They had seen this effect in mice, now they’ve seen in men. N.B.: That's a John Steinbeck reference, not sexism They use PET/CT scans on people who were having them for other reasons and had no CVD. Then they followed them, assessing Amygdalar activity, bone-marrow activity, and arterial inflammation.
The report, published in The Lancet, is the first to link regional brain activity with cardiovascular disease, and the first to suggest a possible mechanism to explain the relationship between chronic stress and myocardial infarction and stroke.
It’s not news that stress causes heart damage, the news is that we are beginning to find out how.
Amygdalar activity was associated with increased bone-marrow activity (r=0·47; P<0·0001), arterial inflammation (r=0·49; P<0·0001), and risk of cardiovascular disease events (standardized hazard ratio 1·59, 95% CI 1·27–1·98; P<0·0001), and this finding remained significant after multivariate adjustments.
Still, the definitive association is with heavy drinking, defined as two drinks or more a day. A drink is an ounce of alcohol, so one beer, one shot or one five ounce glass of wine would all qualify. There's a surge during the holidays, when money people over-indulge.
And after a diagnosis of Afib, "those who continue to consume alcohol have higher rates of progression from paroxysmal to persistent Afib, more Afib recurrences following pulmonary vein isolation, and potentially higher rates of adverse outcomes, such as thromboembolism," Peter M. Kistler, MBBS, PhD, of Baker IDI Heart and Diabetes Institute in Australia, and colleagues wrote in the Dec. 13 issue of the Journal of the American College of Cardiology.
"Habitual drinking at moderate levels, as well as binge drinking, predisposes to Afib, with an increase in Afib recurrence in those who continue to drink. Although a small amount of alcohol is considered cardioprotective, these benefits do not extend to Afib," the authors wrote in what they dubbed a "sobering" review.
Granted this is an association based on pooled observational studies. The effect isn’t apparent in smaller data groupings. So perhaps it is nothing to panic over. However, as someone who enjoys an adult beverage (or two) on a regular basis, it did make me sit up and notice.
Patients commonly present to emergency departments nationwide with "holiday heart syndrome," or Afib precipitated by alcohol, they noted. One study found that while "many patents develop Afib at the time of intoxication, others may present 12 to 36 hours later," they added -- with a quarter of patients showing recurrences at 1 year with subsequent binges.
Although heavy habitual alcohol consumption and binge drinking are closely associated with Afib, three large meta-analyses have also shown a link between light-to-moderate alcohol consumption and the condition, according to the authors.
This is just further justification for a decision I am already completely comfortable with. I can’t say that it amounted into increased productivity or book reading though as I'd hoped when I announced my decision.
Linemen are more likely to suffer from hypertension and associated secondary cardiac remodeling than other football players and other young adults are, according to a study online in JACC: Cardiovascular Imaging.
Of course the BMJ (and MedPage) gives critics their say too. From an email sent to MedPage:
The BMJ paper was based on 24 to 28 years of follow-up of 73,147 women in the Nurses' Health Study and 42,635 men in the Health Professionals Follow-up Study. In this report, the investigators focused on the role of individual saturated fatty acids (SFAs) and found a strong correlation with all the main SFAs and coronary heart disease. They calculated that replacing 1% daily energy intake of SFAs -- including lauric acid, myristic acid, palmitic acid, and stearic acid -- with an equivalent number of calories from polyunsaturated fats, whole grain carbohydrates, or plant proteins would lead to a 6% to 8% reduction in the risk of coronary heart disease.
"Epidemiologic studies are observational studies. This means that people who tend to eat high (or low) saturated fats tend to also do other things that may reduce or increase risk of heart disease. For example, in this study, those who ate more saturated fat also ate more protein from animals, 'refined' carbohydrate, and trans fats. They also ate less fiber, fruits and vegetables, and whole grain carbohydrates. They were more likely to smoke. Though the authors carefully controlled for many of these confounders in their analyses, the risk of what we call residual confounding is always present."