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

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 5, September/October 2021 266 AFRICA … continued from page 253 ‘It is thought that those who have had a heart attack may be particularly vulnerable to plaque rupture as a result of these inflammatory mechanisms at play,’ Garcia said. ‘The association we found was independent of known cardiovascular risk factors and suggests mechanisms involving systemic inflammation in response to stress may be implicated in the likelihood of a subsequent cardiac event.’ The researchers also found that patients with high distress were more often black, female and from a disadvantaged socio-economic background and were more likely to smoke or have diabetes or high blood pressure. ‘This finding highlights the importance of socio-economic status with regard to higher distress and raises important questions about the role of race, gender and other factors,’ Garcia said. The researchers plan to further investigate how socio- economic and demographic factors may influence mental health among people who suffer a heart attack at a young age. Recent studies have suggested younger adults, especially women, account for an increasing proportion of the heart attacks occurring each year in the USA, Garcia said, underscoring the importance of improving outcomes in this population. ‘Outreach to the community has led to increased awareness of traditional heart disease risk factors and focuses on things such as diet and exercise, but many people, particularly younger people, may not be aware of the importance of mental health,’ Garcia said. ‘Our study offers a strong message to people recovering from a heart attack that ameliorating psychological distress is equally important. 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