Healthsifter by mary desmond pinkowish, since 2003

Stress Management for People Recovering from Heart Attacks

Chronic stress (employment or marital problems) and emotional issues (depression, anxiety, hostility) have been tied to a higher risk of heart attacks, or acute myocardial infarction (AMI). But does managing these psychological risk factors reduce the risk of AMI? The studies that have asked the question so far have had conflicting results, but a new, large one reported today in the Archives of Internal Medicine seems to suggest that stress-management therapy may reduce the risk of a heart attack in people who have already had one.

The strength of this study is that they compared two treatments. All of the patients had had MIs during the past year. All received "normal" post-MI medical care, meaning that no one got substandard help during recovery. All patients had similar "traditional" risk factors for MI, like high blood pressure and cholesterol problems. But slightly more than half of the participants also got stress management therapy--20 two-hour sessions over the course of a year. Researchers kept in touch with the people for an average of 94 months. The outcome? The rate of recurrent cardiovascular events was 41% lower in people who participated in the stress management program. And one of the most interesting findings was that among the people who were assigned to get stress management therapy, the risk was lower in those who went to sessions regularly than those who skipped frequently. 

Pretty cool. Read the study summary here.

When A Broken Heart Can Kill

Did you read Ron Winslow's article in yesterday's Wall Street Journal about new research into a heart condition called, fittingly, Broken Heart Syndrome? The condition mimics a heart attack, but when cardiologists search for clogged arteries, they come up empty-handed. Instead, they may find a misshapen left ventricle, and the patient usually has a story about a strong emotional trauma, like sudden loss of a spouse, that preceded the symptoms. Adrenaline seems to be the culprit, because it blasts the cells of the left ventricle in overwhelming concentrations, leaving the chamber incapable of effective pumping. Most vulnerable: postmenopausal women, perhaps because they no longer have enough estrogen to buffer the effects of adrenaline surges. Strange and scary stuff. The condition has also been called stress cardiomyopathy and tako-tsubo cardiomyopathy. Recent articles on this topic:  

MayoClinic.com

About.com, Dr. Fogoros

Journal of the American College of Cardiology

Cardiology

Enjoy this tape, which includes a patient story and an explanation of why the condition is sometimes called tako tsubo.

The Super Bowl: A Hazard to Your Heart?

 It's possible, especially if your team loses, according to blogger Anahad O'Connor, writing at NYT.com: 

Last year, a team of scientists focused on the Super Bowl, looking at residents of Los Angeles in two different years when local teams were in the game. In 1980, the Rams lost to the Pittsburgh Steelers, and in 1984 the Raiders defeated the Washington Redskins. The study, published in The American Journal of Cardiology, found that compared with other years, deaths from heart attacks rose in Los Angeles on the day the Rams lost the Super Bowl and for two weeks afterward. The game, played in California, was highly charged, with the lead changing a half-dozen times. But in 1984, when the Raiders won handily, overall mortality fell.

Why? No one knows, but it could be a combination of emotional stress, over-exertion by the unfit (you know, huge guy jumping up and down off the sofa), and the all the nutritionally incorrect foods we like to eat while celebrating this rite. 

TV is Killing You

 Slate has the story, which originally appeared in the LA Times. Here's an excerpt from Slate: 

Australian researchers found that each hour spent watching TV translates into an 18 percent greater risk of dying from cardiovascular disease and an 11 percent greater risk of all causes of death, reports the Los Angeles Times. The first thing that comes to mind is that obviously those who watch more TV will have a greater risk of death since they're probably more likely to be overweight and less likely to get exercise. But researchers found the connection between TV-watching and death from cardiovascular disease even among those with a healthy weight who exercised. And we're not talking about small numbers. Those who watched more than four hours a day had an 80 percent greater risk of dying from cardiovascular disease than those who watched fewer than two hours a day. Bottom line? Even if you exercise, it's not good to be sitting inactive in front of a television (or computer!) for hours at a time.

What a drag this is, if the findings are corroborated by other research teams. You'd think that a healthy weight and good exercise habits would protect against the effects on cardiovascular disease, but no. And as far as computers go...geez--lots of us are screwed. Why? The LA Times quotes lead investigator Dr. David Dunstan, professor and head of the Physical Activity Laboratory at the Baker IDI Heart and Diabetes Institute in Victoria, Australia:

To him, the results weren't unexpected. "When we're in that sitting posture, we're not using our muscles, and we know from extensive evidence that muscle contractions are important for the body's regulatory processes, such as the ability to break down glucose and use it as energy." That can cause insulin resistance, which can trigger a spike in blood sugar levels, possibly leading to type 2 diabetes.

Ron Winslow also covers this story in the Wall Street Journal. Never before has a bar graph freaked me out like the one that accompanies his story. The original research appears in the journal Circulation. This could be a life-changer.

Eat fish? Yeah! Go Fish! GoFishn!

This isn't my usual beat, but I have a great site for you: GoFISHn.com. Like fish? Like to fish? Check out GoFISHn.com, and network with fellow ichthyologically inclined sportspeople. Swap fishing stories, and probably some fishing lies. Swap photos. Pick up tips. What a great encyclopedia they have, with comprehensive information on species, techniques, gear, and locations. Best of all, you can find a fishing guide. Full disclosure: This site belongs to my brother, and that's a great thing! The guy was born with gills. 

 

Whole Grain Cereal vs Heart Failure?

Read this from the WSJ Health Blog about a piece of evidence apparently linking whole grain cereal (the stuff that resembles tree bark) consumption to a reduced risk of heart failure. This is at least the second time the connection has shown up, this time from a very large observational study. Hey--chomping the twigs and buds won't compensate for your failure to quit smoking or take your blood pressure medicine, but it can't hurt.

Music and Your Heart

In 1638, Claudio Monteverdi, the granddaddy of opera, said that the purpose of all music was to move the soul.  Modern cardiovascular research is confirming his assertion--if you substitute "heart" for "soul." It's a stretch, but stick with me on this. Researchers present data about the effect of music on the heart in the current issue of Circulation, a journal published by the American Heart Association. Here is a segment of the press release about the study:

Five random tracks of classical music were played — including selections from Beethoven’s Ninth Symphony; an aria from Puccini’s Turandot; a Bach cantata (BMW 169); Va Pensiero from Nabucco; Libiam Nei Lieti Calici from La Traviata — as well as two minutes of silence.

Researchers found:

• Every crescendo led to increased narrowing of blood vessels under the skin, increased blood pressure and heart rate and increased respiration amplitude. In each music track the extent of the effect was proportional to the change in music profile.
• During the silent pause, changes decreased, with blood vessels under the skin dilating and marked reductions in heart rate and blood pressure. Unlike with music, silence reduced heart rate and other variables, indicating relaxation.
• Music phrases around 10 seconds long, like those used in “Va Pensiero” and “Libiam Nei Lieti Calici,” synchronized inherent cardiovascular rhythm, thus modulating cardiovascular control.

Music can induce physiologic changes that may precede the psychological appreciation. Such autonomic modulations could be of practical use to induce body sensation which might reach the level of consciousness, or at least create a continuous stimulus to the upper brain; moreover, the inter-individual synchronization of body physiology mediated by music could aid in strengthening the sense of sharing within the human relationship.

The researchers think that these and other, earlier findings may lead to the inclusion of music in stroke rehab, for example. At the very least, rehab sessions will be more fun. Music makes everything better, right?

Large Neck Size = Increased Risk of Heart Disease

From the American Heart Association meeting via WebMD:

The finding comes from data collected from 3,320 people in two studies of heart disease risk factors.

Belly fat -- specifically, fatty deposits around the organs of the central body -- is known to increase the risk of heart disease. Sarah Rosner Preis, ScD, MPH, and colleagues theorized that upper-body fat, as measured by neck circumference, also raises heart risk.

Sure enough, they found that the bigger a person's neck size, the greater that person's risk of high levels of LDL "bad" cholesterol and blood fat, insulin resistance, and high blood sugar. This held true even after controlling for belly fat.

Psoriasis Linked to Heart Disease

Inflammation may be the common denominator between psoriasis and heart disease. That's what led researchers to recommend that anyone with moderate or severe psoriasis be counseled about the strong relationship between this skin disorder and cardiovascular risk. ScienceDaily wrote about this a few weeks ago. Among the recommendations made by cardiologists and dermatologists in the American Journal of Cardiology consensus statement were these:

• Informing patients with moderate to severe psoriasis that they are at increased risk of CAD and performing a medical evaluation to assess cardiovascular risk. For patients with milder psoriasis, evaluation is recommended if other CAD risk factors are present, such as obesity or high blood pressure.
• Prescribing treatment to reduce high cholesterol levels and other risk factors, if present.
• Paying close attention to possible interactions or adverse effects of the medications used to treat psoriasis.

More Sleep, Healthier Heart

I think 2009 may be the Year of Sleep. There's more research data every week about the detrimental effects of too little sleep. This week it came from an article in the Journal of the American Medical Association (JAMA). Back story: Calcification of the coronary arteries predicts heart disease risk. These researchers measured coronary artery calcification in a group of male and female volunteers aged 37 to 45 who were enrolled in the long-term CARDIA study. The measurements took place twice: in 2000/2001 and again in the same people in 2005/2006. The investigators also gathered information on all the other usual suspects in heart disease--blood pressure, cholesterol levels, smoking status, age, race, depression, educational attainment, and so forth. Calcification occurred in 12.3% of the participants during the 5-year study but was significantly less likely in people who got more sleep. Here's what the authors said in their conclusions:

We have found a robust and novel association between objectively measured sleep duration and 5-year incidence of coronary artery calcification. One hour more of sleep decreased the estimated odds of calcification by 33%.

The full text of the original article is available for free. And if you're interested, I highly recommend the story and audio at NPR.org. Here's a quote from that story by the chief investigator, Diane Lauderdale, PhD:

"...this study does add to mounting evidence that there are subtle but potentially important health consequences of routinely sleeping very short hours — say, less than five hours a night," she says.

She says it's wise to sleep at least six or seven hours a night. That's pretty benign advice, she says, which is "why I'm feeling OK about giving it."

Good stuff. Sleep tight.