No abstract present.
I read with great interest the systematic review and meta-analysis of Al Ali
et al. (2020)  aiming to explore the clinical cardiovascular effects
of narghile smoking. The authors consulted four databases (i.e., PubMed, EMBASE,
Web of Science, and Cochrane Library) for studies published until December 2019
and assessing acute and/or chronic cardiovascular effects of narghile smoking.
The final meta-analysis included 31 studies. The authors concluded that current
level of evidence suggests that narghile smoking is associated with substantial
adverse effects on cardiovascular system. The results related to the narghile
smoking are remarkable and should be highlighted , because ignoring its
serious impacts on cardiovascular and metabolic data will certainly lead to a
worldwide public health problem, which doctors can undertake to prevent [2, 3, 4, 5, 6]. Moreover, the 2015-World Health Organization advisory note on narghile
smoking , acclaimed additional research related to the narghile-associated
disease risk. However, it is “surprising” that a systematic review “ignores”
one Tunisian article , especially since it meets the inclusion criteria
detailed by the authors. The study, which was published in early 2019 , aimed
to compare the metabolic profiles of 29 narghile smokers and 29 apparently
healthy non-smokers (AHNS) (both groups were males free from a known history of
metabolic and/or cardiovascular diseases). The authors reported that compared to
the AHNSs’ group, the narghile smokers’ group had “(i) higher values of body
mass index (26.5
Thanks to all the peer reviewers for their positive opinions and suggestions.
This research received no external funding.
I report personal fees from the following pharmaceutical laboratories: AstraZeneca, Teriak, Hikma and Chiesi.