Cardiovascular Journal of Africa: Vol 32 No 5 (SEPTEMBER/OCTOBER 2021)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 5, September/October 2021 AFRICA 253 … continued from page 247 Previous research has indicated that moderate drinking could slow cognitive decline, protecting against dementia. Second study In a related study by the same research team led by Mezue, exercise was found to have a similar effect on brain activity as well as on the incidence of CVD and events. The authors said exercise was associated with decreased stress-associated brain activity in a dose-dependent manner. While the connection between stress and heart disease is widely accepted, the authors said relatively little research has been done on how modifying stress may help protect heart health. Third study Also at the ACC 2021, a Chinese study found that individuals, especially men, living with a spouse with CVD were more than twice as likely to have CVD themselves. ‘In addition to sharing lifestyle factors and socio-economic environment, our study suggests the stress of caring for a spouse with CVD may contribute to increased cardiovascular risk.’ The prominent role of women in determining a family’s diet could also help explain the findings. Researchers surveyed more than 5 000 heterosexual couples over the age of 45 living in seven regions of China from 2014 to 2016. Among men whose wives had CVD, 28% had CVD themselves, compared to 12.8% of men whose wives did not have CVD. A man’s likelihood of CVD was highest if his wife had a history of stroke, obesity or smoking. Among women whose husbands had CVD, 21% had CVD themselves, compared to just 9% of women whose husbands did not have CVD. A woman’s likelihood of CVD was highest if her husband had a history of stroke. Fourth study Adults who reported severe psychological distress, such as depression or anxiety, after suffering a heart attack were more than twice as likely to suffer a second cardiac event within five years compared with those experiencing only mild distress. The study is the first to comprehensively assess how mental health influences the outlook for younger (aged 18–61 years) heart attack survivors, according to the researchers. The study tracked inflammatory markers that appear to have a role in increasing cardiovascular risk among people experiencing distress. The findings align with previous studies focusing on older adults, bolstering the evidence for mental health as an integral part of a person’s recovery after a heart attack. ‘Our findings suggest that cardiologists should consider the value of regular psychological assessments, especially among younger patients,’ said Dr Mariana Garcia, a cardiology fellow at Emory University in Atlanta and the study’s lead author. ‘Equally importantly, they should explore treatment modalities for ameliorating psychological distress in young patients after a heart attack, such as meditation, relaxation techniques and holistic approaches, in addition to traditional medical therapy and cardiac rehabilitation.’ The researchers analysed health outcomes in 283 heart attack survivors between the ages of 18 and 61 years, with an average age of 51 years. Study participants completed a series of validated questionnaires measuring depression, anxiety, anger, perceived stress and post-traumatic stress disorder within six months of their heart attack. Based on these questionnaires, the researchers established a composite score of psychological distress for each participant and grouped patients based on experiences of mild, moderate and high distress. Within five years after their heart attack, 80 of the 283 patients suffered a subsequent heart attack or stroke, were hospitalised for heart failure or died from cardiovascular causes. These outcomes occurred in nearly half (47%) of patients experiencing high distress compared to 22% of those experiencing mild distress. Previous studies suggest inflammation is one mechanism through which psychological distress may lead to heart problems. In the new study, patients who experienced high distress were also found to have higher levels of two inflammatory markers, interleukin-6 and monocyte chemoattract protein-1, in their blood during rest and after mental stress. These markers, which increase during times of mental stress, are known to be associated with plaque build- up in the arteries and adverse cardiac events. continued on page 266 … Ann Noninvasive Electrocardiol 2008; 13 : 81–85. 16. Baman TS, Lange DC, Ilg KJ, Gupta SK, Liu T-Y, Alguire C, et al . Relationship between burden of premature ventricular complexes and left ventricular function. Heart Rhythm 2010; 7 : 865–869. 17. Dukes JW, Dewland TA, Vittinghoff E, Mandyam MC, Heckbert SR, Siscovick DS, et al . Ventricular ectopy as a predictor of heart failure and death . J Am Coll Cardiol 2015; 66 : 101–109. 18. Wang Y, Eltit JM, Kaszala K, Tan A, Jiang M, Zhang M, et al . Cellular mechanism of premature ventricular contraction-induced cardiomyopa- thy . 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