The Effect of Low-Nicotine Cigarettes on Angina Pectoris

Ten subjects with classical exertional angina pectoris were exercised in an upright position with an exercise load of 60 w measured on a bicycle ergometer until the onset of angina pectoris. Exercise was performed four times in a nonsmoking state and four times after smoking a low-nicotine filter cigarette for 5 min. All patients developed angina sooner if they smoked before exercising. The exercise period before angina developed was shortened by an average of 14% after smoking. All subjects developed an increase in the product of systolic blood pressure times heart rate after smoking, indicating an increase in myocardial oxygen consumption. Patients with diseased coronary arteries who exercise after smoking even very low-nicotine cigarettes may be unable to meet the increased demand for myocardial oxygen and may therefore develop angina pectoris sooner.