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Acute MI risk increased by excessive physical activity, anger, emotional upset
Patients who experience anger and emotional upset and engage in heavy physical activity are twice as likely to experience acute MI, according to a new study.
The results of the international INTERHEART study showed a link between emotional upset, vigorous physical activity, anger and the onset of acute MI symptoms within 1 hour.
“Previous studies have explored these [MI] triggers; however, they had fewer participants or were completed in one country, and data are limited from many parts of the world,” Andrew Smyth, MD, PhD, a researcher at the Population Health Research Institute at McMaster University in Hamilton, Ontario, Canada, and at the HRB Clinical Research Facility in Galway, Ireland, said in a press release. “This is the first study to represent so many regions of the world, including the majority of the world’s major ethnic groups.”
The case-control study focused on first occurrences of acute MI throughout 52 countries, which were categorized into 10 geographical regions.
Participants (mean age, 58 years; 76% men) received a standardized physical examination and were given a questionnaire.
Patients with prior acute MI were questioned on the events leading up to the MI, including their level of physical activity and their emotional state in the 24 hours before their MI. The case period, defined as 1 hour before onset of acute MI symptoms, was compared with the control period, defined as the same 1-hour period the day before onset of MI symptoms.
Data on medical history, age, ethnicity, diet, physical activity, tobacco use, education, employment, psychosocial factors and CV risk factors were also taken into account.
MI odds elevated
Among the 12,461 individuals with acute MI, 13.6% (n = 1,650) engaged in physical activity and 14.4% (n = 1,746) were angry or upset in the 1-hour period before symptoms. During the case period, physical activity was associated with increased odds of acute MI (OR = 2.31; 99% CI, 1.96-2.72), with a population-attributable risk of 7.7% (99% CI, 6.3-8.8).
Anger or emotional upset in the hour before MI was associated with increased odds of acute MI (OR = 2.44; 99% CI, 2.06-2.89), with a population-attributable risk of 8.5% (99% CI, 7-9.6), according to the researchers.
Results did not differ by geographical region, prior CVD, CV risk factor burden, CV prevention medications, or time of day or day of onset of acute MI.
The occurrence of physical activity and anger or emotional upset in the case period was linked to further increase in the odds of acute MI (OR = 3.05; 99% CI, 2.29-4.07; P for interaction < .001).
Avoid extremes
Although the results of the study do not cancel out the heart-healthy benefits of regular physical activity, excessive physical exertion and anger or emotional upset are risk factors for acute MI worldwide regardless of sex or ethnicity, the researchers wrote.
“This large, nearly worldwide study provides more evidence of the crucial link between mind and body,” Barry J. Jacobs, PsyD, American Heart Association volunteer and director of behavioral sciences at the Crozer-Keystone Family Medicine Residency Program in Springfield, Pennsylvania, said in the release. “Excess anger, under the wrong conditions, can cause a life-threatening [MI]. All of us should practice mental wellness and avoid losing our temper to extremes.” – by Dave Quaile
Disclosure: The researchers and Jacobs report no relevant financial disclosures.