New York: The way a person reacts to stressful events in life holds greater importance in terms of health as compared to the frequency with which one encounters it.
According to the researchers, the more negatively an individual perceives and reacts to a situation the more he/she may be at risk of developing heart disease.
The team wanted to find out whether daily stress and heart rate variability, a measure of autonomic regulation of the heart, are linked.
A potential pathway that links stress to future heart disease is a dysregulation of the autonomic nervous system- a case of a person’s normally self-regulated nervous system getting off track.
“Higher heart rate variability is better for health as it reflects the capacity to respond to challenges,” said Nancy L Sin from Pennsylvania State University.
“People with lower heart rate variability have a greater risk of cardiovascular disease and premature death,” Sin added in the paper published in the journal Psychosomatic Medicine.
Depression and major stressful events are known to be harmful to health, but less attention has been paid to the health consequences of frustrations and hassles in everyday life.
The team analysed the data collected from 909 participants between the ages of 35 and 85, including daily telephone interviews over eight consecutive days and the results from an electrocardiogram.
During daily phone interviews, participants were asked to report the stressful events as well as negative emotions they had experienced that day.
The researchers found that participants who reported a lot of stressful events in their lives were not necessarily those who had lower heart rate variability.
No matter how many or how few stressful events a person faces, it was those who perceived the events as more stressful or who experienced a greater spike in negative emotions had lower heart rate variability- meaning these people may be at a higher risk for heart disease, the authors noted. (IANS)
For people without heart disease, taking a daily aspirin to prevent heart attacks and strokes may increase the risk of severe brain bleeding to the point where it outweighs any potential benefit, a research review suggests.
U.S. doctors have long advised adults who haven’t had a heart attack or stroke but are at high risk for these events to take a daily aspirin pill, an approach known as primary prevention. Even though there’s clear evidence aspirin works for this purpose, many physicians and patients have been reluctant to follow the recommendations because of the risk of rare but potentially lethal internal bleeding.
For the current study, researchers examined data from 13 clinical trials testing the effects of aspirin against a placebo or no treatment in more than 134,000 adults. The risk of intracranial hemorrhage, or brain bleeds, was rare: taking aspirin was associated with two additional cases of this type of internal bleeding for every 1,000 people, the study found.
But the bleeding risk was still 37 percent higher for people taking aspirin than for people who didn’t take this drug. “Intracranial hemorrhage is a special concern because it is strongly associated with a high risk of death and poorer health over a lifetime,” said study co-author Dr. Meng Lee of Chang Gung University College of Medicine in Taiwan.
“These findings suggest caution regarding using low-dose in individuals without symptomatic cardiovascular disease,” Lee said by email.
Post-cardiac event use
For people who have already had a heart attack or stroke, the benefit of low-dose aspirin to prevent another major cardiac event is well established, researchers note in JAMA Neurology. But the value of aspirin is less clear for healthier people, for whom bleeding risks may outweigh any benefit, the study team writes.
Already, guidelines on aspirin for primary prevention of heart disease in the U.S., Europe and Australia have incorporated a need to balance the potential benefits against the risk of bleeding. For elderly people, who have a greater risk of bleeding than younger adults, the risks may be too great to recommend aspirin.
For adults ages 50 to 59 considering aspirin to prevent heart attacks and strokes, for example, the U.S Preventive Services Task Force (USPSTF) recommends the pill only for people who have at least a 10 percent risk of having a heart attack or stroke over the next decade and who don’t have a higher-than-average risk of bleeding. (The American College of Cardiology provides an online risk calculator.
One limitation of the analysis is that the smaller clinical trials examined a variety of aspirin doses up to 100 milligrams daily. The analysis also only focused on brain bleeds, and not on other types of internal bleeding associated with aspirin.
“We have long known that aspirin can precipitate bleeding, most commonly in the gastrointestinal tract, but most devastatingly in the brain,” said Dr. Samuel Wann, a cardiologist at Ascension Healthcare in Milwaukee, Wisconsin, who wasn’t involved in the study.
Despite the benefits for preventing heart attacks, the consensus on aspirin has changed over time, particularly for people without heart disease or hardening and narrowing of thearteries (atherosclerosis).
“We have previously recommended aspirin to prevent platelets from sticking to the inside of an individual’s arteries, but the benefit, while real, turns out to be small compared to the rare but devastating incidence of brain hemorrhage,” Wann said by email. “We no longer recommend routine use of aspirin in individuals who have no demonstrable cardiovascular disease or atherosclerosis.” (VOA)