We found that a considerable proportion of patients with acute coronary syndromes develop elevated PTSD symptoms, and elevated intrusion symptoms in particular. Further, our results confirm and extend prior findings of an association between post-ACS PTSD symptoms and increased risk of recurrent MACE/ACM.anxiety as a risk factor for cardiovascular disease …The findings of the present study demonstrate that patients who have intrusive, emotionally-charged thoughts, nightmares, or flashbacks related to their ACS may be at especially high risk for MACE recurrence and mortality.
“Anxiety disorders are associated with an elevated risk of a range of different cardiovascular events, including stroke, coronary heart disease, heart failure, and cardiovascular death. Whether these associations are causal is unclear.”
Lancet PSTD studies
bereavement and mortality
Within 30 days of their partner’s death, 50 of the bereaved group (0.16%) experienced an MI or a stroke compared with 67 of the matched nonbereaved controls (0.08%) during the same period (IRR, 2.20 [95% CI, 1.52-3.15]).
We found a dose-response association between psychological distress across the full range of severity and an increased risk of mortality (age and sex adjusted hazard ratio for General Health Questionnaire scores of 1-3 v score 0: 1.20, 95% confidence interval 1.13 to 1.27; scores 4-6: 1.43, 1.31 to 1.56; and scores 7-12: 1.94, 1.66 to 2.26; P<0.001 for trend). This association remained after adjustment for somatic comorbidity plus behavioural and socioeconomic factors. A similar association was found for cardiovascular disease deaths and deaths from external causes. Cancer death was only associated with psychological distress at higher levels.
association increased mortality for CVS death
carers and stress
participants who were providing care and experiencing caregiver strain had mortality risks that were 63% higher than noncaregiving controls (relative risk [RR], 1.63; 95% confidence interval [CI], 1.00-2.65). Participants who were providing care but not experiencing strain (RR, 1.08; 95% CI, 0.61-1.90) and those with a disabled spouse who were not providing care (RR, 1.37; 95% CI, 0.73-2.58) did not have elevated adjusted mortality rates relative to the noncaregiving controls.
Among those participants with disabled spouses, about 81% were providing care and about 56% of those reported caregiver strain.
After 4 years of follow-up, 103 deaths (12.6%) occurred among the total sample. Death occurred in 40 (9.4%) of the 427 participants whose spouses were not disabled at baseline, in 13 (17.3%) of the 75 subjects whose spouses were disabled but who were not providing help, in 19 (13.8%) of the 138 subjects who were providing care but were not strained, and in 31 (17.3%) of the 179 who were providing care and reported caregiver strain ( χ23, 9.38; P<.025). As would be expected, there was a strong linear trend (χ21, 31.59; P<.001) in mortality rates for physical health status: no prevalent or subclinical disease (14/261 [5.4%]); subclinical (no prevalent) disease (39/336 [11.6%]); and prevalent disease (50/222 [22.5%]
Christmas BMJ – Dutch football matches and heart attacks
“numerous clinical triggers of MI have been identified, including blizzards, the Christmas and New Year’s holidays, experiencing an earthquake, the threat of violence, job strain, Mondays for the working population, sexual activity, overeating, smoking cigarettes, smoking marijuana, using cocaine, and particulate air pollution