Hospitalizations for cardiovascular disease rose in the wake of the 2020 US election

Biden and Trump’s bitter fight appears to have led to CVD events, particularly acute MI, highlighting the dangers of emotional stress.

In the immediate aftermath of the 2020 presidential election — a belligerent and divisive relationship between Donald Trump and Joe Biden — the number of hospitalizations for acute cardiovascular disease in the United States has increased, according to a new analysis of a major health care system.

Compared with the 5-day control period two weeks before the election, the risk of hospitalization for acute myocardial infarction, heart failure (HF) or stroke was significantly higher in the five days after the election, a finding that investigators say adds more evidence. . Support the association between psychological stress and cardiovascular risk.

Jamal Rana, MD, PhD (Kaiser Permanente Northern California, Oakland), who led the study with Matthew Meiford, PhD (Kaiser Permanente Southern California, Pasadena), said the harmful effects of emotional stress on the heart are well known and that the 2020 election has been long-running. and associated stress. While researchers haven’t studied the mechanisms of stress on the heart, “stress can affect inflammation, the autonomic system, blood pressure, and possibly even the immune response,” Rana told TCTMD.

Although easier said than done, we should all try not to take these outside pressures, literally, to heart. Jamal Rana

However, negative emotional traits rated — whether it’s anger, hostility, emotional/psychological stress, or anxiety — evidence suggests they contribute to CVD risk, the researchers say. Studies have linked emotional stress to large-scale national and international events – anything from Hurricane Katrina to me EnergyWith negative clinical results.

In the hours and days following the 2020 election, there were widespread and unsubstantiated allegations of voter fraud, as well as controversy over different timelines for mail-in and in-person vote counting and reporting, leading to altered vote totals. There has also been speculation that Donald Trump will not admit losing the election. All of this contributed to creating “an emotionally charged atmosphere across the United States regardless of demographic or political affiliation,” say Mefford and colleagues. Two years ago, researchers Published a similar study The increased risk of hospitalization for MI and stroke emerges in the days after the 2016 election, and it’s another divisive and contentious battle.

High acute hospitalization rate at MI

Continuing their previous work, Mayford and his colleagues turned to health care systems in Kaiser Permanente Southern and Northern California. The analysis, published online on April 20, 2022, in JAMA Network is open, including 6.4 million adults (53.5% female), 62.1% of them aged 18-54 years, 29.6% aged 55-74 years, and 8.3% 75 years of age and older. Among the participants, 41.3% were White, 32.9% Hispanic, 16.9% Asian/Pacific Islander, and 7.9% Black.

The hospitalization rate for acute MI, HF, or stroke in the five days before and after the 2020 election was 648.0 and 760.5 per 100,000 person-years, respectively (rate ratio 1.17; 95% CI 1.05–1.31). The hospitalization rate for acute MI was 1.42 higher in the 5 days after the election than in the control period of 5 days before the election (204.4 vs. 143.5 per 100 000 person-years, respectively), but there was no significant difference in the risk of HF or stroke.

In a subgroup analysis, the rate of hospitalization for CVD was higher among those 75 years and older (s For interaction by age = 0.10), among men (s for interaction by sex = 0.04), and among white individuals (s For interaction by race/ethnicity = 0.51).

Viola Vacarino, MD, PhD (Emory University School of Medicine, Atlanta, Georgia), who has taught The effect of pressure on the heartThe association between psychological stressors and CVD events is fairly consistent across different studies, outcome measures, and populations, he said. However, she noted, “The strength of the association tends to be higher when examining stress as a trigger for acute CVD events, as in studies that used a case-crossing design, and when examining high-risk populations, such as those already with heart disease.” and blood vessels, such as myocardial infarction survivors.”

These findings support the idea that vulnerable people may be affected by election-related stress, especially if they have underlying conditions, such as pre-existing heart disease, that put them at greater risk. Viola Vaccarino

For TCTMD, Vaccarino cautioned against over-interpreting these latest findings, saying the study only “suggests” that election stress increases risk of acute cardiovascular disease. Overall, the effect size is small although it is statistically significant, she noted, adding that there were only 112 hospital excess cases per 100,000 patients.

“There’s a lot of noise in these types of data, especially because the pressure wasn’t actually measured, and you can see that from the numbers,” she said, “The jump in rates is small.” Even for MI, the 40% increase is small enough to be explained by confounding factors. And seasonality is what worries me the most, especially because the elections took place near the end of daylight saving time. It was useful to compare the results with the same time periods in the previous year, for example. “

However, Vaccarino noted that acute stress can lead to myocardial ischemia and this Mental stress ischemia is associated with adverse cardiovascular outcomes. Even with the limitations of this latest analysis, “these findings support the idea that vulnerable people may be affected by election-related stress, especially if they have underlying conditions, such as pre-existing heart disease, that put them at greater risk,” Vacarino said.

Rana said awareness of negative emotional traits as a potential CVD risk factor is a reminder for people at risk to try to reduce stress and anxiety using various well-known techniques. “This includes exercising, not forgetting to take heart or blood pressure medications, and getting enough sleep,” he said. “Finally, although easier said than done, we should all try not to take these external pressures, literally, too seriously.”

Leave a Reply

Your email address will not be published.