Affiliation:
1. American Samoa Government Department of Public health Pago Pago American Samoa USA
2. Department of Basic Medical Sciences, School of Medicine and Health Sciences University of Papua New Guinea Port Moresby Papua New Guinea
Abstract
AbstractIntroductionHabitual betel quid chewing, a tobacco product, is a leading cause of oral cancer in Asia–Pacific countries where this practice is most prevalent. However, it is not well understood whether betel quid chewing is also a cause of adverse cardiovascular outcomes. To address this gap, we conducted a systematic literature review of peer‐reviewed published studies evaluating the association between habitual betel quid use on the risk of adverse cardiovascular outcomes.MethodsWe searched PubMed for studies assessing the correlation between betel quid chewing and cardiovascular health. We included studies if (i) they included human subjects; (ii) were peer‐reviewed articles in indexed journals; and (iii) were in English. We extracted data from eligible studies and stratified them by geographical location, study designs and cardiovascular outcomes. Finally, we did a narrative synthesis of the data to identify adverse cardiovascular outcomes associated with chronic betel quid use.FindingsWe reviewed data from 19 studies that met the inclusion criteria. Habitual betel quid chewing was associated with hypertension, atherosclerosis, inflammation and ischaemic heart disease. In addition, betel quid use was a risk factor for arrhythmias. Interestingly, betel quid use was an independent risk factor for cardiovascular disease in women. Long‐term betel quid consumption was associated with higher risks for all‐cause mortality and increased overall cardiovascular risk.ConclusionsHabitual betel quid chewing is an important cardiovascular risk factor in populations where the practice is prevalent.