Effect of non-nicotine cigarettes and carbon monoxide on angina

The effect of smoking five non-nicotine cigarettes and of breathing carbon monoxide on exercise-induced angina was evaluated in 12 patients with angina. Smoking increased venous carboxyhemoglobin from 1.71 to 5.35%, decreased exercise duration until angina 45%, increased ischemic ST-segment depression at angina from 1.33 to 1.52 mm, and decreased systolic blood pressure times heart rate at angina. Breathing carbon monoxide increased venous carboxyhemoglobin from 1.73 to 5.37%, decreased exercise duration until angina 35%, increased ischemic ST-segment depression at angina from 1.31 to 1.50 mm, and decreased systolic blood pressure times heart rate at angina. Greater decreases in exercise duration until angina and in systolic blood pressure times heart rate at angina (p less than 0.001) were observed after smoking than after breathing carbon monoxide. Tobacco components other than nicotine or carbon monoxide are responsible for a small decrease in exercise performance until angina.