Central and peripheral cardiovascular changes immediately after waterpipe smoking

<div><p></p><p><i>Background</i>: Tobacco cigarette smoking is a global health problem that kills millions each year. Recently, tobacco smoking using a waterpipe (WP) has become popular worldwide. However, unlike cigarettes, the cardiovascular (CV) risks associated with WP smoking are uncertain. In this study, the immediate effects of WP smoking on central and peripheral CV indices were evaluated in 53 young healthy smokers.</p><p><i>Materials and methods</i>: Strain-gauge plethysmography was used to measure forearm blood flow (Bf), vascular resistance (Vr), and venous capacitance (Vc) and outflow (Vf) at rest (R) and after occlusion (Oc), whereas heart rate (HR) and blood pressure (BP) were measured using standard automated auscultatory methods immediately before and after a 30-min WP smoking session.</p><p><i>Results</i>: Smoking resulted in HR, diastolic BP, mean arterial BP, rate pressure product and OcVr increases (<i>p</i> < 0.05) 6.6, 3.6, 2.5, 8.0 and 16%, respectively, whereas OcBf and OcVf decreased (<i>p</i> < 0.05) 8.8 and 14.3%, respectively. Additionally, smoking-induced changes in the central CV components correlated (<i>p</i> < 0.05) with changes in the periphery.</p><p><i>Conclusion</i>: These results demonstrated changes in the CV central and peripheral components immediately after WP smoking. The correlations between the changes in these components suggest that the periphery is controlled, at least partially, by the same mechanism(s) affecting the central CV components during WP smoking.</p></div

Age-standardized rates of mental disorder DALYs, by country and sex.

<p>Age-standardized rates of mental disorder DALYs, by country and sex.</p

Change in DALYS/100,000 from 1990–2013, by income.

<p>Change in DALYS/100,000 from 1990–2013, by income.</p

Rate of DALYs due to mental disorders in EMR and globally, by income level and gender.

<p>Rate of DALYs due to mental disorders in EMR and globally, by income level and gender.</p

Rate of DALYs in EMR, by age and gender.

<p>Rate of DALYs in EMR, by age and gender.</p

Change in DALY rates from 1990–2013, by gender.

<p>Change in DALY rates from 1990–2013, by gender.</p

Rate of DALYs in EMR in 2013, by age and disorder.

<p>Rate of DALYs in EMR in 2013, by age and disorder.</p

Proportion of DALYs explained by each mental disorder within the EMR.

<p>Proportion of DALYs explained by each mental disorder within the EMR.</p