Risultati per: Come stress e attacchi di cuore sono collegati

Circulation, Volume 150, Issue Suppl_1, Page A4140852-A4140852, November 12, 2024. Introduction:Posttraumatic stress disorder (PTSD) is an independent cardiovascular disease (CVD) risk factor with high prevalence in women, particularly women veterans (WV). While the impact of PTSD on ischemic heart disease (IHD) and stroke has been well established, its impact on a comprehensive set of CVD outcomes has not been studied in WV, a growing population at high risk for CVD in the U.S. The goal of this project was to investigate the impact of PTSD on a comprehensive set of CVD conditions in WV.Methods:National Veterans Health Affairs (VHA) electronic health records were used to identify all women who visited any VAs from 1/1/2000 to 12/31/2019. PTSD and CVD were identified based on International Classification of Disease versions 9 and 10 diagnoses ( 1 inpatient or 2 outpatient encounter documentations). Incident CVD outcomes included first onset of IHD, stroke, cardiomyopathy/heart failure (HF), pulmonary arterial hypertension/pulmonary hypertension (PH), atrial flutter/fibrillation (AF), peripheral arterial disease (PAD), venous thromboembolism (VTE), and aortic stenosis (AS). Propensity score matching and Cox survival analyses were performed to assess associations of PTSD with incident CVD outcomes.Results:We identified 622,312 WV, with 140,210 (22.53%) with PTSD. After 1:1 matching, 202,896 patients were included in the final analysis. WV had a mean age of 39.1 years, and the mean [MOU1] follow-up was 5.72 years. Table 1 reveals the association of PTSD with an incident CVD composite and the different component outcomes individually.Conclusion:In a large sample of WV, we demonstrate significant and clinically relevant associations of PTSD with a comprehensive set of incident CVD outcomes. The potential association with some of the specific outcomes warrant further investigation. Maybe more of a call to action for PTSD screening and treatment to potentially offset CVD risk instead?

Circulation, Volume 150, Issue Suppl_1, Page A4141934-A4141934, November 12, 2024. Introduction:Heightened psychosocial stress is a CVD risk factor. While stressors are common and often co-occur, identifying sources and patterns of psychosocial stress exposure may provide insight into individual susceptibility to CVD. Therefore, we sought to identify and examine the longitudinal associations of baseline psychosocial stress subgroups with CVD events in MESA.Methods:Data from 6,349 adults (aged: 62.2±10.2 years; 52.9% women) from the MESA cohort with no prior CVD event at baseline (years 2000-2002) were used in this analysis. Latent class analysis (LCA) was used to specify distinct stress subgroups based on 6 variables: chronic burden, neighborhood safety, adequate food shopping, neighborhood noise, lifetime- and past-year discrimination. Five classes were determined after examining traditional fit indices. Adjudicated fatal and nonfatal CVD events were ascertained in annual follow-up visits through the year 2019. Cox proportional hazards models with sequential adjustment of baseline variables were used to examine the associations between subgroup membership and CVD events.Results:Five distinct stress subgroups were identified via LCA and were labeled “moderate neighborhood noise” (12.1%), “excessive noise/crime” (6.4%), “elevated on all” (6.3%), “high discrimination/safe neighborhood” (21.4%), “optimal” (53.8%) (see figure). By the year 2019, 1,121 participants had experienced a CVD event. Membership in the “elevated on all” and “high discrimination/safe neighborhood” subgroups (see table) were associated with higher risk of a CVD event when adjusted for sociodemographic characteristics and cardiovascular health metrics. However, when adjusted for measures of anxiety and depression, possible mediators, only membership in the “high discrimination/safe neighborhood” subgroup was associated with increased risk of a CVD event.Conclusions:Among 5 distinct stress subgroups those experiencing high discrimination had higher risk for CVD events.

Circulation, Volume 150, Issue Suppl_1, Page A4143092-A4143092, November 12, 2024. Background:Very high level, lifelong aerobic exercise results in lower ventricular stiffness and left ventricular wall stress (LVWS) LVWS is an important predictor of future heart failure risk. To what degree LVWS changes with various doses of lifelong aerobic exercise is unknown.Objective:The purpose of this study was to determine the impact of lifelong exercise on LVWS.Methods:Seniors (n = 58) who consistently participated in lifelong patterns of exercise training were recruited and categorized into 3 groups: “sedentary” (

Circulation, Volume 150, Issue Suppl_1, Page A4125939-A4125939, November 12, 2024. Background:Prophylactic steroids are often used to reduce the systemic inflammatory response to cardiopulmonary bypass in infants undergoing heart surgery. The STRESS trial found that the likelihood of a worse outcome did not differ between infants randomized to methylprednisolone vs placebo in a risk-adjusted primary analysis (adjusted odds ratio [OR], 0.86; 95% CI, 0.71 to 1.05; P=0.14). However, secondary unadjusted analyses showed possible benefits with methylprednisolone. We re-analyzed the STRESS trial using Bayesian analytics to assess probability of benefit with methylprednisolone.Methods:We used a covariate-adjusted proportional odds model using the original STRESS trial model covariates and primary outcome (a ranked composite of death, transplant, major complications and post-op length of stay). We assessed effect thresholds from OR 0.6 to 1.25 (OR 1 conveys harm). We assumed a neutral probability of benefit vs harm with weak prior belief (SD of the normal prior distribution = 0.425). In sensitivity analyses, we evaluated pessimistic (5%-30% prior likelihood of benefit), neutral and optimistic (70%-95% prior likelihood of benefit) prior beliefs, and controlled strength of prior belief as weak (SD = 0.425), moderate (SD = 0.215) and strong (SD = 0.135). We compared posterior distribution of the OR under these priors with the reference results under the vague prior distribution. Analyses consisted of 10 Markov Chain Monte Carlo simulations each consisting of 2000 iterations with a 1000 iteration burn-in to ensure proper posterior convergence.Results:In primary analysis, the posterior probability of benefit from methylprednisolone was 92% and the probability of harm was 8%. The mean absolute benefit was 12%. In sensitivity analyses, the probability of benefit was ≥ 79% for all informative priors except the most pessimistic (Table/Figure).Conclusion:In Bayesian re-analysis of the STRESS trial, probability of benefit with prophylactic methylprednisolone is high and harm is unlikely. Assessing probability of benefit or harm may be more informative than frequentist analytics relying on a p-value threshold. Another advantage is the ability to consider a range of prior evidence.

Aumenta la sopravvivenza ma il percorso di cura può essere lungo

Segnala al cervello il bisogno di sonno riparatore

Esce l’autobiografia scritta con Alessandro Repossi

Current evidence supports strong anticholinergics, non-selective beta-blockers, adrenaline, and anti-Parkinson’s agents impairing thermoregulation during heat stress. No evidence indicated thermoregulation is impacted by other WHO-listed medications. Evidence is predominantly limited to healthy young men, with short heat stress exposures. Studies over longer durations, in women, older adults and those with chronic diseases are required to better inform the pharmaceutical management of patients during hot weather.

Objectives
Sleep quality is a critical concern among healthcare professionals, yet the role of uncertainty stress has been inadequately explored. This study aims to explore the associations between sleep quality and uncertainty stress among healthcare professionals working in Chinese hospitals.

Design
Cross-sectional survey.

Setting
Data were collected via a cross-sectional survey administered to healthcare professionals across three Chinese provinces from 29 September 2022 to 18 January 2023.

Participants
A total of 1902 participants contributed valid responses for analysis.

Primary outcome measure
Sleep quality.

Results
Out of 1902 respondents, 26.4% reported uncertainty stress and 50.5% experienced insomnia. Binary logistic regression analysis revealed that higher uncertainty stress significantly predicted poor sleep quality (OR=3.89; 95% CI 3.06, 4.95; p

Objective
To estimate the prevalence of cyberbullying and its association with depression, anxiety and stress among female adolescents attending higher secondary schools in Deumai Municipality, Nepal.

Design
Cross-sectional survey study.

Setting
The survey was conducted at all available higher secondary schools of Deumai Municipality, Ilam District, Nepal, from February to April 2022.

Participants
A total of 501 female adolescents enrolled in grades 11 and 12 were included in the study. All eligible participants available on the day of data collection were approached until the calculated sample size was reached.

Outcome measures
The study assessed the prevalence of cyberbullying victimisation, along with the prevalence of depression, anxiety and stress and their associated factors. The level of psychological distress was explored using the Depression Anxiety Stress Scale-21. Pearson’s 2 test and multivariate logistic regression analysis were applied to determine the association between psychological distress and related variables, including cyberbullying victimisation, at 95% CI and 5% level of significance.

Results
Nearly a third (32.5%) of the female adolescents included in the study had experienced cyberbullying. The overall prevalence of depression, anxiety and stress was 46.5%, 52.7% and 34.9%, respectively. Cyberbullying victims were observed to have increased odds of experiencing depression (adjusted OR (aOR): 1.64, 95% CI 1.11 to 2.42), anxiety (aOR: 2.49, 95% CI 1.67 to 3.70) and stress (aOR: 2.59, 95% CI 1.74 to 3.86) in comparison with non-victims.

Conclusion
Cyberbullying victims are significantly more likely to experience psychological distress. There is an urgent need to strengthen cybersecurity and to have strong legislative measures to address cyberbullying in order to safeguard the mental health of adolescents in the digital age.

US Surgeon General Vivek Murthy, MD, MBA, issued an advisory on the mental health and well-being of parents and caregivers of children younger than 18 years. The report comes in response to the intense pressure reported by the roughly 63 million parents of children in the US: 33% reported high levels of stress over the course of a month compared with 20% of other adults in 2023.

Dati Ipsos e Fondazione Paoletti

Studio Fimmg-Metis, fino a 630 mila casi misconosciuti in Italia

Sip, incidono anche i pregiudizi, la discriminazione e le molestie

Sip,incidono anche i pregiudizi,la discriminazione e le molestie

I risultati del progetto Iss “Veterani in Sella”