‘Depression, stress, anxiety, anger compound heart disease woes’
Moderate physical activity associated with reduced cases of cardiac arrest
NEW research reveals that depressive symptoms, stress, anxiety, and anger and lack of social support in patients with rheumatoid arthritis (RA) were linked to atherosclerosis – a build-up of fatty deposits in the arteries that contributes to cardiovascular disease. The study published in Arthritis Care & Research, a journal of the American College of Rheumatology (ACR), suggests that screening and treatment of psychosocial symptoms may curb the cardiovascular disease burden in RA patients.
The United States Centers for Disease Control and Prevention (CDC) report that 1.5 million Americans are burdened by RA – an autoimmune disease that causes fatigue along with joint pain, swelling, and stiffness.
Previous studies have shown that cardiovascular disease is more prevalent in RA patients compared with the general population, and contributes to greater mortality in this patient group. However the reasons for this increased risk of heart disease in those with RA remains unknown. “Understanding the risk factors that lead to greater mortality in those with chronic conditions like RA is extremely important,” explains lead investigator Dr. Jon Giles, Assistant Professor of Medicine at Columbia University, College of Physicians & Surgeons in New York City.
“Our study is the first to investigate the association between psychosocial comorbidities and elevated risk of atherosclerosis in RA patients.” The present study used data from the Evaluation of Subclinical Cardiovascular Disease and Predictors of Events in Rheumatoid Arthritis Study (ESCAPE), which examined the prevalence, progression, and risk factors for cardiovascular disease in RA.
The cohort included 195 RA patients and 1,073 controls without RA who underwent computed tomography and ultrasound to measure coronary artery calcium (CAC) and carotid artery thickness for plaque build-up to determine the degree of atherosclerosis. According to the study results higher anxiety and anger scores, depression and caregiver stress were associated with increased risk of CAC greater than 100 units (moderate to severe disease) in patients with RA.
After adjustment for relevant covariates and markers of inflammation, findings persisted in those with RA and not in the controls. Meanwhile, men who participated in moderate amounts of physical activity, particularly walking and bicycling, were associated with a lower risk of future heart failure compared to those with lower and higher levels of activity.
However, recent active behavior may play a more important role than past physical activity, according to a study published in the Journal of the American College of Cardiology: Heart Failure. Researchers followed 33,012 men from the Cohort of Swedish Men from 1998 until 2012—or first event of heart failure—to determine if physical activity was associated with heart failure risk. Overall, men who had the lowest and highest levels of physical activity had a higher risk of heart failure, 47 percent and 51 percent respectively, than men with a median level. When analyzing the different types of physical activity, walking or bicycling for 20 minutes per day was associated with the largest risk reduction.
Meanwhile, a new study suggests children with multiple sclerosis (MS) who exercise regularly may have a less active disease. The research is published in the online issue of Neurology®, the medical journal of the American Academy of Neurology. “Up to three-quarters of children with MS experience depression, tiredness, or memory and thinking impairment,” said study author E. Ann Yeh, MD, with The Hospital for Sick Children (SickKids) in Toronto, Associate Professor at the University of Toronto in Toronto, Ontario, Canada and a member of the American Academy of Neurology. “Our research is important since little is known regarding how lifestyle behaviors may affect the disease.”
For the study, 31 children with MS and 79 who had experienced a single inflammatory neurologic event were given questionnaires about tiredness, depression and how often they exercised. Of those, 60 were also given MRI brain scans to measure brain volume and the amount and type of MS lesions they had.
Only 45 percent of the children with MS reported participating in any strenuous physical activity, compared to 82 percent of the other children. The children with MS who took part in strenuous physical activity were more likely to have a lower overall volume (amount) of lesions in the brain that indicate disease activity, or T2 lesions, than the children with MS who did not do strenuous activity.
Those who did strenuous activity had a median of 0.46 cm3 of T2 lesions, compared to 3.4 cm3 for those with no strenuous activity. Also, those with strenuous activity had a median of 0.5 relapses per year, compared to 1 per year for those with no strenuous activity.
The children with MS also had higher levels of tiredness and depression compared to the other children studied. There were no differences in whole brain volumes. The results were the same after researchers adjusted for the severity of the children’s disease.
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