Smoking while wearing a mask can promote vascular dysfunction, worsening CV health

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One author reports consulting for Cardionovum, Crannmedical, Innovheart, Meditrial, Replycare and Terumo. Iconomidis and the other authors report no such financial disclosures.

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The re-inhalation of carbon monoxide among smokers while wearing a mask promotes vascular dysfunction and can worsen CV health, according to findings from a single-center study.

In an analysis of adults who were smokers of conventional or non-combustible cigarettes but free of CVD at baseline, researchers found that all vascular signs, including pulse rate, magnification rate, and systolic BP, were higher after 8 hours of wearing a mask. compared to periods. of no mask-wearing, while there were no differences observed in non-smokers.

Graphical visualization of data presented in an article
Data were derived from Ikonomidis I, et al. Eur J Previous Cardiol. 2022; doi: 10.1093 / eurjpc / zwac101.

“The study suggests that smoking any tobacco product became even more dangerous during the COVID-19 pandemic due to the need to wear a mask for long hours,” Ignatio IkonomidisMDPhD, FESC, an assistant professor of cardiology at Attikon Hospital, of the National and Kapodistrian University of Athens, Greece, said in a press release. “Previous research has shown that impaired vascular function is linked with heart problems and premature death.”

For 1 month, Ikonomidis and colleagues analyzed data from 40 smokers of conventional cigarettes, 40 smokers of hot cigarettes and 40 non-smokers of similar age and sex who were medical staff in a tertiary care hospital. The average age of participants was 45 years; 28% were men. Researchers measured exhaled carbon monoxide in parts per million (ppm) per validated device, as well as pulse rate (PWV), magnification rate adjusted for heart rate, and central systolic BP by validated pulse analysis. Basic measurements were made early in the morning after a night of sleep without any use of a mask. Researchers then randomly assessed participants a second time at the end of an 8-hour morning shift wearing a mask in a hospital or at the end of an 8-hour morning period without wearing a mask during outpatient activities. Participants then transitioned to a third assessment either at the end of an 8-hour period without a mask out of the hospital after a morning shift, or after an 8-hour period wearing a mask during an afternoon hospital shift. Researchers instructed participants not to smoke for at least 1 hour before measurements to avoid any acute effect of smoking.

The findings were published in a research letter in the European Journal of Preventive Cardiology.

Compared with baseline measurements, the increase in carbon monoxide among conventional cigarette smokers was greater when wearing versus not wearing a mask for 8 hours, with an absolute difference of 9.45 ppm (95% CI, 8.01–10.88) versus 4.15 ppm (95). % Cl, 3.15-5.14; P .001). Among non-combustible cigarette smokers, exhaled carbon monoxide increased from 1.15 ppm at baseline to 1.43 ppm without a mask and 2.2 ppm with a mask. Among non-smokers, exhaled carbon monoxide did not differ between the baseline, unmasked, and masked periods.

For conventional cigarette smokers and non-combustible cigarette smokers, all vascular signs were increased after 8 hours with or without mask wear compared to baseline measurements (P .05). In non-smokers, the use of a mask did not affect vascular markers (P > .05).

The researchers noted that a subsequent period is needed to detect whether the increase in the measured signs while wearing a mask is related to a higher incidence of CVD.

“Compared to smokers of combustible cigarettes, non-combustible cigarette users had lower baseline levels of carbon monoxide and smaller increases in vascular damage while wearing a mask,” Ikonomidis said in the release. “However, the findings show that smoking any tobacco product while wearing a mask can further impair blood vascular function compared to non-mask periods, at least in part due to greater re-inhalation of carbon monoxide and / or nicotine-rich vapor. The results give even more impetus for all smokers to kick the habit. ”

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