Links among poor sleep, high blood pressure, gut microbiome discovered

September 2, 2020

Science Daily/University of Illinois at Chicago

In the first study of its kind, University of Illinois Chicago researchers have found associations among disrupted sleep, elevated blood pressure and changes in the gut microbiome.

The research aimed to determine whether a 28-day period of disrupted sleep changed the microbiota in rats. The gut microbiota refers to the collection of microorganisms living in the intestines. The researchers also sought to identify biological features associated with undesirable arterial blood pressure changes.

The results were published in Physiological Genomics.

Using rats, the researcher disrupted their sleep periods. Rats are nocturnal, so the experiments were designed to interfere with their daytime sleep periods.

Telemetry transmitters measured the rats' brain activity, blood pressure and heart rate. Fecal matter also was analyzed to examine changes in the microbial content.

The research idea was generated by several of the paper's authors who are or have been health care providers with night-shift schedules.

"When rats had an abnormal sleep schedule, an increase in blood pressure developed -- the blood pressure remained elevated even when they could return to normal sleep. This suggests that dysfunctional sleep impairs the body for a sustained period," Maki said.

Undesirable changes also were found in the gut microbiome -- the genetic material of all bacteria living in the colon.

Contrary to her initial hypothesis, Maki found that the gut microbiome changes did not happen immediately, but instead took a week to show unfavorable responses such as an imbalance among different types of bacteria including an increase in microbes associated with inflammation.

"When the sleep disruption stopped, everything did not come back to normal immediately," Maki said. "This research shows a very complex system with the presence of multiple pathological factors."

This was initial research, and studies will continue to examine pathways involving the gut microbiome and metabolites produced by gut bacteria. The researchers will see exactly how sleep characteristics are changed and how long blood pressure and gut microbiome alterations persist. Researchers will then determine how this information translates to humans.

"We hope to find an intervention that can help people who are at risk for cardiovascular disease because of their work and sleep schedules. People will always have responsibilities that interrupt their sleep. We want to be able to reduce their risk by targeting the microbiome with new therapies or dietary changes," Fink said.

https://www.sciencedaily.com/releases/2020/09/200902182439.htm

COVID-19 has likely tripled depression rate

September 2, 2020

Science Daily/Boston University School of Medicine

A first-of-its-kind study from the Boston University School of Public Health (BUSPH) finds 27.8% of U.S. adults had depression symptoms as of mid-April, compared to 8.5% before the COVID-19 pandemic.

Published in the journal JAMA Network Open, the study also found that income and savings are the most dramatic predictors of depression symptoms in the time of COVID.

"Depression in the general population after prior large scale traumatic events has been observed to, at most, double," says study senior author Dr. Sandro Galea, Dean and Robert A. Knox Professor at BUSPH, citing examples such as September 11, the Ebola outbreak, and civil unrest in Hong Kong.

"We were surprised to see these results at first, but other studies since conducted suggest similar-scale mental health consequences," Galea says. These studies have mainly been conducted in Asia and focused on specific populations such as healthcare workers and college students (one such study found depression symptoms among half of Chinese healthcare workers who had treated COVID patients).

But the new BUSPH study is the first nationally-representative study in the U.S. to assess the change in depression prevalence before and during COVID using the Patient Health Questionnaire-9 (PHQ 9), the leading self-administered depression screening tool.

The researchers used data from 5,065 respondents to the 2017-2018 National Health and Nutrition Examination Survey (NHANES), and 1,441 respondents from the COVID-19 Life Stressors Impact on Mental Health and Well-Being (CLIMB) study, which was conducted from March 31 to April 13, 2020, when 96% of the U.S. population was under stay-at-home advisories or shelter-in-place policies.

Both surveys used the PHQ 9 to assess depression symptoms and gathered the same demographic data, and the 2020 survey also gathered data on COVID-related stressors including job loss, the death of a friend or loved one from COVID, and financial problems.

Across the board, the researchers found an increase in depression symptoms among all demographic groups. Not surprisingly, experiencing more COVID-related stressors was a major predictor of depression symptoms.

However, the biggest demographic difference came down to money. After adjusting for all other demographics, the researchers found that, during COVID, someone with less than $5,000 in savings was 50% more likely to have depression symptoms than someone with more than $5,000.

"Persons who were already at risk before COVID-19, with fewer social and economic resources, were more likely to report probable depression, suggesting that inequity may increase during this time and that health gaps may widen," says study lead author Catherine Ettman, a doctoral student at the Brown University School of Public Health and director of strategic development in the Office of the Dean at BUSPH.

"We would hope that these findings promote creating a society where a robust safety net exists, where people have fair wages, where equitable policies and practices exist, and where families can not only live on their income but can also save money towards the future," she says.

As COVID continues to grip the country, Ettman says, "There may be steps that policymakers can take now to help reduce the impact of COVID-19 stressors on depression, such as eviction moratoria, providing universal health insurance that is not tied to employment, and helping people return to work safely for those able to do so."

At the same time, Ettman says she and her colleagues hope the study findings will also help those who are experiencing depression in this incredibly difficult time see that they are not alone: On the contrary, one in four U.S. adults is probably going through the same thing.

https://www.sciencedaily.com/releases/2020/09/200902152202.htm

Circadian rhythms help guide waste from brain

September 2, 2020

Science Daily/University of Rochester Medical Center

New research details how the complex set of molecular and fluid dynamics that comprise the glymphatic system -- the brain's unique process of waste removal -- are synchronized with the master internal clock that regulates the sleep-wake cycle. These findings suggest that people who rely on sleeping during daytime hours are at greater risk for developing neurological disorders.

"These findings show that glymphatic system function is not solely based on sleep or wakefulness, but by the daily rhythms dictated by our biological clock," said neuroscientist Maiken Nedergaard, M.D., D.M.Sc., co-director of the Center for Translational Neuromedicine at the University of Rochester Medical Center (URMC) and senior author of the study, which appears in the journal Nature Communications.

The findings add to a growing understanding of the operation and function of glymphatic system, the brain's self-contained waste removal process which was first discovered in 2012 by researchers in the Nedergaard's lab. The system consists of a network of plumbing that follows the path of blood vessels and pumps cerebrospinal fluid (CSF) through brain tissue, washing away waste. Research a few years later showed that the glymphatic system primarily functions while we sleep.

Since those initial discoveries, Nedergaard's lab and others have shown the role that blood pressure, heart rate, circadian timing, and depth of sleep play in the glymphatic system's function and the chemical signaling that occurs in the brain to turn the system on and off. They have also shown how disrupted sleep or trauma can cause the system to break down and allow toxic proteins to accumulate in the brain, potentially giving rise to a number of neurodegenerative diseases, such as Alzheimer's.

The link between circadian rhythms and the glymphatic system is the subject of the new paper. Circadian rhythms -- a 24-hour internal clock that regulates several important functions, including the sleep-wake cycle -- are maintained in a small area of the brain called the suprachiasmatic nucleus.

The new study, which was conducted in mice, the researchers showed that when the animals were anesthetized all day long, their glymphatic system still only functioned during their typical rest period -- mice are nocturnal, so their sleep-wake cycle is the opposite of humans.

"Circadian rhythms in humans are tuned to a day-wake, night-sleep cycle," said Lauren Hablitz, Ph.D., first author of the new study and a research assistant professor in the URMC Center for Translational Neuromedicine. "Because this timing also influences the glymphatic system, these findings suggest that people who rely on cat naps during the day to catch up on sleep or work the night shift may be at risk for developing neurological disorders. In fact, clinical research shows that individuals who rely on sleeping during daytime hours are at much greater risk for Alzheimer's and dementia along with other health problems."

The study singles out cells called astrocytes that play multiple functions in the brain. It is believed that astrocytes in the suprachiasmatic nucleus help regulate circadian rhythms. Astrocytes also serve as gatekeepers that control the flow of CSF throughout the central nervous system. The results of the study suggest that communication between astrocytes in different parts of the brain may share the common goal of optimizing the glymphatic system's function during sleep.

The researchers also found that during wakefulness, the glymphatic system diverts CSF to lymph nodes in the neck. Because the lymph nodes are key waystations in the regulation of the immune system, the research suggests that CSF may represent a "fluid clock" that helps wake up the body's infection fighting capabilities during the day.

"Establishing a role for communication between astrocytes and the significant impacts of circadian timing on glymphatic clearance dynamics represent a major step in understanding the fundamental process of waste clearance regulation in the brain," said Frederick Gregory, Ph.D., program manager for the Army Research Office, which helped fund the research and is an element of the U.S. Army Combat Capabilities Development Command's Army Research Laboratory. "This knowledge is crucial to developing future countermeasures that offset the deleterious effects of sleep deprivation and addresses future multi-domain military operation requirements for Soldiers to sustain performance over longer periods without the ability to rest."

https://www.sciencedaily.com/releases/2020/09/200902082326.htm

Blood pressure-lowering is even more beneficial than previously thought

September 1, 2020

Science Daily/European Society of Cardiology

Blood pressure medication can prevent heart attacks and strokes -- even in people with normal blood pressure. That's the finding of late breaking research presented in a Hot Line session today at ESC Congress 2020.

"Greater drops in blood pressure with medication lead to greater reductions in the risk of heart attacks and strokes," said principal investigator Professor Kazem Rahimi of the University of Oxford, UK. "This holds true regardless of the starting blood pressure level, in people who previously had a heart attack or stroke, and in people who have never had heart disease."

"The fact that the relative effects are similar for everyone does not mean that everyone should be treated," he added. "This decision will depend on an individual's likelihood of suffering cardiovascular disease in the future -- there are a number of risk calculators health professionals can use. Other factors to consider are the potential for side effects and the cost of treatment."

There has been controversy about whether pharmacological blood pressure lowering is equally beneficial in people with versus without a prior heart attack or stroke, and when blood pressure is below the threshold for hypertension (typically 140/90 mmHg). Evidence from previous studies has been inconclusive, leading to contradictory treatment recommendations around the world.

This was the largest -- and most detailed -- study ever conducted to examine these questions. The researchers combined data on individuals who had participated in a randomised clinical trial and conducted a meta-analysis. The study included 348,854 participants from 48 trials.

Participants were divided into two groups: those with a prior diagnosis of cardiovascular disease and those without. Each group was divided into seven subgroups based on systolic blood pressure at study entry (less than 120, 120-129, 130-139, 140-149, 150-159, 160-169, 170 and above mmHg).

Over an average four years of follow-up, each 5 mmHg reduction in systolic blood pressure lowered the relative risk of major cardiovascular events by about 10%. The risks for stroke, ischaemic heart disease, heart failure and death from cardiovascular disease were reduced by 13%, 7% and 14% and 5%, respectively.

Neither the presence of cardiovascular disease nor the level of blood pressure at study entry modified the effect of treatment.

Professor Rahimi said: "The decision to prescribe blood pressure medication should not be based simply on a prior diagnosis of cardiovascular disease or an individual's current blood pressure. Rather, blood pressure medication should be viewed as an effective tool for reducing cardiovascular risk when an individual's probability of having a heart attack or stroke is elevated."

https://www.sciencedaily.com/releases/2020/09/200901094058.htm

Sleep restriction amplifies anger

August 28, 2020

Science Daily/American Academy of Sleep Medicine

Feeling angry these days? New research suggests that a good night of sleep may be just what you need.

This program of research comprised an analysis of diaries and lab experiments. The researchers analyzed daily diary entries from 202 college students, who tracked their sleep, daily stressors, and anger over one month. Preliminary results show that individuals reported experiencing more anger on days following less sleep than usual for them.

The research team also conducted a lab experiment involving 147 community residents. Participants were randomly assigned either to maintain their regular sleep schedule or to restrict their sleep at home by about five hours across two nights. Following this manipulation, anger was assessed during exposure to irritating noise.

The experiment found that well-slept individuals adapted to noise and reported less anger after two days. In contrast, sleep-restricted individuals exhibited higher and increased anger in response to aversive noise, suggesting that losing sleep undermined emotional adaptation to frustrating circumstance. Subjective sleepiness accounted for most of the experimental effect of sleep loss on anger. A related experiment in which individuals reported anger following an online competitive game found similar results.

"The results are important because they provide strong causal evidence that sleep restriction increases anger and increases frustration over time," said Zlatan Krizan, who has a doctorate in personality and social psychology and is a professor of psychology at Iowa State University in Ames, Iowa. "Moreover, the results from the daily diary study suggest such effects translate to everyday life, as young adults reported more anger in the afternoon on days they slept less."

The authors noted that the findings highlight the importance of considering specific emotional reactions such as anger and their regulation in the context of sleep disruption.

https://www.sciencedaily.com/releases/2020/08/200828204952.htm

Atheists are more likely to sleep better than Catholics and Baptists

August 28, 2020

Science Daily/American Academy of Sleep Medicine

A new study of sleep, religious affiliation, and perceptions of heaven found that atheists and agnostics are significantly more likely to be better sleepers than Catholics and Baptists.

Preliminary results show that 73% of atheists and agnostics reported getting seven or more hours of nightly sleep, which is recommended by the American Academy of Sleep Medicine to promote optimal health. In contrast, 63% of Catholics and only 55% of Baptists reported sleeping at least seven hours per night. Atheists and agnostics also reported experiencing less difficulty falling asleep.

"Mental health is increasingly discussed in church settings -- as it should be -- but sleep health is not discussed," said lead author Kyla Fergason, a student at Baylor University in Waco, Texas. "Yet we know that sleep loss undercuts many human abilities that are considered to be core values of the church: being a positive member of a social community, expressing love and compassion rather than anger or judgment, and displaying integrity in moral reasoning and behavior. Could getting better sleep help some people grow in their faith or become better Christians? We don't know the answer to that question yet, but we do know that mental, physical and cognitive health are intertwined with sleep health in the general population."

The study involved a population-based sample of 1,501 participants in the Baylor Religion Survey, which includes questions on religious affiliation, behaviors, and perceptions. Participants also rated their difficulty falling asleep and their average total sleep time.

Results also show that those participants who reported sleeping seven or more hours per night were significantly more likely to believe that they would get into heaven. However, these perceptions of heaven were unrelated to difficulty falling asleep at night. According to the authors, this pattern indicates that better sleep leads to a more optimistic outlook, which in this case is manifesting as positive expectations of getting into heaven.

The research abstract was published recently in an online supplement of the journal Sleep and will be presented as a poster Aug. 28-30 during Virtual SLEEP 2020. SLEEP is the annual meeting of the Associated Professional Sleep Societies, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

https://www.sciencedaily.com/releases/2020/08/200828204948.htm

American Academy of Sleep Medicine calls for elimination of daylight saving time

August 27, 2020

Science Daily/American Academy of Sleep Medicine

Public health and safety would benefit from eliminating daylight saving time, according to a position statement from the American Academy of Sleep Medicine.

The AASM supports a switch to permanent standard time, explaining in the statement that standard time more closely aligns with the daily rhythms of the body's internal clock. The position statement also cites evidence of increased risks of motor vehicle accidents, cardiovascular events, and mood disturbances following the annual "spring forward" to daylight saving time.

"Permanent, year-round standard time is the best choice to most closely match our circadian sleep-wake cycle," said lead author Dr. M. Adeel Rishi, a pulmonology, sleep medicine and critical care specialist at the Mayo Clinic in Eau Claire, Wisconsin, and vice chair of the AASM Public Safety Committee. "Daylight saving time results in more darkness in the morning and more light in the evening, disrupting the body's natural rhythm."

The position statement, published online as an accepted paper in the Journal of Clinical Sleep Medicine, outlines the acute effects of daylight saving time, which range from increased risk of stroke and hospital admissions to sleep loss and increased production of inflammatory markers, one of the body's responses to stress. In addition, studies show that traffic fatalities have increased as much as six percent in the first few days following the change to daylight saving time, and a recently published research abstract found an 18 percent increase in adverse medical events related to human error in the week after switching to daylight saving time.

"There is ample evidence of the negative, short-term consequences of the annual change to daylight saving time in the spring," said AASM President Dr. Kannan Ramar. "Because the adoption of permanent standard time would be beneficial for public health and safety, the AASM will be advocating at the federal level for this legislative change."

In July, an AASM survey of more than 2,000 U.S. adults found that 63 percent support the elimination of seasonal time changes in favor of a national, fixed, year-round time, and only 11 percent oppose it. Additionally, a 2019 survey by the AASM found that 55 percent of adults feel extremely or somewhat tired after the spring change to daylight saving time.

The AASM position statement on daylight saving time has been endorsed by the following organizations:

• American Academy of Cardiovascular Sleep Medicine

• American Academy of Dental Sleep Medicine

• American College of Chest Physicians (CHEST)

• American College of Occupational and Environmental Medicine

• California Sleep Society

• Dakotas Sleep Society

• Kentucky Sleep Society

• Maryland Sleep Society

• Michigan Academy of Sleep Medicine

• Missouri Sleep Society

• National PTA

• National Safety Council

• Society of Anesthesia and Sleep Medicine

• Society of Behavioral Sleep Medicine

• Southern Sleep Society

• Start School Later

• Tennessee Sleep Society

• Wisconsin Sleep Society

• World Sleep Society.

https://www.sciencedaily.com/releases/2020/08/200827150951.htm

Got fatigue? Study further pinpoints brain regions that may control it

August 26, 2020

Science Daily/Johns Hopkins Medicine

Scientists at Johns Hopkins Medicine using MRI scans and computer modeling say they have further pinpointed areas of the human brain that regulate efforts to deal with fatigue.

The findings, they say, could advance the development of behavioral and other strategies that increase physical performance in healthy people, and also illuminate the neural mechanisms that contribute to fatigue in people with depression, multiple sclerosis and stroke.

Results of the research were published online Aug. 12 in Nature Communications.

"We know the physiologic processes involved in fatigue, such as lactic acid build-up in muscles, but we know far less about how feelings of fatigue are processed in the brain and how our brain decides how much and what kind of effort to make to overcome fatigue," says Vikram Chib, Ph.D., assistant professor of biomedical engineering at the Johns Hopkins University School of Medicine and research scientist at the Kennedy Krieger Institute.

Knowing the brain regions that control choices about fatigue-moderating efforts can help scientists find therapies that precisely alter those choices, says Chib. "It might not be ideal for your brain to simply power through fatigue," says Chib. "It might be more beneficial for the brain to be more efficient about the signals it's sending."

For the study, Chib first developed a novel way to objectively quantify how people "feel" fatigue, a difficult task because rating systems can vary from person to person. Physicians often ask their patients to rate their fatigue on a scale of 1 to 7, but like pain scales, such ratings are subjective and varied.

To standardize the metric for fatigue, Chib asked 20 study participants to make risk-based decisions about exerting a specific physical effort. The average age of participants was 24 and ranged from 18 to 34. Nine of the 20 were female.

The 20 participants were asked to grasp and squeeze a sensor after training them to recognize a scale of effort. For example, zero was equal to no effort and 50 units of effort were equal to half the participant's maximum force. The participants learned to associate units of effort with how much to squeeze, which helped to standardize the effort level among individuals.

The participants repeated the grip exercises for 17 blocks for 10 trials each, until they were fatigued, then were offered one of two choices for making each effort. One was a random ("risky") choice based on a coin flip, offering the chance to exert no effort or a predetermined effort level. The other choice was a predetermined set effort level. By introducing uncertainty, the researchers were tapping in to how each subject valued their effort -- a way, in effect, of shedding light on how their brains and minds decided how much effort to make.

Based on whether the participant chose a risky option versus the predetermined one, the researchers used computerized programs to measure how participants felt about the prospect of exerting particular amounts of effort while they were fatigued.

"Unsurprisingly, we found that people tend to be more risk averse -- to avoid -- effort," says Chib. Most of the participants (19 of 20) opted for the risk-free choice of a predetermined effort level. This means that, when fatigued, participants were less willing to take the chance of having to exert large amounts of effort.

"The predetermined amount had to get pretty high in relative effort for participants to choose the coin toss option," says Chib.

Among a separate group of 10 people trained on the gripping system but not given numerous, fatiguing trials, there was no significant tendency toward picking either the risky coin toss or defined effort.

Chib's research team also evaluated participants' brain activity during the gripping exercises using functional magnetic resonance imaging (fMRI) scans, which track blood flow through the brain and show which neurons are firing most often.

Chib's team confirmed previous findings that brain activity when participants chose between the two options seemed to increase in all participants in an area of the brain's known as the insula.

Also using fMRI scans, they took a closer look at the motor cortex of the brain when the participants were fatigued. This region of the brain is responsible for exerting the effort itself.

The researchers found that the motor cortex was deactivated at the time participants "decided" between the two effort choices. That finding is consistent, Chib says, with previous studies showing that when people perform repeated fatiguing exertions, motor cortex activity is decreased, associated with fewer signals being sent down to the muscles.

Participants whose motor cortex activity changed the least, in response to fatiguing exertion, were the ones who were most risk averse in their effort choices and were most fatigued. This suggests that fatigue might arise from a miscalibration between what an individual thinks they are able to achieve and the actual activity in motor cortex.

Essentially, the body attunes to the motor cortex when fatigued, because if the brain kept sending more signals to muscles to act, physiological constraints would begin to take over, for example, increased lactic acid, contributing to even more fatigue.

These findings, says Chib, may advance the search for therapies -- physical or chemical -- that target this pathway in healthy people to advance performance and in people with conditions that are associated with fatigue.

https://www.sciencedaily.com/releases/2020/08/200826113713.htm

Social connection is the strongest protective factor for depression

August 14, 2020

Science Daily/Massachusetts General Hospital

Researchers from Massachusetts General Hospital (MGH) have identified a set of modifiable factors from a field of over 100 that could represent valuable targets for preventing depression in adults. In a study published in The American Journal of Psychiatry, the team named social connection as the strongest protective factor for depression, and suggested that reducing sedentary activities such as TV watching and daytime napping could also help lower the risk of depression.

"Depression is the leading cause of disability worldwide, but until now researchers have focused on only a handful of risk and protective factors, often in just one or two domains," says Karmel Choi, PhD, investigator in the Department of Psychiatry and the Harvard T.H. Chan School of Public Health, and lead author of the paper. "Our study provides the most comprehensive picture to date of modifiable factors that could impact depression risk."

To that end, researchers took a two-stage approach. The first stage drew on a database of over 100,000 participants in the UK Biobank -- a world-renowned cohort study of adults -- to systematically scan a wide range of modifiable factors that might be associated with the risk of developing depression, including social interaction, media use, sleep patterns, diet, physical activity, and environmental exposures. This method, known as an exposure-wide association scan (ExWAS), is analogous to genome-wide association studies (GWAS) that have been widely used to identify genetic risk factors for disease. The second stage took the strongest modifiable candidates from ExWAS and applied a technique called Mendelian randomization (MR) to investigate which factors may have a causal relationship to depression risk. MR is a statistical method that treats genetic variation between people as a kind of natural experiment to determine whether an association is likely to reflect causation rather than just correlation.

This two-stage approach allowed the MGH researchers to narrow the field to a smaller set of promising and potentially causal targets for depression. "Far and away the most prominent of these factors was frequency of confiding in others, but also visits with family and friends, all of which highlighted the important protective effect of social connection and social cohesion," points out Jordan Smoller, MD, ScD associate chief for research in the MGH Department of Psychiatry, and senior author of the study. "These factors are more relevant now than ever at a time of social distancing and separation from friends and family." The protective effects of social connection were present even for individuals who were at higher risk for depression as a result of genetic vulnerability or early life trauma.

On the other hand, factors associated with depression risk included time spent watching TV, though the authors note that additional research is needed to determine if that risk was due to media exposure per se or whether time in front of the TV was a proxy for being sedentary. Perhaps more surprising, the tendency for daytime napping and regular use of multivitamins appeared to be associated with depression risk, though more research is needed to determine how these might contribute.

The MGH study demonstrates an important new approach for evaluating a wide range of modifiable factors, and using this evidence to prioritize targets for preventive interventions for depression. "Depression takes an enormous toll on individuals, families, and society, yet we still know very little about how to prevent it," says Smoller. "We've shown that it's now possible to address these questions of broad public health significance through a large-scale, data-based approach that wasn't available even a few years ago. We hope this work will motivate further efforts to develop actionable strategies for preventing depression." The study's two-stage approach could also be used to inform the prevention of other health conditions.

https://www.sciencedaily.com/releases/2020/08/200814131007.htm

None of the most common blood pressure medications increased the risk of depression, some lowered the risk

August 24, 2020

Science Daily/American Heart Association

Among the 41 most common blood pressure medications, none of them raised the risk of depression, according to an analysis from Denmark. The study also found that some high blood pressure medications lowered the risk of depression. These findings may help guide medical professionals in selecting the right hypertension medication, particularly for people with a personal or family history of depression.

Depression is common among patients with high blood pressure (also called hypertension), heart disease and stroke, and this is the first study to systematically investigate whether individual blood pressure medications might influence the risk of developing depression.

"It was highly surprising that none of the 41 most-used anti-hypertensives was associated with increased risk of developing depression and that some within each of the three classes of anti-hypertensives showed protective effects against depression," said Lars Vedel Kessing, M.D., D.M.Sc., lead author of the study and professor of psychiatry at the Psychiatric Center Copenhagen and the University of Copenhagen, Faculty of Health and Medical Sciences in Denmark.

Researchers analyzed real-life data on more than 3.7 million adults who took any of the 41 most-commonly prescribed high blood pressure medications, as reported in health records across several Danish health registries from 2005 to 2015. Thirty-seven of these medications are approved for use in the U.S. by the U.S. Food and Drug Administration. Patients who had been diagnosed with depression or previously prescribed antidepressants were excluded.

The four main categories of blood pressure-lowering medications were reviewed: angiotensin agents (angiotensin converting enzyme inhibitors, ACE inhibitors and angiotensin II receptor blockers, or ARBs); calcium antagonists; beta-blockers; and diuretics.

The analysis found:

None of the 41 most common high blood pressure medications increased the risk of depression. 

Nine medications -- a few within each category -- significantly lowered depression risk: 2 of 16 angiotensin agents, 3 of 10 calcium antagonists and 4 of 15 beta-blockers.

Diuretic medications showed no impact on depression risk.

The nine individual high blood pressure medications found to significantly lower depression risk are enalapril and ramipril (angiotensin agents); amlodipine, verapamil and verapamil combinations (calcium antagonists); and propranolol, atenolol, bisoprolol and carvedilol (beta-blockers). All nine are approved for prescribing in the U.S.

"It is possible that the mechanism involved in decreasing the risk of depression is the anti-inflammatory effect among these nine medications," Kessing continued. "In the future, it will be important to compare the inflammatory properties of these nine hypertensives that lowered depression risk." (Low-grade inflammation is common in high blood pressure and heart disease, as well as in depression.)

"Our study's findings could help guide prescriptions for patients with high blood pressure who are at risk of developing depression, those with prior depression or anxiety, and patients with a family history of depression," said Kessing. "However, if a patient is doing well with their current blood pressure prescription, there is no reason to switch. If depression develops, a medication switch may be considered to one of the nine anti-hypertensive medications that lowered depression risk."

The findings of this study are likely generalizable to other populations. However, limitations of the study include it relied on a clinical diagnosis of depression, that it was not a controlled clinical trial that randomly selected which medication patients receive, and that the impact on depression risk was analyzed for each high blood pressure medication individually; they were not tested side by side or as combinations of one or more other antihypertensive medications.

https://www.sciencedaily.com/releases/2020/08/200824092017.htm

This online calculator can predict your stroke risk

August 14, 2020

Science Daily/University of Virginia Health System

Doctors can predict patients' risk for ischemic stroke based on the severity of their metabolic syndrome, a conglomeration of conditions that includes high blood pressure, abnormal cholesterol levels and excess body fat around the abdomen and waist, a new study finds.

The study found that stroke risk increased consistently with metabolic syndrome severity even in patients without diabetes. Doctors can use this information -- and a scoring tool developed by a UVA Children's pediatrician and his collaborator at the University of Florida -- to identify patients at risk and help them reduce that risk.

"We had previously shown that the severity of metabolic syndrome was linked to future coronary heart disease and type 2 diabetes," said UVA's Mark DeBoer, MD. "This study showed further links to future ischemic strokes."

Ischemic Stroke Risk

DeBoer developed the scoring tool, an online calculator to assess the severity of metabolic syndrome, with Matthew J. Gurka, PhD, of the Department of Health Outcomes and Biomedical Informatics at the University of Florida, Gainesville. The tool is available for free at https://metscalc.org/.

To evaluate the association between ischemic stroke and metabolic syndrome, DeBoer and Gurka reviewed more than 13,000 participants in prior studies and their stroke outcomes. Among that group, there were 709 ischemic strokes over a mean period of 18.6 years assessed in the studies. (Ischemic strokes are caused when blood flow to the brain is obstructed by blood clots or clogged arteries. Hemorrhagic strokes, on the other hand, are caused when blood vessels rupture.)

The researchers used their tool to calculate "Z scores" measuring the severity of metabolic syndrome among the study participants. They could then analyze the association between metabolic syndrome and ischemic stroke risk.

The subgroup with the highest association between metabolic syndrome and risk for ischemic stroke was white women, the researchers found. In this group, the research team was able to identify relationships between the individual contributors to metabolic syndrome, such as high blood pressure, and stroke risk.

The researchers note that race and sex did not seem to make a major difference in stroke risk overall, and they caution that the increased risk seen in white women could be the results of chance alone. "Nevertheless," they write in a new scientific article outlining their findings, "these results are notable enough that they may warrant further study into race and sex differences."

The overall relationship between metabolic syndrome severity and stroke risk was clear, however. And this suggests people with metabolic syndrome can make lifestyle changes to reduce that risk. Losing weight, exercising more, choosing healthy foods -- all can help address metabolic syndrome and its harmful effects.

DeBoer hopes that the tool he and Gurka developed will help doctors guide patients as they seek to reduce their stroke risk and improve their health and well-being.

"In case there are still individuals out there debating whether to start exercising or eating a healthier diet," DeBoer said, "this study provides another wake-up call to motivate us all toward lifestyle changes."

https://www.sciencedaily.com/releases/2020/08/200814101659.htm

Stress and anger may exacerbate heart failure

August 12, 2020

Science Daily/Yale University

Mental stress and anger may have clinical implications for patients with heart failure according to a new report published in the Journal of Cardiac Failure.

Heart failure is a life-threatening cardiovascular disease in which the heart is damaged or weakened. This can lead to a reduced ejection fraction, in which the heart muscle pumps out a lower amount of blood than is typical with each contraction.

In this study of patients who had heart failure with reduced ejection fraction, the authors -- including researchers at Yale -- evaluated the effects of stress and anger on diastolic function. Diastolic function describes the ability of the heart to relax and refill between muscle contractions and is predictive of mortality risk.

For one week, participants completed daily questionnaires about their experiences of stress, anger, and negative emotions during the previous 24 hours. Participants then completed a standardized "mental stress" protocol in which they solved challenging arithmetic problems and described a recent stressful experience. Echocardiograms were performed to assess diastolic function at rest and during the stress task.

Patients who reported experiencing anger in the week prior to the laboratory mental stress protocol exhibited worse baseline resting diastolic pressure, the researchers said. Furthermore, most patients demonstrated stress-provoked changes in diastolic function, including decreased early relaxation and increased diastolic pressure.

"Mental stress is common in patients with heart failure due in part to the complexities of disease self-management, progressively worsening functional limitations, and frequent symptom exacerbations and hospitalizations," said the lead author Kristie Harris, a postdoctoral associate in cardiovascular medicine at Yale.

"We have evidence that patients who experience chronically elevated levels of stress experience a more burdensome disease course with diminished quality of life and increased risk for adverse events. Clarifying the relevant behavioral and physiological pathways is especially important in the era of COVID-19 when the typical stressors of heart failure may be further compounded by pandemic-related stressors," Harris said.

"Factors such as mental stress and anger often go unrecognized and are under-addressed," said Matthew Burg, a Yale clinical psychologist and senior author of the study. "This study contributes to the extensive literature showing that stress and anger affect clinical outcomes for patients with heart disease, adding chronic heart failure to the list that includes ischemic heart disease (narrowed arteries) and arrhythmic disease."

Burg said that while stress management and related techniques have been shown to reduce risk for adverse events among patients with ischemic heart disease (narrowed arteries), further work is needed to identify factors that increase vulnerability to the effects of stress in heart failure, and to determine whether stress management can improve outcomes for these patients.

https://www.sciencedaily.com/releases/2020/08/200812144020.htm

Pinpointing the cells that keep the body's master circadian clock ticking

A new mouse model helps researchers study the roles of cell types in keeping time inside the body

August 7, 2020

Science Daily/UT Southwestern Medical Center

UT Southwestern scientists have developed a genetically engineered mouse and imaging system that lets them visualize fluctuations in the circadian clocks of cell types in mice. The method, described online in the journal Neuron, gives new insight into which brain cells are important in maintaining the body's master circadian clock. But they say the approach will also be broadly useful for answering questions about the daily rhythms of cells throughout the body.

"This is a really important technical resource for advancing the study of circadian rhythms," says study leader Joseph Takahashi, Ph.D., chair of the department of neuroscience at UT Southwestern Medical Center, a member of UT Southwestern's Peter O'Donnell Jr. Brain Institute, and an investigator with the Howard Hughes Medical Institute (HHMI). "You can use these mice for many different applications."

Nearly every cell in humans -- and mice -- has an internal circadian clock that fluctuates on a roughly 24-hour cycle. These cells help dictate not only hunger and sleep cycles, but biological functions such as immunity and metabolism. Defects in the circadian clock have been linked to diseases including cancer, diabetes, and Alzheimer's, as well as sleep disorders. Scientists have long known that a small part of the brain -- called the suprachiasmatic nucleus (SCN) -- integrates information from the eyes about environmental light and dark cycles with the body's master clock. In turn, the SCN helps keep the rest of the cells in the body in sync with each other.

"What makes the SCN a very special kind of clock is that it's both robust and flexible," says Takahashi. "It's a very strong pacemaker that doesn't lose track of time, but at the same time can shift to adapt to seasons, changing day lengths, or travel between time zones."

To study the circadian clock in both the SCN and the rest of the body, Takahashi's research group previously developed a mouse that had a bioluminescent version of PER2 -- one of the key circadian proteins whose levels fluctuate over the course of a day. By watching the bioluminescence levels wax and wane, the researchers could see how PER2 cycled throughout the animals' bodies during the day. But the protein is present in nearly every part of the body, sometimes making it difficult to distinguish the difference in circadian cycles between different cell types mixed together in the same tissue.

"If you observe a brain slice, for instance, almost every single cell has a PER2 signal, so you can't really distinguish where any particular PER2 signal is coming from," says Takahashi.

In the new work, the scientists overcame this problem by turning to a new bioluminescence system that changed color -- from red to green -- only in cells that expressed a particular gene known as Cre. Then, the researchers could engineer mice so that Cre, which is not naturally found in mouse cells, was only present in one cell type at a time.

To test the utility of the approach, Takahashi and his colleagues studied two types of cells that make up the brain's SCN -- arginine vasopressin (AVP) and vasoactive intestinal polypeptide (VIP) cells. In the past, scientists have hypothesized that VIP neurons hold the key to keeping the rest of the SCN synchronized.

When the research team looked at VIP neurons -- expressing Cre in just those cells, so that PER2 luminesced green in VIP cells, while red elsewhere -- they found that removing circadian genes from the neurons had little overall effect on the circadian rhythms of the VIP neurons, or the rest of the SCN. "Even when VIP neurons no longer had a functioning clock, the rest of the SCN behaved essentially the same," explains Yongli Shan, Ph.D., a UTSW research scientist and lead author of the study. Nearby cells were able to signal to the VIP neurons to keep them in sync with the rest of the SCN, he says.

When they repeated the same experiment on AVP neurons, however -- removing key clock genes -- not only did AVP neurons themselves show disrupted rhythms, but the entire SCN stopped synchronously cycling on its usual 24-hour rhythm.

"What this showed us was that the clock in AVP neurons is really essential for the synchrony of the whole SCN network," says Shan. "That's a surprising result and somewhat counterintuitive, so we hope it leads to more work on AVP neurons going forward."

Takahashi says other researchers who study circadian rhythms have already requested the mouse line from his lab to study the daily cycles of other cells. The mice might allow scientists to hone in on the differences in circadian rhythms between cell types within a single organ, or how tumor cells cycle differently than healthy cells, he says.

"In all sorts of complex or diseased tissues, this can let you see which cells have rhythms and how they might be similar or different from the rhythms of other cell types."

https://www.sciencedaily.com/releases/2020/08/200807111938.htm

Vitamin D twice a day may keep vertigo away

August 5, 2020

Science Daily/American Academy of Neurology

Taking vitamin D and calcium twice a day may reduce your chances of getting vertigo again, according to a study published in the August 5, 2020, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"Our study suggests that for people with benign paroxysmal positional vertigo, taking a supplement of vitamin D and calcium is a simple, low-risk way to prevent vertigo from recurring," said Ji-Soo Kim, M.D., Ph.D., of Seoul National University College of Medicine in Korea. "It is especially effective if you have low vitamin D levels to begin with."

Benign paroxysmal positional vertigo happens when a change in head position gives you a sudden spinning sensation. It's one of the most common types of vertigo. Treatment includes a doctor performing a series of head movements that shift particles in the ears that cause the vertigo, but the condition tends to recur frequently. About 86% of people with this form of vertigo find that it interrupts their daily life or causes them to miss days at work.

The study looked at 957 people in Korea with benign paroxysmal positional vertigo who were treated successfully with the head movements. The participants were separated into two groups, intervention and observation.

The 445 people in the intervention group had their vitamin D levels taken at the start of the study. The 348 people with vitamin D levels below 20 nanograms per milliliter (ng/mL) were started on supplements with 400 international units of vitamin D and 500 milligrams of calcium twice daily, while those with vitamin D levels equal to or greater than 20 ng/mL were not given supplements.

The 512 people in the observation group did not have their vitamin D levels monitored and they did not get supplements.

Those in the intervention group who took the supplements had a lower recurrence rate for vertigo episodes after an average of one year than those in the observation group. People taking supplements had an average recurrence rate of 0.83 times per person-year, compared to 1.10 times per person-year for those in the observation group, or a 24% reduction in the annual recurrence rate.

There appeared to be greater benefit for those who were more deficient in vitamin D at the start of the study. Those who started with vitamin D levels lower than 10 ng/mL saw a 45% reduction in annual recurrence rate, while those starting with vitamin D levels at 10 to 20 ng/mL saw only a 14% reduction. A total of 38% of the people in the interventional group had another episode of vertigo, compared to 47% of those in the observation group.

"Our results are exciting because so far, going to the doctor to have them perform head movements has been the main way we treat benign paroxysmal positional vertigo," said Kim. "Our study suggests an inexpensive, low-risk treatment like vitamin D and calcium tablets may be effective at preventing this common, and commonly recurring, disorder."

A limitation of the study is that a large number of participants did not complete the entire study, with more people assigned to take the supplements dropping out of the study than in the observation group.

https://www.sciencedaily.com/releases/2020/08/200805160933.htm

REM sleep tunes eating behavior

August 6, 2020

Science Daily/University of Bern

Despite our broad understanding of the different brain regions activated during rapid-eye-movement sleep, little is known about what this activity serves for. Researchers at the University of Bern and the Inselspital have now discovered that the activation of neurons in the hypothalamus during REM sleep regulates eating behaviour: suppressing this activity in mice decreases appetite.

While we are asleep, we transition between different phases of sleep each of which may contribute differently to us feeling rested. During (rapid eye movement) REM sleep, a peculiar sleep stage also called paradoxical sleep during which most dreaming occurs, specific brain circuits show very high electrical activity, yet the function of this sleep-specific activity remains unclear.

Among the brain regions that show strong activation during REM sleep are areas that regulate memory functions or emotion, for instance. The lateral hypothalamus, a tiny, evolutionarily well conserved brain structure in all mammals also shows high activity during REM sleep. In the awake animals, neurons from this brain region orchestrate appetite and the consumption of food and they are involved in the regulation of motivated behaviours and addiction.

In a new study, researchers headed by Prof. Dr. Antoine Adamantidis at the University of Bern set out to investigate the function of the activity of hypothalamic neurons in mice during REM sleep. They aimed at better understanding how neural activation during REM sleep influences our day-to-day behaviour. They discovered that suppressing the activity of these neurons decreases the amount of food the mice consume. "This suggests that REM sleep is necessary to stabilize food intake," says Adamantidis. The results of this study have been published in the journal Proceedings of the National Academy of Sciences (PNAS).

Long-lasting effect on neuronal activity and feeding behavior

The researcher discovered that specific activity patterns of neurons in the lateral hypothalamus that usually signal eating in the awake mouse are also present when the animals were in the stage of REM sleep. To assess the importance of these activity patterns during REM sleep the research group used a technique called optogenetics, with which they used light pulses to precisely shut down the activity of hypothalamic neurons during REM sleep. As a result, the researchers found that the activity patterns for eating were modified and that the animals consumed less food.

"We were surprised how strongly and persistently our intervention affected the neural activity in the lateral hypothalamus and the behaviour of the mice," says Lukas Oesch, the first author of the study. He adds: "The modification in the activity patterns was still measurable after four days of regular sleep." These findings suggest that electrical activity in hypothalamic circuits during REM sleep are highly plastic and essential to maintain a stable feeding behaviour in mammals.

It is a question of quality

These findings point out that sleep quantity alone is not solely required for our well-being, but that sleep quality plays a major role in particular to maintain appropriate eating behaviour. "This is of particular relevance in our society where not only sleep quantity decreases but where sleep quality is dramatically affected by shift work, late night screen exposure or social jet-lag in adolescents," explains Adamantidis.

The discovered link between the activity of the neurons during REM sleep and eating behaviour may help developing new therapeutical approaches to treat eating disorders. It might also be relevant for motivation and addiction. "However, this relationship might depend on the precise circuitry, the sleep stage and other factors yet to be uncovered," adds Adamantidis.

https://www.sciencedaily.com/releases/2020/08/200806111820.htm

Gut feelings help promote positive body image

Study finds association between feeling full and positive body image

July 30, 2020

Science Daily/Anglia Ruskin University

New research has found that paying greater attention to internal bodily sensations can increase our appreciation of our own bodies.

The study, led by Jennifer Todd of Anglia Ruskin University (ARU) and published in the journal Body Image, focused on gastric interoception, which are the feelings of hunger or fullness that originate in the gut.

The researchers carried out an experiment involving 191 adults in the UK and Malaysia fasting and then consuming water.

They measured both the quantity of water consumed in relation to stomach capacity, and the feelings and experiences of the adults during the task. This included completing questionnaires examining different aspects of body image, such as appreciation of the body and appreciation of the body's functionality.

Body image refers to appearance-related thoughts and feelings, and positive body image refers specifically to an active love, respect, and appreciation for one's body.

The study found that a greater change in the intensity of feelings in the gut after consuming water was associated with significantly higher levels of appreciation of the body and appreciation of the body's functionality for adults in both the UK and Malaysia.

Lead author Jennifer Todd, a Psychology PhD student at Anglia Ruskin University (ARU), said: "Our study shows a clear link between bodily awareness, in this case the feeling of fullness, and body image. In other words, people who are more in tune with their body's internal workings have a greater appreciation of their body in general. Interestingly, we found that this link exists in two very different countries.

"We think that greater sensitivity to gastric signals might increase awareness of the positive functions the body performs and improve the ability to respond to the body's needs, both of which promote positive body image.

"Individuals who are less in tune with internal stimuli, such as feeling full, could be more at risk of developing negative body image, due to an over-reliance on external, appearance-related characteristics such as shape and size.

"It is possible that body image can be promoted by encouraging people to be more aware of internal sensations, such as feeling full. Gut feelings can be good for you!"

https://www.sciencedaily.com/releases/2020/07/200730205826.htm

Major depressive episodes far more common than previously believed

July 30, 2020

Science Daily/Yale School of Public Health

The number of adults in the United States who suffer from major depressive episodes at some point in their life is far higher than previously believed, a new study by the Yale School of Public Health finds.

National survey data currently shows that approximately 17% of women and 10% of men report having a history of major depressive episodes (MDEs) in their lifetimes. But these data are subject to "recall error," or the tendency of people to forget or misreport their health histories when taking a survey.

Researchers led by Jamie Tam, Ph.D., assistant professor in the Department of Health Policy and Management, created a simulation model to generate corrected estimates of lifetime depression. They found that the proportion of U.S. adults who have had MDEs is actually closer to 30% of women and 17% of men after factoring in recall error.

"Major depressive episodes are far more common than we thought," said Tam. "Our model shows that the probability of someone having a first major depressive episode is especially high during adolescence. We also know from other research that having a first major depressive episode increases the likelihood you'll have a second one. This means that anything we can do to prevent or treat episodes among young people could lead to larger health benefits over the course of their life."

The findings are published in the American Journal of Preventive Medicine.

A major depressive episode is defined as a period of two weeks or longer in which a person experiences feelings of intense sadness and hopelessness, fatigue, weight gain or weight loss, changes in sleeping habits, loss of interest in activities and thoughts of suicide or attempts at suicide. These persistent symptoms cannot be easily changed, even if they are contradictory to a person's circumstances. Depressive episodes typically recur periodically in people diagnosed with major depression.

The study shows that mental health programs that screen for, prevent and treat depression could benefit a much larger segment of the population than previously thought, Tam said.

"If you think about chronic health conditions like heart disease, we do a lot to identify people who might be at risk for additional health events like heart attacks because that group would benefit from maintenance treatment and clinical monitoring," Tam said. "We don't do such a great job when it comes to mental health conditions. So, if we're able to assess how many people actually have histories of depression, that also tells us that more people are at risk of experiencing more depressive episodes."

The researchers also found that older adults are especially likely to under-report their history of having depressive symptoms. Among adults 65 years and older, underreporting for depression was as high as 70%. Older adults often experience what is referred to as "minor depression," where they still report significant depressive symptoms but don't always meet clinical requirements for major depression. Tam said there may be a tendency for older adults to downplay negative experiences of depression from when they were younger, classifying them as "growing pains" rather than major depression.

"Unfortunately, many people with depression or with histories of depression don't access, or don't have access to, treatment or support," Tam said. "There's a broader problem in our society of mental health not receiving the same attention and investment of resources compared to physical health conditions."

https://www.sciencedaily.com/releases/2020/07/200730132813.htm

Laughter acts as a stress buffer -- and even smiling helps

July 30, 2020

Science Daily/University of Basel

People who laugh frequently in their everyday lives may be better equipped to deal with stressful events -- although this does not seem to apply to the intensity of laughter. These are the findings reported by a research team from the University of Basel in the journal PLOS ONE.

It is estimated that people typically laugh 18 times a day -- generally during interactions with other people and depending on the degree of pleasure they experience. Researchers have also reported differences related to time of day, age, and gender -- for example, it is known that women smile more than men on average. Now, researchers from the Division of Clinical Psychology and Epidemiology of the Department of Psychology at the University of Basel have recently conducted a study on the relationship between stressful events and laughter in terms of perceived stress in everyday life.

Questions asked by app

In the intensive longitudinal study, an acoustic signal from a mobile phone app prompted participants to answer questions eight times a day at irregular intervals for a period of 14 days. The questions related to the frequency and intensity of laughter and the reason for laughing -- as well as any stressful events or stress symptoms experienced -- in the time since the last signal.

Using this method, the researchers working with the lead authors, Dr. Thea Zander-Schellenberg and Dr. Isabella Collins, were able to study the relationships between laughter, stressful events, and physical and psychological symptoms of stress ("I had a headache" or "I felt restless") as part of everyday life. The newly published analysis was based on data from 41 psychology students, 33 of whom were women, with an average age of just under 22.

Intensity of laughter has less influence

The first result of the observational study was expected based on the specialist literature: in phases in which the subjects laughed frequently, stressful events were associated with more minor symptoms of subjective stress. However, the second finding was unexpected. When it came to the interplay between stressful events and intensity of laughter (strong, medium or weak), there was no statistical correlation with stress symptoms. "This could be because people are better at estimating the frequency of their laughter, rather than its intensity, over the last few hours," says the research team.

https://www.sciencedaily.com/releases/2020/07/200730110114.htm

Hedonism leads to happiness

July 27, 2020

Science Daily/University of Zurich

Relaxing on the sofa or savoring a delicious meal: Enjoying short-term pleasurable activities that don't lead to long-term goals contributes at least as much to a happy life as self-control, according to new research from the University of Zurich and Radboud University in the Netherlands. The researchers therefore argue for a greater appreciation of hedonism in psychology.

We all set ourselves long-term goals from time to time, such as finally getting into shape, eating less sugar or learning a foreign language. Research has devoted much time to finding out how we can reach these goals more effectively. The prevailing view is that self-control helps us prioritize long-term goals over momentary pleasure and that if you are good at self-control, this will usually result in a happier and more successful life.

"It's time for a rethink," says Katharina Bernecker, researcher in motivational psychology at the University of Zurich. "Of course self-control is important, but research on self-regulation should pay just as much attention to hedonism, or short-term pleasure." That's because Bernecker's new research shows that people's capacity to experience pleasure or enjoyment contributes at least as much to a happy and satisfied life as successful self-control.

Distraction disrupts pleasure

Bernecker and her colleague Daniela Becker of Radboud University developed a questionnaire to measure respondents' capacity for hedonism, i.e. their ability to focus on their immediate needs and indulge in and enjoy short-term pleasures. They used the questionnaire to find out whether people differ in their capacity to pursue hedonic goals in a variety of contexts, and whether this ability is related to well-being.

They found that certain people get distracted by intrusive thoughts in moments of relaxation or enjoyment by thinking about activities or tasks that they should be doing instead. "For example, when lying on the couch you might keep thinking of the sport you are not doing," says Becker. "Those thoughts about conflicting long-term goals undermine the immediate need to relax." On the other hand, people who can fully enjoy themselves in those situations tend to have a higher sense of well-being in general, not only in the short term, and are less likely to suffer from depression and anxiety, among other things.

More isn't always better

"The pursuit of hedonic and long-term goals needn't be in conflict with one another," says Bernecker. "Our research shows that both are important and can complement each other in achieving well-being and good health. It is important to find the right balance in everyday life."

Unfortunately, simply sitting about more on the sofa, eating more good food and going to the pub with friends more often won't automatically make for more happiness. "It was always thought that hedonism, as opposed to self-control, was the easier option," says Bernecker. "But really enjoying one's hedonic choice isn't actually that simple for everybody because of those distracting thoughts."

Conscious planning of downtime

This is currently a topical issue with more people working from home, as the environment where they normally rest is suddenly associated with work. "Thinking of the work you still need to do can lead to more distracting thoughts at home, making you less able to rest," says Bernecker.

So what can you do to enjoy your downtime more? More research is needed, but the researchers suspect that consciously planning and setting limits to periods of enjoyment could help to separate them more clearly from other activities, allowing pleasure to take place more undisturbed.

https://www.sciencedaily.com/releases/2020/07/200727114739.htm

Wealthier men are more likely to develop high blood pressure

July 26, 2020

Science Daily/European Society of Cardiology

Working men with higher incomes are more likely to develop high blood pressure, reports a study presented at the 84th Annual Scientific Meeting of the Japanese Circulation Society (JCS 2020).

JCS 2020 takes place online from 27 July to 2 August in conjunction with the Asian Pacific Society of Cardiology Congress 2020 (APSC 2020). Joint scientific sessions are being held by the European Society of Cardiology (ESC) and JCS as part of the ESC Global Activities programme.

"Men with higher incomes need to improve their lifestyles to prevent high blood pressure," said study author Dr. Shingo Yanagiya of the Hokkaido University Graduate School of Medicine, Sapporo, Japan. "Steps include eating healthily, exercising, and controlling weight. Alcohol should be kept to moderate levels and binge drinking avoided."

More than one billion people have high blood pressure worldwide.2 Around 30-45% of adults are affected, rising to more than 60% of people over 60 years of age. High blood pressure is the leading global cause of premature death, accounting for almost 10 million deaths in 2015. Of those, 4.9 million were due to ischaemic heart disease and 3.5 million were due to stroke.

Japan alone has more than 10 million people with high blood pressure, and the number continues to rise. Dr. Yanagiya said: "High blood pressure is a lifestyle-related disease. As a physician seeing these patients I wanted to know if risk varies with socioeconomic class, to help us focus our prevention efforts."

This analysis of the J-HOPE3 study examined the relationship between household income and high blood pressure in Japanese employees. A total of 4,314 staff (3,153 men and 1,161 women) with daytime jobs and normal blood pressure were enrolled in 2012 from 12 workplaces.

Workers were divided into four groups according to annual household income: less than 5 million, 5 to 7.9 million, 8 to 9.9 million, and 10 million or more Japanese yen per year. The researchers investigated the association between income and developing high blood pressure over a two-year period.

Compared to men in the lowest income category, men in the highest income group were nearly twice as likely to develop high blood pressure. Men in the 5 to 7.9 million and 8 to 9.9 million groups had a 50% higher risk of developing high blood pressure compared to men with the lowest incomes, although the positive association did not reach statistical significance in the 8 to 9.9 million group.

The findings were consistent regardless of age, and were independent of baseline blood pressure, worksite, occupation, number of family members, and smoking. The relationships were slightly weakened after accounting for alcohol consumption and body mass index (BMI; kg/m2), both of which were higher for men in the higher income groups.

In women, there was no significant link between income and blood pressure. However, women with higher household income tended to have a lower risk of developing high blood pressure.

"Some previous Japanese surveys have reported that higher household income is associated with more undesirable lifestyles in men, but not in women," said Dr. Yanagiya. "Our study supports this: men, but not women, with higher household incomes were more likely to be obese and drink alcohol every day. Both behaviours are major risk factors for hypertension."

He concluded: "Men with high-paying daytime jobs are at particular risk of high blood pressure. This applies to men of all ages, who can greatly decrease their chance of a heart attack or stroke by improving their health behaviours."

Dr. Yusuke Yoshikawa, public relations coordinator for JCS 2020, said: "Hypertension is one of the most important risk factors of cardiovascular disease in Japan, because the average daily salt intake in Japan (approx. 10 g/day) is much higher than desired. As the current guidelines2 strongly recommend healthy lifestyle to control high blood pressure, this study suggests a potential key to successful intervention for those who are at risk of heart disease and stroke."

https://www.sciencedaily.com/releases/2020/07/200726214837.htm