Graded exercise testing (GXT) is a fundamental component of the diagnosis/treatment of patients with suspected/known cardiovascular disease (CVD). Amid the current pandemic, patients must wear a facemask during GXTs, yet the impact of facemask use on peak values from a GXT has not been evaluated in individuals at increased risk of developing CVD. The objective is to examine potential differences in peak values obtained from a GXT performed under facemask versus no facemask conditions among adults at increased risk for CVD.


Using a randomized, crossover study design, 16 adults at moderate risk for developing CVD completed 2 trials (facemask versus no facemask). Peak speed, grade, heart rate (HR), and rating of perceived exertion were recorded during a Modified Bruce Treadmill GXT for each trial. Peak speed and grade were used to estimate peak oxygen consumption (Vo2peak) and peak metabolic equivalents of task (Vo2peak/3.5).


Total exercise time (17:10 ± 2:04 versus 15:58 ± 1:51 minutes, P = 0.0005), peak HR (170 ± 11 versus 164 ± 11 b·min−1, P = 0.01), estimated Vo2peak (42.3 ± 8.9 versus 36.8 ± 6.6 mL·kg−1·min−1, P = 0.005), and peak metabolic equivalents of task (12.2 ± 2.6 versus 10.5 ± 1.9, P = 0.005) were higher during the no facemask versus the facemask trial. Peak rating of perceived exertion was similar between trials (18.1 ± 1.3 versus 18.3 ± 1.2, P = 0.84).


Facemask use had a significant but modest clinical impact on hemodynamic responses during a GXT among moderate risk adults.

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