Air pollution and noise increase risk for heart attacks
October 24, 2018
Science Daily/Swiss Tropical and Public Health Institute
Air pollution and transportation noise are both associated with an increased risk of heart attacks. Studies on air pollution, which do not take into account traffic noise, tend to overestimate the long-term effect of air pollution on heart attacks.
Where air pollution is high, the level of transportation noise is usually also elevated. Not only air pollution negatively impacts on health, but also car, train and aircraft noise increases the risk for cardiovascular diseases and diabetes, as previous research has demonstrated. Studies investigating the effect of air pollution without sufficiently taking into account the impact that noise exhibits on health, might overestimate the effect of air pollution. These are the results of a comprehensive study conducted by the Swiss Tropical and Public Health Institute (Swiss TPH), which was published today in the peer-reviewed European Heart Journal.
The study looked at the combined effects of air pollution and transportation noise for heart attack mortality, by considering all deaths that occurred in Switzerland between 2000 and 2008. Analyses that only included fine particulates (PM2.5) suggest that the risk for a heart attack rises by 5.2% per 10 ?g/m³ increase in the long-term concentration at home. Studies which also account for road, railway and aircraft noise reveal that the risk for a heart attack attributable to fine particulates in fact increases considerably less; 1.9% per 10 ?g/m³ increase. These findings indicate that the negative effects of air pollution may have been overestimated in studies which fail to concurrently consider noise exposure.
"Our study showed that transportation noise increases the risk for a heart attack by 2.0 to 3.4% per 10 decibels increase in the average sound pressure level at home." said Martin Röösli, Head of the Environmental Exposures and Health Unit at Swiss TPH, and lead author of the published research. "Strikingly, the effects of noise were independent from air pollution exposure."
Effect of noise and air pollution are additive
The study also found that people exposed to both air pollution and noise are at highest risk of heart attack. Hence, the effects of air pollution and noise are additive. "Public discussions often focus on the negative health effects of either air pollution or noise but do not consider the combined impact." said Röösli. "Our research suggests that both exposures must be considered at the same time." This has implications for both policy as well as future research. Hence, Röösli and co-researchers recommend including transportation noise exposure in any further research related to air pollution and health to avoid overestimating the negative effects of air pollution on the cardiovascular system.
Data from across Switzerland
The study included all deaths (19,261) reported across Switzerland from the period 2000 to 2008. The air pollution (PM2.5) was modelled using satellite and geographic data, calibrated with air pollution measurements from 99 measurement sites throughout Switzerland. Nitrogen dioxides (NO2) were also modelled using 9,469 biweekly passive sampling measurements collected between 2000 and 2008 at 1,834 locations in Switzerland. Transportation noise was modelled by well-established noise propagation models (sonRoad, sonRAIL and FLULA 2) by Empa and n-sphere. The air pollution and the transportation noise models were applied for each address of the 4.4 million Swiss adult citizen (aged 30 years and above).
https://www.sciencedaily.com/releases/2018/10/181024112244.htm
Heart attack patients prescribed antidepressants have worse one-year survival
March 3, 2018
Science Daily/European Society of Cardiology (ESC)
Heart attack patients prescribed antidepressants have lower one-year survival rates, according to new research.
The observational study of nearly 9,000 patients found that those prescribed antidepressants at discharge from hospital after a heart attack had a 66% greater risk of mortality one year later than patients not prescribed the drugs, although they noted the cause is not necessarily related directly to the antidepressants.
Lead author Ms Nadia Fehr, a medical student at the University of Zurich, Switzerland, said: "Previous studies have suggested that cardiovascular disease may increase the likelihood of being depressed. On the other hand, depression appears to increase the probability of developing cardiovascular risk factors. However, little is known about the impact of depression on outcome after a heart attack."
This study assessed the association of antidepressant prescription at hospital discharge with the one-year outcomes of patients with acute myocardial infarction (heart attack).
Data from AMIS Plus, the Swiss nationwide registry for acute myocardial infarction, were used to analyse 8,911 heart attack patients admitted to hospitals in Switzerland between March 2005 and August 2016. Patients were followed up by telephone 12 months after discharge.
The researchers compared patients who received antidepressant medication at discharge with those who did not with regard to baseline characteristics and one-year outcomes including mortality, a subsequent heart attack, and stroke.
A total of 565 (6.3%) patients received antidepressants at discharge from hospital. Compared to those who did not receive the drugs, patients prescribed antidepressants were predominantly female, older, and more likely to have hypertension, diabetes, dyslipidaemia, obesity and comorbidities. They were less likely to undergo percutaneous coronary intervention or receive P2Y12 blockers or statins, and stayed in hospital longer.
After adjusting for baseline characteristics the researchers found that the rates of stroke and subsequent heart attacks were similar between the two groups, but patients prescribed antidepressants had significantly worse survival. The rate of all-cause mortality at one-year after discharge was 7.4% in patients prescribed antidepressants compared to 3.4% for those not prescribed antidepressants (p<0.001).
Antidepressant prescription was an independent predictor for mortality, and increased the odds by 66% (odds ratio: 1.66; 95% confidence interval: 1.16 to 2.39).
"This was an observational study so we cannot conclude that antidepressants caused the higher death rate," noted Ms Fehr.
She concluded: "Our study showed that many patients are treated with antidepressants after a heart attack. More research is needed to pinpoint the causes and underlying pathological mechanisms for the higher mortality we observed in this patient group."
https://www.sciencedaily.com/releases/2018/03/180303095445.htm
Daytime Dozing Linked to Increased Stroke Risk In Elderly
February 22, 2008
Science Daily/American Heart Association
Regular daytime dozing forewarns of a significantly increased risk of stroke in older Americans, researchers reported at the American Stroke Association's International Stroke Conference 2008.
Among 2,153 participants in a prospective study with an average follow-up of 2.3 years, the risk of stroke was 2.6 times greater for those classified as doing "some dozing" compared to those with "no dozing." Those in the "significant dozing" group had a 4.5 times higher risk.
After controlling for several stroke risk factors -- age, race-ethnicity, sex, education, blood pressure, diabetes, obesity and physical activity -- they found unexpectedly high stroke risks for the "some dozing" and "significant dozing" groups compared to "no dozing."
The risk of a heart attack or vascular death was higher -- 1.6 percent for the moderate dozers and 2.6 percent for the significant dozers. The findings were similar for all ethnicities and both genders.
"Given what's known now, it's worth assessing patients for sleep problems," Boden-Albala said. "And the initial assessment can be something as simple as the Epworth scale. If patients are moderately or significantly dozing, physicians need to think about sending them for further evaluation."
http://www.sciencedaily.com/releases/2008/02/080221153730.htm