Obscure COPD in Patients having Ischemic Heart Disease

Tobacco is killer in any form or disguise.COPD and ischemic heart disease (IHD)/coronary artery disease (CAD) may co-exist as they share tobacco abuse as a common risk factor.Hookah (water pipe) smoking, a traditional form of tobacco smoking practiced long ago is now in bloom as a new disguise of tobacco in the form of flavored ‘shisha’ smoking which is nowadays in vogue across the globe.There are differences in tobacco processing, burning rate and temperature, and the use of additives for burning tobacco.Reports by the WHO and the American cancer society have shown that, in a one-hour hookah session, users consume about 100 to 200 times the smoke and about 70 times the nicotine as they do in one cigarette.We have evaluated different types of tobacco smokers who had proven IHD and performed spirometry which is gold standard for the diagnosis of COPD and concluded a high frequency of obscure COPD in this population. It was also seen that water pipe smokers were as prone to have COPD as that of cigarette smokers in contradistinction to the general perception of safety of water pipe smoking among consumers.COPD treatment in IHD patients has the potential to bring positive impacts.