Waterpipe Use and Its Cardiovascular Effects: A Systematic Review and Meta-Analysis of Case-Control, Cross-Sectional, and Non-Randomized Studies

Figures

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  Figure 1. The search procedure depicted in the PRISMA flowchart was used to locate the 16 studies. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; MEDLINE, Medical Literature Analysis and Retrieval System Online; EMBASE, Excerpta Medica Database

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  Figure 2. Risk-of-bias assessment, with green, yellow, orange, and white indicating low, moderate, serious, and critical risks, respectively. [20,27-41]

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  Figure 3. Plot demonstrating the acute effect of WPS. WPS, waterpipe smoking; HR, heart rate; SBP, systolic blood pressure; DBP, diastolic blood pressure [20,27-30,37]

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  Figure 4. Forest plot showing a comparison of WPS and NS. WPS, waterpipe smoking; NS, non-smoking [29,30,32-34,39,41]

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  Figure 5. Forest plots showing individual and pooled mean differences in cholesterol blood values in WPS when compared to NS. WPS, waterpipe smoking; NS, non-smoking; TC, total cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TG, triglycerides [32-34,38,40]

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  Figure 6. A forest plot demonstrating HDL, LDL, TC, and TG pooled mean differences in WPS versus CS. WPS, waterpipe smoking; CS, cigarette smoking; TC, total cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TG, triglycerides [34,38,40]

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  Figure 7. A plot showing a comparison of WPS and CS. WPS, waterpipe smoking; CS, cigarette smoking; HR, heart rate; SBP, systolic blood pressure; DBP, diastolic blood pressure [20,34,39,41]