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Levy SB, Pirtle S, Bastien R, Cruz K, Vernon J. The wintertime brown adipose tissue thermogenesis of New York City residents amidst climate change. Ann Hum Biol 2025; 52:2455685. [PMID: 39936594 DOI: 10.1080/03014460.2025.2455685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Revised: 12/11/2024] [Accepted: 12/29/2024] [Indexed: 02/13/2025]
Abstract
BACKGROUND The built environment buffers residents of large cities, such as New York (NYC), from exposure to low temperatures. Furthermore, average winter temperatures are rising in NYC due to climate change. The degree to which NYC residents exhibit metabolic adaptations to cold stress is currently unclear. AIM This study quantified variation in brown adipose tissue (BAT), energy expenditure (EE), and ambient temperature among NYC residents. SUBJECTS AND METHODS We recruited 46 adults (31 females; 15 males) and quantified anthropometrics, change in EE, and BAT thermogenesis after a cooling condition in the lab. A subsample of 21 participants wore temperature loggers for three days in order to quantify ambient temperature exposure. RESULTS BAT thermogenesis was not significantly associated with change in EE. Participants that were exposed to lower average temperatures exhibited greater BAT thermogenesis (p = 0.013). Change in EE, however, was not significantly associated with time spent outside nor average temperature exposure. CONCLUSION Our study provides mixed evidence for the role of BAT thermogenesis in metabolic adaptations to cold stress among NYC residents. Many young adults in NYC are exposed to minimal amounts of cold stress, and this trend is likely to be exacerbated by climate change.
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Affiliation(s)
- Stephanie B Levy
- Department of Anthropology, CUNY Hunter College, New York City, NY, USA
- New York Consortium in Evolutionary Primatology, New York City, NY, USA
| | - Shelby Pirtle
- Department of Anthropology, CUNY Graduate Center, New York City, NY, USA
| | | | - Kandra Cruz
- Department of Anthropology, New York University, New York City, NY, USA
| | - Jahnae Vernon
- Department of Anthropology, CUNY Hunter College, New York City, NY, USA
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Gau YC, Kuo CY, Su WY, Tsai WL, Wu YJ, Wu PH, Lin MY, Wu CD, Kuo CH, Chen SC. Association between wet-bulb globe temperature with peptic ulcer disease in different geographic regions in a large Taiwanese population study. BMC Gastroenterol 2025; 25:216. [PMID: 40175940 PMCID: PMC11967042 DOI: 10.1186/s12876-025-03803-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Accepted: 03/19/2025] [Indexed: 04/04/2025] Open
Abstract
BACKGROUND Peptic ulcer disease (PUD) is a common and important cause of morbidity worldwide, with a large impact on healthcare costs. Little research has been conducted on the association between wet-bulb globe temperature (WBGT) and PUD. The aim of this study was to explore this association among different geographical regions of Taiwan in a large sample of participants. METHODS This is a cross-sectional study. The study participants (n = 120,424) were enrolled from the Taiwan Biobank (TWB) and resided across northern, central, southern and eastern Taiwan. Self-reported questionnaires were used to ascertain the occurrence of PUD. Average WBGT values were recorded during working hours (8:00 AM to 5:00 PM) and the noon period (11:00 AM to 2:00 PM) for each participant at 1, 3, and 5 years before the TWB survey year. The association between WBGT and PUD was examined with logistic regression analysis. RESULTS The 1-year and 5-year noon WBGT values per 1℃ increase were significantly associated with a low prevalence of PUD in northern Taiwan (odds ratio [OR], 0.960, 95% confidence interval [CI], 0.925-0.955; OR, 0.962, 95% CI, 0.929-0.997; respectively). In contrast, there were no significant associations between WBGT and PUD in central Taiwan. In southern Taiwan, the 1-, 3-, and 5-year WBGT values per 1℃ increase during the noon period (OR, 0.875, 95% CI, 0.873-0.909; OR, 0.860, 95% CI, 0.825-0.896; OR, 0.848, 95% CI, 0.812-0.885; respectively) and working period (OR, 0.852, 95% CI, 0.825-0.880; OR, 0.845, 95% CI, 0.816-0.876; OR, 0.832, 95% CI, 0.0.801-0.863; respectively) were significantly associated with a low prevalence of PUD. However, in eastern Taiwan, the 1-, 3-, and 5-year WBGT values per 1℃ increase during the noon period (OR, 1.074, 95% CI, 1.022-1.127; OR, 1.058, 95% CI, 1.013-1.104; OR, 1.058, 95% CI, 1.013-1.105; respectively), and the 3- and 5-year WBGT values per 1℃ increase during the working period were significantly associated with a high prevalence of PUD (OR, 1.049, 95% CI, 1.003-1.097; OR, 1.047, 95% CI, 1.001-1.095; respectively). Based on nonlinear trend analysis, WBGT was categorized into three groups for the noon period or work period, and the results were similar to and generally consistent with those in linear models. CONCLUSION The associations between WBGT and PUD differed across the geographical regions of Taiwan. In northern and southern Taiwan, increases in average WBGT values were significantly associated with a low prevalence of PUD. In addition, this relationship was much stronger in southern Taiwan than in northern Taiwan. Of note, there was a reverse relationship between WBGT and PUD during the noon and working periods in eastern Taiwan. Further studies are needed to elucidate the effects of WBGT on PUD.
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Affiliation(s)
- Yuh-Ching Gau
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Gangshan Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Yu Kuo
- Teaching and Research Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Yu Su
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Ling Tsai
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung, 812, Taiwan, R.O.C
| | - Ying-Jhen Wu
- Teaching and Research Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ping-Hsun Wu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Yen Lin
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Da Wu
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Innovation and Development Center of Sustainable Agriculture, National Chung-Hsing University, Taichung, Taiwan
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung, 812, Taiwan, R.O.C..
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Szu-Chia Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung, 812, Taiwan, R.O.C..
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Guo R, Liu M, Yu L, Li Q, Hou S, Liu M. Holiday Impact on Trends in Quality of Acute Coronary Syndrome Care. J Eval Clin Pract 2025; 31:e70109. [PMID: 40290093 DOI: 10.1111/jep.70109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 03/18/2025] [Accepted: 04/11/2025] [Indexed: 04/30/2025]
Abstract
BACKGROUND Acute coronary syndrome (ACS) is a common and serious cardiovascular disease with high morbidity and mortality. Timely diagnosis and treatment can help reduce the mortality of patients, but the arrival of the holidays may affect the quality of ACS treatment. OBJECTIVES To analyse the trends in the treatment quality of ACS care and the holiday season effect. METHODS Joinpoint regression was performed to measure the overall trend in adherence rate of QIs from 1 January 2016, to 30 June 2020. The trends in emergency care quality over time was quantised by average monthly percentage change (AMPC). Interrupted time series were used to analyse the holiday season effect of the Spring Festival. RESULTS The completion rates of five QIs (QI2, QI4, QI5, QI7, QI8) showed a continuous upward trend between 1 January 2016 and 30 June 2020, with QI4 showing the fastest upward trend between month 35 and month 38 (AMPC = 24.31%, p < 0.05). The completion rates of QI3, QI6 and QI9 showed an increasing trend at the beginning of the study and a decreasing trend at the later stages. Results of ITS model showed that there were immediate changes in rates of nine QIs before and after Chinese Spring Festival, with the largest decrease was in QI5 in phase 2 (level change = -13.94%, p < 0.05) and the highest increase was in QI4 in phase 4 (level change = 27.71%, p < 0.05). Excluding the effects of the holiday, completion rates continue to increase across the eight QIs. CONCLUSIONS Quality of care in ACS declined around the Spring Festival. Excluding the effect of holidays, the quality of ACS disease care showed an improving trend, especially in integrated care and multidisciplinary collaboration.
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Affiliation(s)
- Ruize Guo
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Mengyang Liu
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Lei Yu
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Qianni Li
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Shuang Hou
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Meina Liu
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
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Wolf S, Schievano E, Amidei CB, Kucher N, Valerio L, Barco S, Fedeli U. Mortality trend of ischemic heart disease (2008-2022): A retrospective analysis of epidemiological data. Int J Cardiol 2024; 406:132042. [PMID: 38614362 DOI: 10.1016/j.ijcard.2024.132042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/21/2024] [Accepted: 04/10/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Age-sex specific trend analyses of ischemic heart disease (IHD)-related mortality and prevalent risk factors can improve our understanding and approach to the disease. METHODS We performed a 15-year retrospective epidemiological analysis of acute and chronic IHD-related mortality and prevalent cardiovascular risk factors using administrative data from Veneto, a socio-economically homogeneous Italian region. Standard mortality statistics using the underlying cause of death (UCOD) and deaths with any mention of IHD in death certificates (MCOD) from ICD-10 codes I20-I25 was performed between 2008 and 2022. RESULTS A total of 134,327 death certificates reported IHD-related deaths, representing 18.6% of all deaths. Proportional mortality decreased from 14.6% in 2008 to 7.8% in 2022 for deaths with IHD as the UCOD and from 23.5% to 14.6% for deaths with IHD among the MCOD. A more pronounced decline of proportionate and case-specific mortality rate was seen in women. The decline in mortality over the whole study period was larger for acute (vs. chronic) IHD. The COVID-19 pandemic led to a marked increase in mortality in 2020 (+12.2%) with a subsequent further decline. IHD-related deaths displayed a typical seasonal pattern with more deaths during winter. The prevalence of cardiovascular risk factors was higher in IHD (vs. no IHD) deaths: this association appeared more pronounced in younger adults. CONCLUSIONS We provided an analysis of epidemiological trends in IHD-related mortality and prevalence of risk factors. Our findings indicate a change in the pattern of cardiovascular deaths and may suggest a switch in death from acute to chronic conditions.
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Affiliation(s)
- Simon Wolf
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland.
| | - Elena Schievano
- Epidemiological Department, Azienda Zero, Veneto Region, Padua, Italy
| | | | - Nils Kucher
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
| | - Luca Valerio
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stefano Barco
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland; Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ugo Fedeli
- Epidemiological Department, Azienda Zero, Veneto Region, Padua, Italy
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Jung S, Jang WJ, Lee WS, Park IH, Oh JH, Yang JH, Gwon HC, Ahn CM, Yu CW, Kim HJ, Bae JW, Kwon SU, Lee HJ, Jeong JO, Park SD. Seasonal variation and prognosis in patients with acute myocardial infarction complicated by cardiogenic shock. Heliyon 2024; 10:e30078. [PMID: 38720697 PMCID: PMC11076878 DOI: 10.1016/j.heliyon.2024.e30078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 04/05/2024] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
Background Little is known about the association between seasonal variation and prognosis in patients with CS caused by AMI. Objectives We investigated the 12-month clinical outcomes in patients treated with percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) according to season. Methods A total of 695 patients undergoing PCI for AMI complicated by CS was enrolled from 12 centers in South Korea. The study patients were divided into four groups according to season in which the AMI with CS occurred (spring, n = 178 vs. summer, n = 155 vs. autumn, n = 182 vs. winter, n = 180). We compared major adverse cardiovascular events (MACEs; the composite of cardiac death, myocardial infarction, re-hospitalization due to heart failure, and any revascularization) between the four groups. Results The risk of MACE during the 12 months after CS was similar in the four groups: spring, 68 patients, vs. summer, 69, vs. autumn, 73, vs. winter, 68 (p = 0.587). Multivariate Cox-regression analysis revealed no significant difference in 12-month MACE among groups compared to the spring group after inverse probability of treatment weighting adjustment (summer, HR 1.40, 95 % CI 0.98-1.99, p = 0.062; autumn, HR 1.26, 95 % CI 0.89-1.80, p = 0.193; winter, HR 1.18, 95 % CI 0.83-1.67, p = 0.356). The similarity of MACE between the four groups was consistent across a variety of subgroups. Conclusions After adjusting for baseline differences, seasonal variation seems not to influence the mid-term risk of 12-month MACE in patients treated with PCI for AMI complicated by CS. Condensed abstract Data are limited regarding the association between seasonal variation and prognosis in patients with cardiogenic shock (CS) caused by AMI. This study divided patients undergoing PCI for AMI complicated by CS into four groups based on the season of occurrence and found no significant differences in 12-month MACE between the groups after adjusting for bias and confounding factors. Multivariate analysis revealed consistent MACE similarity across subgroups. The study suggests that seasonal variation has no impact on the mid-term risk of 12-month MACE in patients with CS caused by AMI, after adjusting for baseline differences. Trial registration ClinicalTrials.gov NCT02985008RESCUE (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock), NCT02985008, Registered December 5, 2016 - retrospectively and prospectively. Irb information This study was approved by the institutional review board of Samsung Medical Center (Reference number: 2016-03-130).
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Affiliation(s)
- Sodam Jung
- Department of Cardiology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Woo Jin Jang
- Division of Cardiology, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Wang Soo Lee
- Division of Cardiology, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Ik hyun Park
- Department of Cardiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Ju Hyeon Oh
- Department of Cardiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Jeong Hoon Yang
- Division of Cardiology, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyeon-Cheol Gwon
- Division of Cardiology, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chul-Min Ahn
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Cheol Woong Yu
- Division of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Hyun-Joong Kim
- Division of Cardiology, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Jang-Whan Bae
- Division of Cardiology, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Sung Uk Kwon
- Division of Cardiology, Ilsan Paik Hospital, University of Inje College of Medicine, Seoul, Republic of Korea
| | - Hyun-Jong Lee
- Division of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea
| | - Jin-Ok Jeong
- Division of Cardiology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Sang-Don Park
- Division of Cardiology, Inha University Hospital, Incheon, Republic of Korea
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Yang W, Zeng L, Yang H, Guo F, Zhou D, Cui W, Wu S, Chen C, Zhao J, Wang W, Yang N, Lin H, Li L. Effect of national holidays on health outcomes of patients receiving peritoneal dialysis in a single center over a ten-year period. Ren Fail 2023; 45:2153697. [PMID: 36645059 PMCID: PMC9848312 DOI: 10.1080/0886022x.2022.2153697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND National holidays are associated with high mortality in some diseases, but little is known about patients undergoing peritoneal dialysis (PD). The research aimed to investigate the impact of national holidays on the health outcomes of PD patients. METHODS Over ten years, all episodes of unplanned hospitalization, death, and peritonitis in PD patients were collected in our center. Seven national holidays in China were chosen, and non-holiday days were selected as the control period. The effect of national holidays was observed by comparing the hospitalization, death, and peritonitis rates between holiday and non-holiday groups. RESULTS There were 297 events in all holiday periods and 1247 in non-holiday periods. There is no significant difference in hospitalization rate between holiday and non-holiday groups (32.4% ± 6.4% vs. 29.2% ± 3.4%, p = 0.175). So is the death rate [6.3% (4.8-12.3%) vs.5.0% (4.2-8.9%), p = 0.324] and peritonitis rate [0.19 (0.13-0.53) vs. 0.22 (0.18-0.27), p = 0.445] between the two groups. Significant differences were observed in the distribution of peritonitis causes between the two groups (p = 0.017). The rate of secondary to other infections in the holiday group was significantly higher than in the non-holiday group (25.0 vs. 10.3%, p = 0.015). CONCLUSION Our study suggested no national holiday effect on health outcomes of PD patients based on ten-year data in our center.
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Affiliation(s)
- Wei Yang
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Li Zeng
- First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Huibin Yang
- First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Fujia Guo
- First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Dan Zhou
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China,College of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Wenting Cui
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shuran Wu
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Cong Chen
- Graduate School, Dalian Medical University, Dalian, China
| | - Jiayao Zhao
- Graduate School, Dalian Medical University, Dalian, China
| | - Weidong Wang
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ning Yang
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hongli Lin
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China,Hongli Lin Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Longkai Li
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China,CONTACT Longkai Li
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Castelletti S, Orini M, Vischer AS, McKenna WJ, Lambiase PD, Pantazis A, Crotti L. Circadian and Seasonal Pattern of Arrhythmic Events in Arrhythmogenic Cardiomyopathy Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2872. [PMID: 36833593 PMCID: PMC9956986 DOI: 10.3390/ijerph20042872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/22/2023] [Accepted: 01/28/2023] [Indexed: 05/28/2023]
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac disease associated with an increased risk of life-threatening arrhythmias. The aim of the present study was to evaluate the association of ventricular arrhythmias (VA) with circadian and seasonal variation in ARVC. One hundred two ARVC patients with an implantable cardioverter defibrillator (ICD) were enrolled in the study. Arrhythmic events included (a) any initial ventricular tachycardia (VT) or fibrillation (VF) prompting ICD implantation, (b) any VT or non-sustained VT (NSVT) recorded by the ICD, and (c) appropriate ICD shocks/therapy. Differences in the annual incidence of events across seasons (winter, spring, summer, autumn) and period of the day (night, morning, afternoon, evening) were assessed both for all cardiac events and major arrhythmic events. In total, 67 events prior to implantation and 263 ICD events were recorded. These included 135 major (58 ICD therapies, 57 self-terminating VT, 20 sustained VT) and 148 minor (NSVT) events. A significant increase in the frequency of events was observed in the afternoon versus in the nights and mornings (p = 0.016). The lowest number of events was registered in the summer, with a peak in the winter (p < 0.001). Results were also confirmed when excluding NSVT. Arrhythmic events in ARVC follow a seasonal variation and a circadian rhythm. They are more prevalent in the late afternoon, the most active period of the day, and in the winter, supporting the role of physical activity and inflammation as triggers of events.
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Affiliation(s)
- Silvia Castelletti
- Istituto Auxologico Italiano, IRCCS, Department of Cardiology, Piazzale Brescia 20, 20149 Milan, Italy
| | - Michele Orini
- Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
| | - Annina S. Vischer
- Medical Outpatient Department, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
| | - William J. McKenna
- Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
- Department of Cardiology, University of A Coruña, 15001 A Coruña, Spain
| | - Pier D. Lambiase
- Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
- The Barts Heart Centre, Barts Health NHS Trust, London E1 1BB, UK
| | - Antonios Pantazis
- National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK
- Cardiovascular Research Centre, Royal Brompton and Harefield Hospitals, London SW3 6NP, UK
| | - Lia Crotti
- Istituto Auxologico Italiano, IRCCS, Department of Cardiology, Piazzale Brescia 20, 20149 Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
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Abrignani MG, Lombardo A, Braschi A, Renda N, Abrignani V. Climatic influences on cardiovascular diseases. World J Cardiol 2022; 14:152-169. [PMID: 35432772 PMCID: PMC8968453 DOI: 10.4330/wjc.v14.i3.152] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/23/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
Classical risk factors only partially account for variations in cardiovascular disease incidence; therefore, also other so far unknown features, among which meteorological factors, may influence heart diseases (mainly coronary heart diseases, but also heart failure, arrhythmias, aortic dissection and stroke) rates. The most studied phenomenon is ambient temperature. The relation between mortality, as well as cardiovascular diseases incidence, and temperature appears graphically as a ''U'' shape. Exposure to cold, heat and heat waves is associated with an increased risk of acute coronary syndromes. Other climatic variables, such as humidity, atmospheric pressure, sunlight hours, wind strength and direction and rain/snow precipitations have been hypothesized as related to fatal and non-fatal cardiovascular diseases incidence. Main limitation of these studies is the unavailability of data on individual exposure to weather parameters. Effects of weather may vary depending on other factors, such as population disease profile and age structure. Climatic stress may increase direct and indirect risks to human health via different, complex pathophysiological pathways and exogenous and endogenous mechanisms. These data have attracted growing interest because of the recent earth's climate change, with consequent increasing ambient temperatures and climatic fluctuations. This review evaluates the evidence base for cardiac health consequences of climate conditions, and it also explores potential further implications.
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Affiliation(s)
- Maurizio Giuseppe Abrignani
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy.
| | - Alberto Lombardo
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Annabella Braschi
- Department of Internal Medicine, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90100, Italy
| | - Nicolò Renda
- Department of Mental Health, ASP Trapani, Trapani 91100, Italy
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Aoyagi T, Chiba Y, Kitaoka H. Association between acute coronary syndrome onset risk and climate change. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:779-788. [PMID: 34907855 DOI: 10.1080/19338244.2021.2016567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study aimed to clarify the association between the onset of acute coronary syndrome (ACS) and weather conditions in summer and winter in the same region. At a general hospital inJapan, weather conditions during the onset of 2,381 cases diagnosed with ACS over 25 years were analyzed using a generalized additive model adopting log-quasi-Poisson distribution as the link function, with "the occurrence of ACS" as the dependent variable and "weather data" as the independent variable. In conclusion, we found that ACS occurred at about the same frequency in winter and summer, and the season did not affect the onset. The onset rate decreased 0.960-fold per 1 °C increase in the minimum temperature one day before the day of onset and decreased 0.987-fold per 1 hPa increase in the mean station pressure of the previous day.
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Affiliation(s)
- Tomokazu Aoyagi
- General Internal Medicine Nurse Practitioner, Mito Saiseikai General Hospital, Mito City, Ibaraki Prefecture, Japan
| | - Yoshiro Chiba
- Department of Cardiology, Mito Saiseikai General Hospital, Mito City, Ibaraki Prefecture, Japan
| | - Hiroaki Kitaoka
- Department of Cardiology and Geriatrics, Kochi Medical School, Nankoku, Kochi, Japan
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10
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La Rovere MT, Gorini A, Schwartz PJ. Stress, the autonomic nervous system, and sudden death. Auton Neurosci 2021; 237:102921. [PMID: 34823148 DOI: 10.1016/j.autneu.2021.102921] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/07/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
The existence of an important relationship between stress, the autonomic nervous system, and sudden cardiac death (SCD) has been long recognized. In the present essay we review the large number of conditions, acting at individual or at population level, that have been causally associated to SCD and discuss the mechanistic and translational value of the studies exploring such associations. These conditions include external stressors (earthquakes, wars) and internal stressors (anger, fear, loss of a loved one) and emotions of even opposite sign. Most situations confirm the time-honored view that increases in sympathetic activity are proarrhythmic whereas increases in vagal activity are protective; however, we will also show and discuss a condition in which the culprit appears to be the excess of vagal activity. The physiologic rationale underlying the most typical situations is on one hand the profibrillatory effect of the increase in the heterogeneity of repolarization secondary to the release of norepinephrine, and on the other the combined effect of acetylcholine to lower heart rate and to antagonize the cardiac effects of norepinephrine at ventricular level. An interesting facet of this potentially lethal relationship is that the elements involved are by no means always exceptional, and they can actually represent part of our everyday life.
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Affiliation(s)
- Maria Teresa La Rovere
- Department of Cardiology, IRCCS Istituti Clinici Scientifici Maugeri, Montescano, Pavia, Italy.
| | - Alessandra Gorini
- Department of Oncology and Hemato-Oncology, University of Milan, Italy.
| | - Peter J Schwartz
- Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Istituto Auxologico Italiano, IRCCS, Milan, Italy.
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11
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Weather Trumps Festivity? More Cardiovascular Disease Events Occur in Winter than in December Holidays in Queensland, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910158. [PMID: 34639460 PMCID: PMC8508171 DOI: 10.3390/ijerph181910158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022]
Abstract
Objective: Cardiovascular disease (CVD) is the leading cause of hospitalisations and deaths in Australia. This study estimates the excess CVD hospitalisations and deaths across seasons and during the December holidays in Queensland, Australia. Methods: The study uses retrospective, longitudinal, population-based cohort data from Queensland, Australia from January 2010 to December 2015. The outcomes were hospitalisations and deaths categorised as CVD-related. CVD events were grouped according to when they occurred in the calendar year. Excess hospitalisations and deaths were estimated using the multivariate ordinary least squares method after adjusting for confounding effects. Results: More CVD hospitalisations and deaths occurred in winter than in summer, with 7811 (CI: 1353, 14,270; p < 0.01) excess hospitalisations and 774 (CI: 35, 1513; p < 0.01) deaths compared to summer. During the coldest month (July), there was an excess of 42 hospitalisations and 7 deaths per 1000 patients. Fewer CVD hospitalisations (-20 (CI: -29, -9; p < 0.01)) occurred during the December holidays than any other period during the calendar year. Non-CVD events were mostly not statistically significant different between periods. Conclusion: Most CVD events in Queensland occurred in winter rather than during the December holidays. Potentially cost-effective initiatives should be explored such as encouraging patients with CVD conditions to wear warmer clothes during cold temperatures and/or insulating the homes of CVD patients who cannot otherwise afford to.
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12
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Affiliation(s)
- David Foster Gaieski
- Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA 19107, USA
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13
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Nakashima T, Ogata S, Noguchi T, Tahara Y, Onozuka D, Kato S, Yamagata Y, Kojima S, Iwami T, Sakamoto T, Nagao K, Nonogi H, Yasuda S, Iihara K, Neumar R, Nishimura K. Machine learning model for predicting out-of-hospital cardiac arrests using meteorological and chronological data. Heart 2021; 107:1084-1091. [PMID: 34001636 PMCID: PMC8223656 DOI: 10.1136/heartjnl-2020-318726] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To evaluate a predictive model for robust estimation of daily out-of-hospital cardiac arrest (OHCA) incidence using a suite of machine learning (ML) approaches and high-resolution meteorological and chronological data. METHODS In this population-based study, we combined an OHCA nationwide registry and high-resolution meteorological and chronological datasets from Japan. We developed a model to predict daily OHCA incidence with a training dataset for 2005-2013 using the eXtreme Gradient Boosting algorithm. A dataset for 2014-2015 was used to test the predictive model. The main outcome was the accuracy of the predictive model for the number of daily OHCA events, based on mean absolute error (MAE) and mean absolute percentage error (MAPE). In general, a model with MAPE less than 10% is considered highly accurate. RESULTS Among the 1 299 784 OHCA cases, 661 052 OHCA cases of cardiac origin (525 374 cases in the training dataset on which fourfold cross-validation was performed and 135 678 cases in the testing dataset) were included in the analysis. Compared with the ML models using meteorological or chronological variables alone, the ML model with combined meteorological and chronological variables had the highest predictive accuracy in the training (MAE 1.314 and MAPE 7.007%) and testing datasets (MAE 1.547 and MAPE 7.788%). Sunday, Monday, holiday, winter, low ambient temperature and large interday or intraday temperature difference were more strongly associated with OHCA incidence than other the meteorological and chronological variables. CONCLUSIONS A ML predictive model using comprehensive daily meteorological and chronological data allows for highly precise estimates of OHCA incidence.
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Affiliation(s)
- Takahiro Nakashima
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral Cardiovascular Centre, Suita, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral Cardiovascular Centre, Suita, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Daisuke Onozuka
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral Cardiovascular Centre, Suita, Japan
| | | | | | - Sunao Kojima
- Department of General Internal Medicine 3, Kawasaki Medical School, Kurashiki, Japan
| | - Taku Iwami
- Health Service, Kyoto University, Kyoto, Japan
| | - Tetsuya Sakamoto
- Department of Emergency Medicine, Teikyo University, Itabashi-ku, Japan
| | - Ken Nagao
- Cardiovascular Centre, Nihon University Hospital, Tokyo, Japan
| | | | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koji Iihara
- National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Robert Neumar
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral Cardiovascular Centre, Suita, Japan
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14
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Rollman JE, Kloner RA, Bosson N, Niemann JT, Gausche-Hill M, Williams M, Clare C, Tan W, Wang X, Shavelle DM, Rafique AM. Emergency Medical Services Responses to Out-of-Hospital Cardiac Arrest and Suspected ST-Segment-Elevation Myocardial Infarction During the COVID-19 Pandemic in Los Angeles County. J Am Heart Assoc 2021; 10:e019635. [PMID: 34058862 PMCID: PMC8477893 DOI: 10.1161/jaha.120.019635] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Public health emergencies may significantly impact emergency medical services responses to cardiovascular emergencies. We compared emergency medical services responses to out-of-hospital cardiac arrest (OHCA) and ST-segment‒elevation myocardial infarction (STEMI) during the 2020 COVID-19 pandemic to 2018 to 2019 and evaluated the impact of California's March 19, 2020 stay-at-home order. Methods and Results We conducted a population-based cross-sectional study using Los Angeles County emergency medical services registry data for adult patients with paramedic provider impression (PI) of OHCA or STEMI from February through May in 2018 to 2020. After March 19, 2020, weekly counts for PI-OHCA were higher (173 versus 135; incidence rate ratios, 1.28; 95% CI, 1.19‒1.37; P<0.001) while PI-STEMI were lower (57 versus 65; incidence rate ratios, 0.87; 95% CI, 0.78‒0.97; P=0.02) compared with 2018 and 2019. After adjusting for seasonal variation in PI-OHCA and decreased PI-STEMI, the increase in PI-OHCA observed after March 19, 2020 remained significant (P=0.02). The proportion of PI-OHCA who received defibrillation (16% versus 23%; risk difference [RD], -6.91%; 95% CI, -9.55% to -4.26%; P<0.001) and had return of spontaneous circulation (17% versus 29%; RD, -11.98%; 95% CI, -14.76% to -9.18%; P<0.001) were lower after March 19 in 2020 compared with 2018 and 2019. There was also a significant increase in dead on arrival emergency medical services responses in 2020 compared with 2018 and 2019, starting around the time of the stay-at-home order (P<0.001). Conclusions Paramedics in Los Angeles County, CA responded to increased PI-OHCA and decreased PI-STEMI following the stay-at-home order. The increased PI-OHCA was not fully explained by the reduction in PI-STEMI. Field defibrillation and return of spontaneous circulation were lower. It is critical that public health messaging stress that emergency care should not be delayed.
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Affiliation(s)
- Jeffrey Eric Rollman
- Department of Health Policy and Management UCLA Fielding School of Public HealthUniversity of California Los Angeles CA
| | - Robert A Kloner
- Huntington Medical Research Institutes Pasadena CA.,Keck School of Medicine University of Southern California Los Angeles CA
| | - Nichole Bosson
- Harbor-UCLA Medical Center Torrance CA.,Los Angeles County Emergency Medical Services Agency Los Angeles CA
| | | | - Marianne Gausche-Hill
- Harbor-UCLA Medical Center Torrance CA.,Los Angeles County Emergency Medical Services Agency Los Angeles CA
| | | | - Christine Clare
- Los Angeles County Emergency Medical Services Agency Los Angeles CA
| | - Weiyi Tan
- Division of Cardiology Department of Medicine University of California Los Angeles CA
| | - Xiaoyan Wang
- Division of General Internal Medicine and Health Services Research Department of Medicine University of California Los Angeles CA
| | - David M Shavelle
- Memorial Heart and Vascular InstituteLong Beach Memorial Medical Center Long Beach CA
| | - Asim M Rafique
- Division of Cardiology Department of Medicine University of California Los Angeles CA
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15
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Lopez PD, Cativo-Calderon EH, Otero D, Rashid M, Atlas S, Rosendorff C. The Impact of Environmental Factors on the Mortality of Patients With Chronic Heart Failure. Am J Cardiol 2021; 146:48-55. [PMID: 33577810 DOI: 10.1016/j.amjcard.2021.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/30/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
Outcomes of acute heart failure hospitalizations are worse during the winter than the rest of the year. Seasonality data are more limited for outcomes in chronic heart failure and the effect of environmental variables is unknown. In this population-level study, we merged 20-year data for 555,324 patients with heart failure from the national Veterans Administration database with data on climate from the National Oceanic and Atmospheric Administration and air pollutants by the Environmental Protection Agency. The outcome was the all-cause mortality rate, stratified by geographical location and each month. The impact of environmental factors was assessed through Pearson's correlation and multiple regression with a family-wise α = 0.05. The monthly all-cause mortality was 13.9% higher in the winter than the summer, regardless of gender, age group, and heart failure etiology. Winter season, lower temperatures, and higher concentrations of nitrogen dioxide were associated with a higher mortality rate in multivariate analysis of the overall population. Different environmental factors were associated in regions with similar patterns of temperature and precipitation. The only environmental factor associated with the mortality rate of patients dwelling in large urban centers was the air quality index. In conclusion, the mortality in chronic heart failure exhibits a seasonal pattern, regardless of latitude or climate. In this group of patients, particularly those of male gender, a higher mortality was associated with environmental factors and incorporating these factors in treatment plans and recommendations could have a favorable cost-benefit ratio.
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16
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Cui J, Gao Z, Blaha C, Luck JC, Brandt K, Sinoway LI. Moderate whole body heating attenuates the exercise pressor reflex responses in older humans. Am J Physiol Regul Integr Comp Physiol 2021; 320:R757-R769. [PMID: 33789459 DOI: 10.1152/ajpregu.00232.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Prior reports show that whole body heat stress attenuates the pressor response to exercise in young healthy subjects. The effects of moderate whole body heating (WBH; e.g., increase in internal temperature Tcore of ∼0.4°C-0.5°C) or limb heating on sympathetic and cardiovascular responses to exercise in older healthy humans remain unclear. We examined the muscle sympathetic nerve activity (MSNA), mean arterial blood pressure (MAP), and heart rate (HR) in 14 older (62 ± 2 yr) healthy subjects during fatiguing isometric handgrip exercise and postexercise circulatory occlusion (PECO). The protocol was performed under normothermic, moderate WBH, and local limb (i.e., forearm) heating conditions during three visits. During the mild WBH stage (increase in Tcore of <0.3°C), HR increased, whereas BP and MSNA decreased from baseline. Under the moderate WBH condition (increase in Tcore of ∼0.4°C), BP decreased, HR increased, and MSNA was unchanged from baseline. Compared with the normothermic trial, the absolute MAP during fatiguing exercise and PECO was lower during the WBH trial. Moreover, MSNA and MAP responses (i.e., changes) to fatiguing exercise were also less than those seen during the normothermic trial. Limb heating induced a similar increase in forearm muscle temperature to that seen in the WBH trial (∼0.7°C-1.5°C). Limb heating did not alter resting MAP, HR, or MSNA. The MSNA and hemodynamic responses to exercise in the limb heating trial were not different from those in the normothermic trial. These data suggest that moderate WBH attenuates MSNA and BP responses to exercise in older healthy humans.
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Affiliation(s)
- Jian Cui
- Penn State Health, Penn State Heart and Vascular Institute, Hershey, Pennsylvania
| | - Zhaohui Gao
- Penn State Health, Penn State Heart and Vascular Institute, Hershey, Pennsylvania
| | - Cheryl Blaha
- Penn State Health, Penn State Heart and Vascular Institute, Hershey, Pennsylvania
| | - Jonathan Carter Luck
- Penn State Health, Penn State Heart and Vascular Institute, Hershey, Pennsylvania
| | - Kristen Brandt
- Penn State Health, Penn State Heart and Vascular Institute, Hershey, Pennsylvania
| | - Lawrence I Sinoway
- Penn State Health, Penn State Heart and Vascular Institute, Hershey, Pennsylvania
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17
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Park JW, Kim KA, Lee MG, Park JY. Effect of Short-Term Sunlight Exposure on Blood Pressure and Pulse Rate in Vitamin D3-Insufficient, Prehypertensive Patients: A Pilot Study. Complement Med Res 2020; 28:206-215. [PMID: 33147594 DOI: 10.1159/000510902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/16/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study was conducted to evaluate the effect of short-term sunlight exposure on blood pressure (BP) and pulse rate (PR) in vitamin D3-insufficient, prehypertensive patients. METHODS Twenty prehypertensive male participants were prospectively enrolled in this pilot study. BP and PR were measured using 24-hour ambulatory BP monitoring and endocrine biomarkers were assessed. RESULTS Sunlight exposure decreased 24-hour systolic BP (SBP), diastolic BP (DBP), and PR (SBP: 132.6 mm Hg to 129.3 mm Hg, DBP: 77.6 mm Hg to 75.7 mm Hg, and PR: 76.1 bpm to 71.3 bpm, p values: 0.0011, 0.0012, and <0.0001, respectively). The decrement patterns of SBP, DBP, and PR during nighttime (SBP: 123.5 mm Hg to 117.9 mm Hg, DBP: 72.2 mm Hg to 68.0 mm Hg, and PR: 68.2 bpm to 59.1 bpm, p values: 0.0015, 0.0003, and <0.0001, respectively) were more profound compared between daytime and nighttime. Blood levels of 25-hydroxyvitamin D3 were significantly increased (p = 0.0001) but aldosterone levels were significantly decreased (p = 0.0014) after sunlight exposure. In addition, an inverse relationship between 25-hydroxyvitamin D3 and aldosterone levels was observed (R = -0.4709, p = 0.0419). DISCUSSION/CONCLUSION The pilot study gives promising results that it is worthwhile to evaluate short-term sunlight exposure as a potentially effective approach in decreasing BP and PR in 25-hydroxyvitamin D3-insufficient prehypertensive patients in a larger trial with a control group.
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Affiliation(s)
- Jin-Woo Park
- Department of Clinical Pharmacology and Toxicology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyoung-Ah Kim
- Department of Clinical Pharmacology and Toxicology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Min-Goo Lee
- Department of Physiology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji-Young Park
- Department of Clinical Pharmacology and Toxicology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea,
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18
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Obesity incidence is related to month of birth. MARMARA MEDICAL JOURNAL 2020. [DOI: 10.5472/marumj.815578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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19
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Bae JM, Kim YS, Choo EH, Kim MY, Lee JY, Kim HO, Park YM. Both cardiovascular and cerebrovascular events are decreased following long-term narrowband ultraviolet B phototherapy in patients with vitiligo: a propensity score matching analysis. J Eur Acad Dermatol Venereol 2020; 35:222-229. [PMID: 32702138 DOI: 10.1111/jdv.16830] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/09/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Systemic effects of long-term narrowband ultraviolet B (NB-UVB) phototherapy have not been well studied in vitiligo patients. An 11-year nationwide population-based retrospective cohort study was conducted using the Korean National Health Insurance claims database (2007-2017). OBJECTIVES To investigate the effects of long-term NB-UVB phototherapy on the risk of cardiovascular and cerebrovascular events in vitiligo patients. METHODS This study included vitiligo patients with ≥100 phototherapy sessions (phototherapy group, n = 3229) and <3 phototherapy sessions (no phototherapy group, n = 9687), in which covariables with age, sex, insurance type and comorbidities such as diabetes, hypertension and hyperlipidemia were matched by 1 : 3 propensity score matching. The outcomes of interest were cardiovascular (ischaemic heart disease and myocardial infarction) and cerebrovascular events (cerebrovascular infraction and haemorrhage). Cox proportional hazards models were used to assess the associations between NB-UVB phototherapy and each event. RESULTS The risk of cardiovascular or cerebrovascular events was significantly decreased in the phototherapy group compared with the no phototherapy group [hazard ratio (HR) 0.637, 95% confidence interval (CI) 0.523-0.776]. Subgroup analysis revealed that the risk of cardiovascular (HR: 0.682, 95% CI: 0.495-0.940) and cerebrovascular events (HR: 0.601, 95% CI: 0.470-0.769) were significantly lower in the phototherapy group than the no phototherapy group, respectively. CONCLUSIONS Our findings suggest that long-term NB-UVB phototherapy could decrease the risk of cardiovascular and cerebrovascular events in patients with vitiligo.
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Affiliation(s)
- J M Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Y-S Kim
- Department of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - E H Choo
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - M-Y Kim
- CNP Skin Clinic, Seoul, Korea
| | - J Y Lee
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H-O Kim
- Line Dermatology Clinic, Seoul, Korea
| | - Y M Park
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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20
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Odoi EW, Nagle N, Zaretzki R, Jordan M, DuClos C, Kintziger KW. Sociodemographic Determinants of Acute Myocardial Infarction Hospitalization Risks in Florida. J Am Heart Assoc 2020; 9:e012712. [PMID: 32427043 PMCID: PMC7428988 DOI: 10.1161/jaha.119.012712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Identifying social determinants of myocardial infarction (MI) hospitalizations is crucial for reducing/eliminating health disparities. Therefore, our objectives were to identify sociodemographic determinants of MI hospitalization risks and to assess if the impacts of these determinants vary by geographic location in Florida. Methods and Results This is a retrospective ecologic study at the county level. We obtained data for principal and secondary MI hospitalizations for Florida residents for the 2005-2014 period and calculated age- and sex-adjusted MI hospitalization risks. We used a multivariable negative binomial model to identify sociodemographic determinants of MI hospitalization risks and a geographically weighted negative binomial model to assess if the strength of associations vary by location. There were 645 935 MI hospitalizations (median age, 72 years; 58.1%, men; 73.9%, white). Age- and sex-adjusted risks ranged from 18.49 to 69.48 cases/10 000 persons, and they were significantly higher in counties with low education levels (risk ratio [RR]=1.033, P<0.0001) and high divorce rate (RR, 0.995; P=0.018). However, they were significantly lower in counties with high proportions of rural (RR, 0.996; P<0.0001), black (RR, 1.026; P=0.032), and uninsured populations (RR, 0.983; P=0.040). Associations of MI hospitalization risks with education level and uninsured rate varied geographically (P for non-stationarity test=0.001 and 0.043, respectively), with strongest associations in southern Florida (RR for <high school education, 1.036-1.041; RR for uninsured rate, 0.971-0.976). Conclusions Black race, divorce, rural residence, low education level, and lack of health insurance were significant determinants of MI hospitalization risks, but associations with the latter 2 were stronger in southern Florida. Thus, interventions for addressing MI hospitalization risks need to prioritize these populations and allocate resources based on empirical evidence from global and local models for maximum efficiency and effectiveness.
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Affiliation(s)
- Evah Wangui Odoi
- Comparative and Experimental Medicine College of Veterinary Medicine The University of Tennessee Knoxville TN
| | - Nicholas Nagle
- Department of Geography The University of Tennessee Knoxville TN
| | - Russell Zaretzki
- Department of Business Analytics and Statistics The University of Tennessee Knoxville TN
| | - Melissa Jordan
- Public Health Research Division of Community Health Promotion Florida Department of Health Tallahassee FL
| | - Chris DuClos
- Environmental Public Health Tracking Division of Community Health Promotion Florida Department of Health Tallahassee FL
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21
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[Influence of extreme weather conditions on the deployment volume of emergency medical services]. Med Klin Intensivmed Notfmed 2019; 116:154-160. [PMID: 31802135 DOI: 10.1007/s00063-019-00641-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/08/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Due to global warming a worldwide increase in the frequency and intensity of heat waves have been forecast. In the context of the overall increasing number of emergency service calls, weather-induced effects on the number of calls are highly relevant. We evaluated the influence of extreme temperatures on emergency medical services. MATERIALS AND METHODS The study was conducted in Bochum, Germany. The authors examined the data from 16,767 emergency calls. In addition, the daily updated temperature data were collected for each emergency doctor call. Data were collected from 01 January 2014 until 31 December 2015. The primary question was the influence of extremes of the perceived temperature (PT; on the day of the call and the three previous days) on the diagnosis group of cardiovascular diseases. A secondary question was the influence of extremes of the temperature parameters (air temperature, PT, physiological equivalent temperature [PET]) on the day of call and the three previous days. RESULTS A total of 16,767 calls were assessed. The threshold values (upper and lower 5%) were -8.7 and 32.5 °C for PT and -0.7 and 26.7 °C for air temperature. Examination of the PT indicated a significantly increased rate of calls for cold spells on the day of the call (RR = 1.14; p = 0.033) as well as a lag effect of 3 days (RR = 1.1; p = 0.049). CONCLUSION The present study shows that during cold spells there is an increased rate of calls for cardiovascular diseases. This effect is not only observable on the extreme day itself but also 3 days later.
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22
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Season and myocardial injury in patients with ST-segment elevation myocardial infarction: A cardiac magnetic resonance imaging study. PLoS One 2019; 14:e0211807. [PMID: 30735561 PMCID: PMC6368377 DOI: 10.1371/journal.pone.0211807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/20/2019] [Indexed: 11/19/2022] Open
Abstract
Background Little is known about the causality and pathological mechanism underlying the association of seasonal variation with myocardial injury in patients with ST-segment elevation myocardial infarction (STEMI). Objective We evaluated the association of seasonal effect with myocardial injury using cardiovascular magnetic resonance (CMR) imaging in STEMI patients undergoing primary percutaneous coronary intervention (PCI). Methods In 279 patients undergoing primary PCI for STEMI, CMR was performed for a median of 3.3 days after the index procedure. Of these, STEMI occurred in 56 patients in the winter (Winter group), 80 patients in the spring (Spring group), 76 patients in the summer (Summer group), and 67 patients in the autumn (Autumn group), respectively. We compared myocardial infarct size, extent of area at risk (AAR), myocardial salvage index (MSI) and microvascular obstruction (MVO) area as assessed by CMR according to the season in which STEMI occurred. Results In the CMR analysis, the myocardial infarct size was not significantly different among the Winter group (21.0 ± 10.5%), the Spring group (19.6 ± 11.5%), the Summer group (18.6 ± 10.6%), and the Autumn group (21.1 ± 11.3%) (P = 0.475). The extent of AAR, MSI, and MVO areas were similar among the four groups. In the subgroup analysis, myocardial infarct size, extent of AAR, MSI, and MVO were not significantly different between the Harsh climate (winter + summer) and the Mild climate (spring + autumn) groups. Conclusions Seasonal influences may not affect advanced myocardial injury in STEMI patients undergoing primary PCI.
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Lapointe-Shaw L, Austin PC, Ivers NM, Luo J, Redelmeier DA, Bell CM. Death and readmissions after hospital discharge during the December holiday period: cohort study. BMJ 2018; 363:k4481. [PMID: 30530782 PMCID: PMC6287120 DOI: 10.1136/bmj.k4481] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To determine whether patients discharged from hospital during the December holiday period have fewer outpatient follow-ups and higher rates of death or readmission than patients discharged at other times. DESIGN Population based retrospective cohort study. SETTING Acute care hospitals in Ontario, Canada, 1 April 2002 to 31 January 2016. PARTICIPANTS 217 305 children and adults discharged home after an urgent admission, during the two week December holiday period, compared with 453 641 children and adults discharged during two control periods in late November and January. MAIN OUTCOME MEASURES The primary outcome was death or readmission, defined as a visit to an emergency department or urgent rehospitalisation, within 30 days. Secondary outcomes were death or readmission and outpatient follow-up with a physician within seven and 14 days after discharge. Multivariable logistic regression with generalised estimating equations was used to adjust for characteristics of patients, admissions, and hospital. RESULTS 217 305 (32.4%) patients discharged during the holiday period and 453 641 (67.6%) discharged during control periods had similar baseline characteristics and previous healthcare utilisation. Patients who were discharged during the holiday period were less likely to have follow-up with a physician within seven days (36.3% v 47.8%, adjusted odds ratio 0.61, 95% confidence interval 0.60 to 0.62) and 14 days (59.5% v 68.7%, 0.65, 0.64 to 0.66) after discharge. Patients discharged during the holiday period were also at higher risk of 30 day death or readmission (25.9% v 24.7%, 1.09, 1.07 to 1.10). This relative increase was also seen at seven days (13.2% v 11.7%, 1.16, 1.14 to 1.18) and 14 days (18.6% v 17.0%, 1.14, 1.12 to 1.15). Per 100 000 patients, there were 2999 fewer follow-up appointments within 14 days, 26 excess deaths, 188 excess hospital admissions, and 483 excess emergency department visits attributable to hospital discharge during the holiday period. CONCLUSIONS Patients discharged from hospital during the December holiday period are less likely to have prompt outpatient follow-up and are at higher risk of death or readmission within 30 days.
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Affiliation(s)
- Lauren Lapointe-Shaw
- Toronto General Hospital, 14 EN room 216, 200 Elizabeth St, Toronto, ON, M5G 2C4, Canada
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24
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Stern M, Broja M, Sansone R, Gröne M, Skene SS, Liebmann J, Suschek CV, Born M, Kelm M, Heiss C. Blue light exposure decreases systolic blood pressure, arterial stiffness, and improves endothelial function in humans. Eur J Prev Cardiol 2018; 25:1875-1883. [PMID: 30196723 DOI: 10.1177/2047487318800072] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIMS Previous studies have shown that ultraviolet light can lead to the release of nitric oxide from the skin and decrease blood pressure. In contrast to visible light the local application of ultraviolet light bears a cancerogenic risk. Here, we investigated whether whole body exposure to visible blue light can also decrease blood pressure and increase endothelial function in healthy subjects. METHODS In a randomised crossover study, 14 healthy male subjects were exposed on 2 days to monochromatic blue light or blue light with a filter foil (control light) over 30 minutes. We measured blood pressure (primary endpoint), heart rate, forearm vascular resistance, forearm blood flow, endothelial function (flow-mediated dilation), pulse wave velocity and plasma nitric oxide species, nitrite and nitroso compounds (secondary endpoints) during and up to 2 hours after exposure. RESULTS Blue light exposure significantly decreased systolic blood pressure and increased heart rate as compared to control. In parallel, blue light significantly increased forearm blood flow, flow-mediated dilation, circulating nitric oxide species and nitroso compounds while it decreased forearm vascular resistance and pulse wave velocity. CONCLUSION Whole body irradiation with visible blue light at real world doses improves blood pressure, endothelial function and arterial stiffness by nitric oxide released from photolabile intracutanous nitric oxide metabolites into circulating blood.
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Affiliation(s)
- Manuel Stern
- 1 Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Germany
| | - Melanie Broja
- 1 Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Germany
| | - Roberto Sansone
- 1 Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Germany
| | - Michael Gröne
- 1 Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Germany
| | - Simon S Skene
- 2 Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, UK
| | | | - Christoph V Suschek
- 4 Department of Trauma and Hand Surgery, Medical Faculty, University Duesseldorf, Germany
| | - Matthias Born
- 3 Philips GmbH, Innovative Technologies, Germany.,5 Heinrich-Heine University, Germany
| | - Malte Kelm
- 1 Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Germany
| | - Christian Heiss
- 1 Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Germany.,2 Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, UK.,6 Surrey and Sussex NHS Healthcare Trust, UK
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25
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Seasonal variations of weather conditions on acute myocardial infarction onset: Oita AMI Registry. Heart Vessels 2018; 34:9-18. [DOI: 10.1007/s00380-018-1213-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 06/22/2018] [Indexed: 10/28/2022]
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Weller RB. The health benefits of UV radiation exposure through vitamin D production or non-vitamin D pathways. Blood pressure and cardiovascular disease. Photochem Photobiol Sci 2018; 16:374-380. [PMID: 28009890 DOI: 10.1039/c6pp00336b] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The detrimental effects of ultraviolet radiation are well known. Skin cancer, photo-aging, and induction or exacerbation of photosensitive dermatoses have been the focus of most photobiological research since 1928 when Findlay confirmed the carcinogenicity of ultraviolet radiation using a murine model of skin cancer. The epidemiological, mechanistic and clinical trial data have enabled the classification by the International Agency for Research on Cancer of ultraviolet radiation as a Group 1 ('sufficient evidence') carcinogen for human skin. Public health advice in most developed countries with a pale-skinned population following this has advocated limiting exposure to sunlight through use of clothing, sunblock and behavioural alterations. Despite this plethora of data, one striking omission is evidence that ultraviolet radiation shortens life, and as I will lay out in this chapter, epidemiological and now mechanistic data suggest that UV may have significant benefits on health and in particular cardiovascular health.
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Affiliation(s)
- Richard B Weller
- MRC Centre for Inflammation Research, University of Edinburgh, UK.
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27
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Crossley TF, Zilio F. The health benefits of a targeted cash transfer: The UK Winter Fuel Payment. HEALTH ECONOMICS 2018; 27:1354-1365. [PMID: 29744970 PMCID: PMC6099427 DOI: 10.1002/hec.3666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 03/06/2018] [Accepted: 03/28/2018] [Indexed: 05/29/2023]
Abstract
Each year, the UK records 25,000 or more excess winter deaths, primarily among the elderly. A key policy response is the "Winter Fuel Payment" (WFP), a labelled but unconditional cash transfer to households with a member above the female state pension age. The WFP has been shown to raise fuel spending among eligible households. We examine the causal effect of the WFP on health outcomes, including self-reports of chest infection, measured hypertension, and biomarkers of infection and inflammation. We find a robust, 6 percentage point reduction in the incidence of high levels of serum fibrinogen. Reductions in other disease markers point to health benefits, but the estimated effects are less robust.
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Affiliation(s)
- Thomas F. Crossley
- Department of EconomicsUniversity of Essex, Colchester, UK, and Institute for Fiscal StudiesLondonUK
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Jallow T, Wennberg P, Forslund AS. Temporal variation in out-of-hospital cardiac arrest with validated cardiac cause. SCAND CARDIOVASC J 2018; 52:149-155. [DOI: 10.1080/14017431.2018.1453080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | - Patrik Wennberg
- Department of Public Health and Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Ann-Sofie Forslund
- Department of Research, Region Norrbotten, The Northern Sweden MONICA Myocardial Registry, Luleå, Sweden
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29
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Obi Y, Kalantar-Zadeh K, Streja E, Rhee CM, Reddy UG, Soohoo M, Wang Y, Ravel V, You AS, Jing J, Sim JJ, Nguyen DV, Gillen DL, Saran R, Robinson B, Kovesdy CP. Seasonal variations in transition, mortality and kidney transplantation among patients with end-stage renal disease in the USA. Nephrol Dial Transplant 2017; 32:ii99-ii105. [PMID: 28201764 DOI: 10.1093/ndt/gfw379] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 09/22/2016] [Indexed: 12/22/2022] Open
Abstract
Background Seasonal variations may exist in transitioning to dialysis, kidney transplantation and related outcomes among end-stage renal disease (ESRD) patients. Elucidating these variations may have major clinical and healthcare policy implications for better resource allocation across seasons. Methods Using the United States Renal Data System database from 1 January 2000 to 31 December 2013, we calculated monthly counts of transitioning to dialysis or first transplantation and deaths. Crude monthly transition fraction was defined as the number of new ESRD patients divided by all ESRD patients on the first day of each month. Similar fractions were calculated for all-cause and cause-specific mortality and transplantation. Results The increasing trend of the annual transition to ESRD plateaued during 2009-2012 (n = 126 264), and dropped drastically in 2013 (n = 117 372). Independent of secular trends, monthly transition to ESRD was lowest in July (1.65%) and highest in January (1.97%) of each year. All-cause, cardiovascular and infectious mortalities were lowest in July or August (1.32, 0.58 and 0.15%, respectively) and highest in January (1.56, 0.71 and 0.19%, respectively). Kidney transplantation was highest in June (0.33%), and this peak was mainly attributed to living kidney transplantation in summer months. Transplant failure showed a similar seasonal variation to naïve transition, peaking in January (0.65%) and nadiring in September (0.56%). Conclusions Transitioning to ESRD and adverse events among ESRD people were more frequent in winter and less frequent in summer, whereas kidney transplantation showed the reverse trend. The potential causes and implications of these consistent seasonal variations warrant more investigation.
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Affiliation(s)
- Yoshitsugu Obi
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
- Fielding School of Public Health at UCLA, Los Angeles, CA, USA
- Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA, USA
| | - Elani Streja
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Connie M Rhee
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Uttam G Reddy
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Melissa Soohoo
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Yaping Wang
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Vanessa Ravel
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Amy S You
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Jennie Jing
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - John J Sim
- Kaiser Permanente of Southern California, Los Angeles, CA, USA
| | - Danh V Nguyen
- Biostatistics, Epidemiology & Research Design Unit, Institute for Clinical and Translational Science, University of California Irvine, Irvine, CA, USA
| | - Daniel L Gillen
- Deptartment of Statistics, Program in Public Health, University of California Irvine, Irvine, CA, USA
| | - Rajiv Saran
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, MI, USA
| | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - Csaba P Kovesdy
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA
- Nephrology Section, Memphis VA Medical Center, Memphis, TN, USA
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Cloutier JM, Liu S, Hiebert B, Tam JW, Seifer CM. Relationship of Extreme Cold Weather and Implantable Cardioverter Defibrillator Shocks. Am J Cardiol 2017; 120:1002-1007. [PMID: 28754564 DOI: 10.1016/j.amjcard.2017.06.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/21/2017] [Accepted: 06/13/2017] [Indexed: 11/30/2022]
Abstract
Cold weather to 0°C has been implicated as a risk factor for ventricular arrhythmias and implantable cardioverter defibrillator (ICD) shocks. The effect of more extreme cold weather on the risk of ventricular arrhythmias and ICD shocks is unknown. We sought to describe the relationship between extreme cold weather and the risk of ICD shocks. We retrospectively identified patients seen at the Pacemaker and Defibrillator Clinic at St. Boniface Hospital in Winnipeg, Manitoba, Canada between 2010 and 2015 with an ICD shock. We excluded multiple shocks occurring on the same day in a single patient. We collected weather data, and evaluated the relationship between ICD shocks and weather on the same day as the shock using Negative Binomial regression. Three hundred and sixty patients experienced a total of 1,355 shocks. When excluding multiple shocks occurring in a single patient on the same day, there were 756 unique shocks. The daily high (DH) was the strongest predictor of receiving an ICD shock. Compared with the warmest days (DH above 10°C), shocks were 25% more common on the coldest days (DH below -10°C), and 8% more common on cold days (DH between -10°C and 10°C). This linear trend was statistically significant, with a p-value of 0.04. In conclusion, we found an association between extreme cold weather and ICD shocks.
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Affiliation(s)
- Justin M Cloutier
- University of Manitoba, Section of Cardiology, Winnipeg, Manitoba, Canada
| | - Shuangbo Liu
- University of Manitoba, Section of Cardiology, Winnipeg, Manitoba, Canada
| | - Brett Hiebert
- Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - James W Tam
- University of Manitoba, Section of Cardiology, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Colette M Seifer
- University of Manitoba, Section of Cardiology, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada.
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31
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Temporal changes in myocardial infarction incidence rates are associated with periods of perceived psychosocial stress: A SWEDEHEART national registry study. Am Heart J 2017; 191:12-20. [PMID: 28888265 DOI: 10.1016/j.ahj.2017.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 05/30/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Psychosocial stress might trigger myocardial infarction (MI). Increased MI incidence coincides with recurrent time periods during the year perceived as particularly stressful in the population. METHODS A stress-triggering hypothesis on the risk of MI onset was investigated with Swedish population data on MI hospital admission date and symptom onset date (N=156,690; 148,176) as registered from 2006 through 2013 in the national quality registry database Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART). Poisson regression was applied to analyze daily MI rates during days belonging to the Christmas and New Year holidays, turns of the month, Mondays, weekends, and summer vacation in July compared with remaining control days. RESULTS Adjusted incidence rate ratios (IRRs) for MI rates were higher during Christmas and New Year holidays (IRR=1.07 [1.04-1.09], P<.001) and on Mondays (IRR=1.11 [1.09-1.13], P<.001) and lower in July (IRR=0.92 [0.90-0.94], P<.001) and over weekends (IRR=0.88 [0.87-0.89], P<.001), yet not during the turns of the month (IRR=1.01 [1.00-1.02], P=.891). These findings were also predominantly robust with symptom onset as alternative outcome, when adjusting for both established and some suggested-but-untested confounders, and in 8 subgroups. CONCLUSIONS Fluctuations in daily MI incidence rates are systematically related to time periods of presumed psychosocial stress. Further research might clarify mechanisms that are amenable to clinical alteration.
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Butala NM, Secemsky EA, Wasfy JH, Kennedy KF, Yeh RW. Seasonality and Readmission after Heart Failure, Myocardial Infarction, and Pneumonia. Health Serv Res 2017; 53:2185-2202. [PMID: 28857149 DOI: 10.1111/1475-6773.12747] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To investigate whether hospital readmission after admission for heart failure (HF), myocardial infarction (MI), and pneumonia varies by season. DATA SOURCES All patients in 2005-2009 Healthcare Cost and Utilization Project State Inpatient Databases for New York and California hospitalized for HF, MI, or pneumonia. STUDY DESIGN The relationship between discharge season and unplanned readmission within 30 days was evaluated using multivariate modified Poisson regression. PRINCIPAL FINDINGS Cohorts included 869,512 patients with HF, 448,945 patients with MI, and 813,593 patients with pneumonia. While admissions varied widely by season, readmission rates only ranged from 25.0 percent (spring) to 25.6 percent (winter) for HF (p > .05), 18.9 percent (summer) to 20.0 percent (winter) for MI (p < .001), and 19.4 percent (spring) to 20.3 percent (summer) for pneumonia (p < .001). In adjusted models, in New York, there was lower readmission in spring and fall (RR: 0.98, 95% CI: 0.96-0.99 for both) after admission for HF and higher readmission in spring (RR: 1.04, 95% CI: 1.01-1.07) after MI. In California, there was lower readmission in spring and winter (RR: 0.95, 95% CI: 0.93-0.96 and RR: 0.96, 95% CI: 0.94-0.98, respectively) after pneumonia. CONCLUSIONS Given marked seasonality in incidence and mortality of HF, MI, and pneumonia, the modest seasonality in readmissions suggests that readmissions may be more related to non-seasonally dependent factors than to the seasonal nature of these diseases.
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Affiliation(s)
- Neel M Butala
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Eric A Secemsky
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Jason H Wasfy
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Kevin F Kennedy
- Saint Luke's Mid America Heart Institute/UMKC, Kansas City, MO
| | - Robert W Yeh
- Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, MA
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Abstract
Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment because of migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultural practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex, and their natural, social, and personal domains are highly variable because of diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such as altitude, latitude, and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment and pollution, as well as by socioeconomic status and social networks. These attributes of the social environment shape lifestyle choices that significantly modify CVD risk. An understanding of how different domains of the environment, individually and collectively, affect CVD risk could lead to a better appraisal of CVD and aid in the development of new preventive and therapeutic strategies to limit the increasingly high global burden of heart disease and stroke.
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Affiliation(s)
- Aruni Bhatnagar
- From the Diabetes and Obesity Center and the Institute of Molecular Cardiology, University of Louisville, KY.
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Bhatia S, Bhatia S, Mears J, Dibu G, Deshmukh A. Seasonal Periodicity of Ischemic Heart Disease and Heart Failure. Heart Fail Clin 2017; 13:681-689. [PMID: 28865777 DOI: 10.1016/j.hfc.2017.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Seasonal variation for ischemic heart disease and heart failure is known. The interplay of environmental, biological, and physiologic changes is fascinating. This article highlights the seasonal periodicity of ischemic heart disease and heart failure and examines some of the potential reasons for these unique observations.
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Affiliation(s)
- Subir Bhatia
- Department of Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Sravya Bhatia
- School of Medicine, Duke University, 8 Duke University Medical Center Greenspace, Durham, NC 27703, USA
| | - Jennifer Mears
- Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - George Dibu
- Division of Cardiovascular Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32608, USA
| | - Abhishek Deshmukh
- Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
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Nalbant A, Vatan MB, Varım P, Varım C, Kaya T, Tamer A. Does Vitamin D Deficiency Effect Heart Rate Variability in Low Cardiovascular Risk Population? Open Access Maced J Med Sci 2017; 5:197-200. [PMID: 28507628 PMCID: PMC5420774 DOI: 10.3889/oamjms.2017.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/15/2017] [Accepted: 02/22/2017] [Indexed: 12/19/2022] Open
Abstract
AIM: This study aimed to evaluate the cardiac autonomic dysfunction and the cardiac arrhythmia risk using heart rate variability parameters in subjects with vitamin D deficiency and low cardiovascular risk. MATERIAL AND METHODS: One hundred five consecutive individuals, 54 patients with low vitamin D status and 51 healthy controls were enrolled in this study. The overall cardiac autonomic tone was quantified by using various heart rate variability parameters included mean RR interval, mean Heart Rate, mean of standard deviations of intervals for 24 hours (SDNN), standard deviation of averages of intervals (SDANN), mean of standard deviation of intervals for 5 minutes (SDNNI), root mean square of difference of successive intervals (rMSSD) and the proportion of intervals differing more than 50 ms (pNN50) values. The 12-lead ECG was recorded from each participant, and QT intervals were measured. RESULTS: Baseline demographic profiles were similar between two groups. The heart rate variability parameters such as mean RR interval, mean HR, SDNN, SDANN, SDNNI, rMSSD and pNN50 (%) values were not significantly different in patients with low vitamin D status compared to control group. The electrocardiography analysis revealed only slight but significant prolongation of corrected QT (QTc) intervals in the control group. CONCLUSION: HRV variables were not significantly altered in patients with vitamin D deficiency in low cardiovascular risk profile group. Further studies evaluating these findings in other cohorts with high cardiovascular risk are required.
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Affiliation(s)
- Ahmet Nalbant
- Sakarya Education and Research Hospital, Internal Medicine, Adapazarı, Sakarya 54000, Turkey
| | | | - Perihan Varım
- Sakarya Universitesi Tip Fakultesi, Cardiology, Sakarya 54000, Turkey
| | - Ceyhun Varım
- Sakarya Education and Research Hospital, Internal Medicine, Adapazarı, Sakarya 54000, Turkey
| | - Tezcan Kaya
- Sakarya Education and Research Hospital, Internal Medicine, Adapazarı, Sakarya 54000, Turkey
| | - Ali Tamer
- Sakarya Education and Research Hospital, Internal Medicine, Adapazarı, Sakarya 54000, Turkey
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Knight J, Schilling C, Barnett A, Jackson R, Clarke P. Revisiting the "Christmas Holiday Effect" in the Southern Hemisphere. J Am Heart Assoc 2016; 5:e005098. [PMID: 28007743 PMCID: PMC5210403 DOI: 10.1161/jaha.116.005098] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 12/07/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND A "Christmas holiday effect" showing elevated cardiovascular mortality over the Christmas holidays (December 25 to January 7) was demonstrated previously in study from the United States. To separate the effect of seasonality from any holiday effect, a matching analysis was conducted for New Zealand, where the Christmas holiday period falls within the summer season. METHODS AND RESULTS New Zealand mortality data for a 25-year period (1988-2013) was analyzed based on the same methodology used in the previous study. Locally weighted smoothing was used to calculate an "expected" number of deaths for each day of the year. The expected value was compared with the actual number of deaths. In addition, mean age at death was estimated and used to assess the life-years lost due to excess mortality. There were 738 409 deaths (197 109 coded as cardiac deaths) during the period. We found evidence of a Christmas holiday effect in our of medical facility's cardiac deaths, with an excess event rate of 4.2% (95% CI 0.7-7.7%) leading to ≈4 additional deaths per annum. The average age of those with fatal cardiac deaths was 76.8 years (SD 13.5) during the Christmas holiday period, resulting in 148 to 222 years of life lost per annum. CONCLUSIONS Cardiac mortality is elevated during the Christmas holiday period relative to surrounding time periods. Our findings are consistent with a previously reported study conducted in the United States, suggesting that cardiac mortality does not take a "summer break."
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Affiliation(s)
- Josh Knight
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
- Section of Epidemiology & Biostatistics, School of Population Health, The University of Auckland, New Zealand
| | - Chris Schilling
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Rod Jackson
- Section of Epidemiology & Biostatistics, School of Population Health, The University of Auckland, New Zealand
| | - Phillip Clarke
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
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Manfredini R, Manfredini F, Fabbian F, Salmi R, Gallerani M, Bossone E, Deshmukh AJ. Chronobiology of Takotsubo Syndrome and Myocardial Infarction: Analogies and Differences. Heart Fail Clin 2016; 12:531-542. [PMID: 27638023 DOI: 10.1016/j.hfc.2016.06.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Several pathophysiologic factors, not harmful if taken alone, are capable of triggering unfavorable events when presenting together within the same temporal window (chronorisk), and the occurrence of many cardiovascular events is not evenly distributed in time. Both acute myocardial infarction and takotsubo syndrome seem to exhibit a temporal preference in their onset, characterized by variations according to time of day, day of the week, and month of the year, although with both analogies and differences.
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Affiliation(s)
- Roberto Manfredini
- Clinica Medica Unit, School of Medicine, University of Ferrara, Via Lodovico Ariosto, 35, Ferrara 44121, Italy.
| | - Fabio Manfredini
- Department of Biomedical Sciences and Surgical Specialties, Vascular Diseases Center, School of Medicine, University of Ferrara, Via Lodovico Ariosto, 35, Ferrara 44121, Italy
| | - Fabio Fabbian
- Clinica Medica Unit, School of Medicine, University of Ferrara, Via Lodovico Ariosto, 35, Ferrara 44121, Italy
| | - Raffaella Salmi
- 2nd Internal Unit of Internal Medicine, General Hospital of Ferrara, Via Aldo Moro 8, Ferrara 44020, Italy
| | - Massimo Gallerani
- 1st Internal Unit of Internal Medicine, General Hospital of Ferrara, Via Aldo Moro 8, Ferrara 44020, Italy
| | - Eduardo Bossone
- 'Cava de' Tirreni and Amalfi Coast' Division of Cardiology, Heart Department, University Hospital of Salerno, Via San Leonardo 1, Salerno 84013, Italy
| | - Abhishek J Deshmukh
- Mayo Clinic Heart Rhythm Section, Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55902, USA
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Basnet S, Merikanto I, Lahti T, Männistö S, Laatikainen T, Vartiainen E, Partonen T. Associations of common chronic non-communicable diseases and medical conditions with sleep-related problems in a population-based health examination study. Sleep Sci 2016; 9:249-254. [PMID: 28123670 PMCID: PMC5241609 DOI: 10.1016/j.slsci.2016.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/18/2016] [Accepted: 11/14/2016] [Indexed: 12/31/2022] Open
Abstract
A cross-sectional population-based survey, the National FINRISK 2012 Study, designed to monitor chronic diseases and their risk factors in Finland. A random sample of 10,000 adults aged 25-74 years, and of them, 64% (n=6424) participated the study. Participants subjectively reported the total durations for sleep and naps (n=6238), sleep quality (n=5878), bedtimes and wake-up times separately for working days and weekends yielding the amount of sleep debt (n=5878), and the seasonal variation in sleep duration (n=4852). The participants were asked whether they were diagnosed or treated for common chronic diseases in the past 12 months. Logistic regression models were adopted to analysis and adjusted for a range of covariates as potential confounding factors. Total sleep duration and nap duration prolonged in depression and other mental disorder (p<.001 for all). Seasonal variation in sleep duration was associated with depression (p=.014), hypertension (p=.018) and angina pectoris (p=.024). Participants with gallstones, cardiac insufficiency, depression, or degenerative arthritis had poor sleep quality (odds ratios of 1.6-6.3, p=.001 or less for each). Those with degenerative arthritis had sleep debt less (p<.05) and those with angina pectoris more (p<.05) than individuals without these medical conditions. Depression is significantly associated with sleep problems, albeit no sleep debt. Cardiovascular diseases, degenerative arthritis, and gallstones had significant associations with one or more sleep problems. There is therefore a need for more successful management of sleep problems in chronic diseases to improve the quality of life, to reduce treatment relapses, and to increase health and longevity in a population.
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Affiliation(s)
- Syaron Basnet
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ilona Merikanto
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology, University of Helsinki, Helsinki, Finland
| | - Tuuli Lahti
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Satu Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Hospital District of North Karelia, Joensuu, Finland
| | - Erkki Vartiainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Timo Partonen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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Shah M, Bhalla V, Patnaik S, Maludum O, Lu M, Figueredo VM. Heart failure and the holidays. Clin Res Cardiol 2016; 105:865-72. [DOI: 10.1007/s00392-016-0995-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/02/2016] [Indexed: 11/30/2022]
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Basnet S, Merikanto I, Lahti T, Männistö S, Laatikainen T, Vartiainen E, Partonen T. Seasonal variations in mood and behavior associate with common chronic diseases and symptoms in a population-based study. Psychiatry Res 2016; 238:181-188. [PMID: 27086231 DOI: 10.1016/j.psychres.2016.02.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 12/10/2015] [Accepted: 02/15/2016] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to assess how seasonality is associated with some of the most common non-communicable diseases (NCDs) in the general Finnish population. The global seasonality score (GSS) was used to measure the magnitude of seasonality in 4689 participants, in addition to which they reported the extent to which the seasonal variations in mood and behavior were experienced as a problem. Regression models and the odds ratios were adopted to analyze the associations adjusted for a range of covariates. Seventy percent of the participants had seasonal variations in sleep duration, social activity, mood, or energy level, and forty percent those in weight and appetite. Angina pectoris and depression were significantly associated with seasonality throughout the analysis. Hypertension, high cholesterol levels, diabetes, other (than rheumatoid) joint diseases and other (than depressive) psychological illnesses were significantly associated with experiencing a problem due to the seasonal variations, with an increase in the GSS, and with seasonal affective disorder and its subsyndromal form. The co-occurrence of the seasonal variations in mood and behavior with certain common NCDs warrants future research to have insights into the etiology and potentially shared pathways and mechanisms of action.
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Affiliation(s)
- Syaron Basnet
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Department of Behavioral Sciences and Philosophy, University of Turku, Finland
| | - Ilona Merikanto
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Department of Biosciences, University of Helsinki, Helsinki, Finland; Orton Orthopaedics Hospital, Helsinki, Finland
| | - Tuuli Lahti
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Department of Behavioral Sciences and Philosophy, University of Turku, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Satu Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Erkki Vartiainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Timo Partonen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
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Schwartz BG, Qualls C, Kloner RA, Laskey WK. Relation of Total and Cardiovascular Death Rates to Climate System, Temperature, Barometric Pressure, and Respiratory Infection. Am J Cardiol 2015; 116:1290-7. [PMID: 26297511 DOI: 10.1016/j.amjcard.2015.07.050] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/03/2015] [Accepted: 07/03/2015] [Indexed: 11/28/2022]
Abstract
A distinct seasonal pattern in total and cardiovascular death rates has been reported. The factors contributing to this pattern have not been fully explored. Seven locations (average total population 71,354,000) were selected where data were available including relatively warm, cold, and moderate temperatures. Over the period 2004 to 2009, there were 2,526,123 all-cause deaths, 838,264 circulatory deaths, 255,273 coronary heart disease deaths, and 135,801 ST-elevation myocardial infarction (STEMI) deaths. We used time series and multivariate regression modeling to explore the association between death rates and climatic factors (temperature, dew point, precipitation, barometric pressure), influenza levels, air pollution levels, hours of daylight, and day of week. Average seasonal patterns for all-cause and cardiovascular deaths were very similar across the 7 locations despite differences in climate. After adjusting for multiple covariates and potential confounders, there was a 0.49% increase in all-cause death rate for every 1°C decrease. In general, all-cause, circulatory, coronary heart disease and STEMI death rates increased linearly with decreasing temperatures. The temperature effect varied by location, including temperature's linear slope, cubic fit, positional shift on the temperature axis, and the presence of circulatory death increases in locally hot temperatures. The variable effect of temperature by location suggests that people acclimatize to local temperature cycles. All-cause and circulatory death rates also demonstrated sizable associations with influenza levels, dew point temperature, and barometric pressure. A greater understanding of how climate, temperature, and barometric pressure influence cardiovascular responses would enhance our understanding of circulatory and STEMI deaths.
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Affiliation(s)
- Bryan G Schwartz
- Division of Cardiology, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico; Heart Institute, Good Samaritan Hospital, Los Angeles, California.
| | - Clifford Qualls
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, New Mexico; Clinical Translational Sciences Center, University of New Mexico, Albuquerque, New Mexico
| | - Robert A Kloner
- Heart Institute, Good Samaritan Hospital, Los Angeles, California; Huntington Medical Research Institute, Pasadena, California; Division of Cardiovascular Medicine, Department of Internal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Warren K Laskey
- Division of Cardiology, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
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Cui J, Muller MD, Blaha C, Kunselman AR, Sinoway LI. Seasonal variation in muscle sympathetic nerve activity. Physiol Rep 2015; 3:3/8/e12492. [PMID: 26265752 PMCID: PMC4562578 DOI: 10.14814/phy2.12492] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Epidemiologic data suggest there are seasonal variations in the incidence of severe cardiac events with peak levels being evident in the winter. Whether autonomic indices including muscle sympathetic nerve activity (MSNA) vary with season remains unclear. In this report, we tested the hypothesis that resting MSNA varies with the seasons of the year with peak levels evident in the winter. We analyzed the supine resting MSNA in 60 healthy subjects. Each subject was studied during two, three, or four seasons (total 237 visits). MSNA burst rate in the winter (21.0 ± 6.8 burst/min, mean ± SD) was significantly greater than in the summer (13.5 ± 5.8 burst/min, P < 0.001), the spring (17.1 ± 9.0 burst/min, P = 0.03), and the fall (17.9 ± 7.7 burst/min, P = 0.002). There was no significant difference in MSNA for other seasonal comparisons. The results suggest that resting sympathetic nerve activity varies along the seasons, with peak levels evident in the winter. We speculate that the seasonal changes in sympathetic activity may be a contribution to the previously observed seasonal variations in cardiovascular morbidity and mortality.
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Affiliation(s)
- Jian Cui
- Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Matthew D Muller
- Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Cheryl Blaha
- Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Allen R Kunselman
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University College of Medicine Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Lawrence I Sinoway
- Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine Milton S. Hershey Medical Center, Hershey, Pennsylvania
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Fernández-García JM, Dosil Díaz O, Taboada Hidalgo JJ, Fernández JR, Sánchez-Santos L. Influencia del clima en el infarto de miocardio en Galicia. Med Clin (Barc) 2015; 145:97-101. [PMID: 25073825 DOI: 10.1016/j.medcli.2014.04.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 03/06/2014] [Accepted: 04/10/2014] [Indexed: 11/18/2022]
Affiliation(s)
| | - Olga Dosil Díaz
- Central de Coordinación de Urgencias 061, Fundación Pública Urgencias Sanitarias de Galicia-061, Santiago de Compostela, La Coruña, España
| | | | - José Ramón Fernández
- Laboratorio de Bioingeniería y Cronobiología, Universidad de Vigo, Vigo, Pontevedra, España
| | - Luis Sánchez-Santos
- Servicio de Docencia e Investigación, Fundación Pública Urgencias Sanitarias de Galicia-061, Santiago de Compostela, La Coruña, España
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Kishimoto I, Review Meeting for Regional Diabetes Clinical Pathway in Toyono Medical District, Ashida Y, Omori Y, Nishi H, Hagiwara Y, Fujimoto T, Makino H, Ohata Y, Tamanaha T, Tochiya M, Yamamoto M, Iinuma K, Maeda K, Miyazono M. Questionnaire surveillance of cardiovascular risk factor awareness in community pharmacy patients with diabetes in an urban area of Japan. Diabetol Int 2015. [DOI: 10.1007/s13340-014-0183-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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RUWALD MARTINH, MOSS ARTHURJ, ZAREBA WOJCIECH, JONS CHRISTIAN, RUWALD ANNECHRISTINE, MCNITT SCOTT, POLONSKY BRONISLAVA, KUTYIFA VALENTINA. Circadian Distribution of Ventricular Tachyarrhythmias and Association with Mortality in the MADIT-CRT Trial. J Cardiovasc Electrophysiol 2015; 26:291-9. [DOI: 10.1111/jce.12592] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 10/23/2014] [Accepted: 10/30/2014] [Indexed: 11/28/2022]
Affiliation(s)
- MARTIN H. RUWALD
- Heart Research Follow-up Program; University of Rochester Medical Center; Rochester New York USA
- Department of Cardiology; Gentofte Hospital; Hellerup Denmark
| | - ARTHUR J. MOSS
- Heart Research Follow-up Program; University of Rochester Medical Center; Rochester New York USA
| | - WOJCIECH ZAREBA
- Heart Research Follow-up Program; University of Rochester Medical Center; Rochester New York USA
| | - CHRISTIAN JONS
- Department of Cardiology; Gentofte Hospital; Hellerup Denmark
| | - ANNE-CHRISTINE RUWALD
- Heart Research Follow-up Program; University of Rochester Medical Center; Rochester New York USA
- Department of Cardiology; Gentofte Hospital; Hellerup Denmark
| | - SCOTT MCNITT
- Heart Research Follow-up Program; University of Rochester Medical Center; Rochester New York USA
| | - BRONISLAVA POLONSKY
- Heart Research Follow-up Program; University of Rochester Medical Center; Rochester New York USA
| | - VALENTINA KUTYIFA
- Heart Research Follow-up Program; University of Rochester Medical Center; Rochester New York USA
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Olsen P, Elliott JM, Frampton C, Bradley PS. Winning or losing does matter: Acute cardiac admissions in New Zealand during Rugby World Cup tournaments. Eur J Prev Cardiol 2014; 22:1254-60. [DOI: 10.1177/2047487314539433] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 05/22/2014] [Indexed: 11/16/2022]
Affiliation(s)
- P Olsen
- Department of Applied Sciences and Allied Health, Christchurch Polytechnic Institute of Technology, New Zealand
| | - JM Elliott
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - C Frampton
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - PS Bradley
- Department of Sport and Exercise Sciences, University of Sunderland, UK
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Kurisu S, Watanabe N, Ikenaga H, Shimonaga T, Higaki T, Iwasaki T, Mitsuba N, Ishibashi K, Dohi Y, Kihara Y. Increased mean platelet volume in patients with coronary artery disease and its seasonal variation. Int J Cardiol 2014; 172:e159-61. [DOI: 10.1016/j.ijcard.2013.12.071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 12/22/2013] [Indexed: 10/25/2022]
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Kozlovskaia IL, Bulkina OS, Lopukhova VV, Kolmakova TE, Karpov IA, Starostin IV, Baratashvili VL, Rubinshtein KG, Emelina SV, Borovikov VP. [Trends in hospitalizations of patients with acute coronary syndrome and indicators of the atmospheric state in Moscow in 2009-2012]. TERAPEVT ARKH 2014; 86:20-6. [PMID: 25804035 DOI: 10.17116/terarkh2014861220-26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To identify the meteorological factors or their combinations, which are most significant for the development of acute coronary syndrome (ACS) in different seasons. SUBJECTS AND METHODS A Statistica package was used to make an exploration analysis of the data of the A.S. Puchkov Central Emergency Medical Care Station on 63,412 admissions of patients diagnosed with acute myocardial infarction (AMI) to Moscow hospitals in 2009-2012 and those of the Hydrometeorology Center of Russia on weather conditions in the period under study. RESULTS Among the 63,412 patients, there were more men than women (p < 0.000005). Two long frost periods and three long abnormal heat periods were recorded in 2009-2012. In summer, the number of patients with a prehospital diagnosis of AMI was an average 19-22% less than in the other seasons. There was no peak in the number of hospitalizations during the abnormally hot summer of 2010. Air temperature proved to be a factor that was most strongly associated with the trend in AMI hospitalizations in men (MS = 1011.52, MSor = 27.27; p < 0.00005) and women (MS = 895.36, MSor = 25.37; p < 0.00005). The number of hospitalizations was negatively associated with daily average temperature in its positive range. In summer, the interdaily temperature difference turned out to be statistically significant; the highest number of hospitalizations was noted when it grew 6 °C colder. On days off, the number of admitted patients was 25% less than that on weekdays. CONCLUSION The trend in hospitalizations for a referral diagnosis of AMI has a significant seasonal component. Their number was minimal in summer, including in the abnormally hot summer of 2010. Air temperature is the most important factor. Positive temperature was found to be strongly negatively correlated with diagnosed AMI hospitalizations.
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Shuhaiber JH, Fava JL, Shin T, Dobrilovic N, Ehsan A, Bert A, Sellke F. The influence of seasons and lunar cycle on hospital outcomes following ascending aortic dissection repair. Interact Cardiovasc Thorac Surg 2013; 17:818-22. [PMID: 23838340 PMCID: PMC3805194 DOI: 10.1093/icvts/ivt299] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 05/27/2013] [Accepted: 06/13/2013] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The effect of the lunar cycle and seasonal variation on ascending aortic dissection surgery outcomes is unknown. We investigated these temporal effects on risk-adjusted hospital mortality and then on the length of stay (LOS) following surgery for survivors. METHODS We examined prospectively collected data from cardiac operations at two major centres within a single state between January 1996 and December 2011. We first examined the relationship between the lunar cycle and seasonal variation, along with demographic and risk profile covariates, with mortality using univariate analyses, followed by multiple logistic regression modelling that controlled for demographic and patient risk variables including age, gender, risk profile (diabetes, hypertension, dyslipidaemia and renal failure), and two surgical groups: Group A, consisting of patients having repair of ascending aorta dissection repair only, and Group B, with those having ascending aorta repair plus aortic valve surgery or coronary bypass surgery or both. We further examined the relationship with LOS using both univariate and multiple regression analyses. RESULTS There were 210 patients who had repair of dissection in the study period, with 109 patients in Group A and 101 in Group B. The average age of this sample was 59.5 (standard deviation = 16.0), 65.7% were male and 18.1% died prior to discharge following repair. The greatest percentage of deaths occurred in winter (31.6%, n = 12), while the least were in summer (21.1%, n = 8) and fall (21.1%, n = 8). An overall χ(2) test found there was no difference in mortality for season (P = 0.55). Univariate analyses also found the age of patients who died vs lived was significantly higher (65.9 vs 58.1 years; P = 0.001), and a significantly greater (P = 0.029) percentage of patients with diabetes vs without diabetes died (41.7 vs 16.7%). Univariate analyses found all other covariates were not significantly related to mortality. In the multiple logistic regression model, there was no significant effect for season, while the odds of dying increased with age (odds ratio [OR] = 1.04, 95% confidence interval [95% CI] = 1.01-1.07, P = 0.012), and the odds of dying in the full-moon cycle vs the new moon cycle was significantly reduced (OR = 0.21, 95% CI = 0.05-0.81, P = 0.024). No other covariate significantly increased or decreased the odds of death, including diabetes risk, which had been significantly related to death in the univariate analysis. Within a linear regression model that examined the relationship with LOS, Group B (P = 0.020), male sex (P = 0.036) and the full-moon lunar phase (P = 0.001) were significantly related to shorter LOS. CONCLUSIONS Season had no effect on mortality or LOS following aortic dissection repair, while patient age significantly increased the odds of death. The full-moon cycle appeared to reduce the odds of death, and the full-moon cycle, along with being male and requiring a concomitant cardiac procedure, was associated with shorter LOS.
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Affiliation(s)
- Jeffrey H. Shuhaiber
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Cardiothoracic Surgery, Rhode Island Hospital, Hasbro Children Hospital, Brown Medical School, Providence, RI, USA
| | - Joseph L. Fava
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Tai Shin
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Nikola Dobrilovic
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Afshin Ehsan
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Arthur Bert
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Frank Sellke
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
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McGuinn L, Hajat S, Wilkinson P, Armstrong B, Anderson HR, Monk V, Harrison R. Ambient temperature and activation of implantable cardioverter defibrillators. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2013; 57:655-62. [PMID: 22990411 DOI: 10.1007/s00484-012-0591-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 08/06/2012] [Accepted: 08/29/2012] [Indexed: 05/20/2023]
Abstract
The degree to which weather influences the occurrence of serious cardiac arrhythmias is not fully understood. To investigate, we studied the timing of activation of implanted cardiac defibrillators (ICDs) in relation to daily outdoor temperatures using a fixed stratum case-crossover approach. All patients attending ICD clinics in London between 1995 and 2003 were recruited onto the study. Temperature exposure for each ICD patient was determined by linking each patient's postcode of residence to their nearest temperature monitoring station in London and the South of England. There were 5,038 activations during the study period. Graphical inspection of ICD activation against temperature suggested increased risk at lower but not higher temperatures. For every 1 °C decrease in ambient temperature, risk of ventricular arrhythmias up to 7 days later increased by 1.2 % (95 % CI -0.6 %, 2.9 %). In threshold models, risk of ventricular arrhythmias increased by 11.2 % (0.5 %, 23.1 %) for every 1° decrease in temperature below 2 °C. Patients over the age of 65 exhibited the highest risk. This large study suggests an inverse relationship between ambient outdoor temperature and risk of ventricular arrhythmias. The highest risk was found for patients over the age of 65. This provides evidence about a mechanism for some cases of low-temperature cardiac death, and suggests a possible strategy for reducing risk among selected cardiac patients by encouraging behaviour modification to minimise cold exposure.
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Affiliation(s)
- L McGuinn
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, University of London, 15-17 Tavistock Place, London WC1H 9SH, UK.
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