe smoking for duration as short as 15min has acute hemodynamic effects and significantly increases systolic BP and HR.