Health Briefs

April 26, 2002

ANGRY YOUNG MEN & RISK OF PREMATURE CARDIOVASCULAR DISEASE
According to the current issue of the Archives of Internal Medicine, young men who respond to stress with high levels of anger are at increased risk of developing premature heart disease. A total of 1,055 male medical students were evaluated for nearly 40 years in this prospective study. At the time of entry into the study, none of the men had any evidence of coronary artery disease. All study participants completed a comprehensive survey, assessing their typical anger levels in response to various stressful events, upon entering the study.

The three examples of angry responses that were evaluated by the survey included expressed or concealed anger, gripe sessions, and irritability.

These young men were then followed for more than 30 years to assess their incidence of heart disease. The men who reported the highest levels of anger experienced a more than three-fold increase in the risk of premature coronary heart disease before age 55, and a more than six-fold increase in the risk of heart attack before age 55, when compared to men reporting the lowest levels of anger response to stressful events. When evaluating study participants who later developed coronary artery disease or/and heart attacks after age 55, there was no longer any correlation between anger levels and risk of these disease processes.

Further study is necessary to eliminate potential health factors that might also be associated with an angry disposition, such as tobacco use, diet, level of exercise, and family history of heart disease.

Bottom line: young men with a predisposition towards anger in the face of stressful experiences may be at very significantly increased risk of developing premature heart disease and, especially, premature heart attack.

STAY-AT-HOME DADS & RISK OF CARDIOVASCULAR DISEASE
We men just can't seem to win when it comes to cardiovascular health. The National Institutes for Health is reporting that dads who elect to stay at home to care for their children appear to experience an 82% increase in the risk of developing coronary artery disease. This American Heart Association study theorized that this unexpected finding might result from increased levels of stress experienced by men who stay at home while their wives work.

While this theory is as yet unproven, it may well be that men who choose this lifestyle experience greater stress levels as they swim against the currents of American society, and despite the significantly increased representation of women in the workplace over the past 30-40 years.

MORE ON THE EFFECTS OF STATINS
I have reported on the beneficial cardiovascular effects of the "statin" class of drugs on several occasions this year. From the journal The Lancet comes yet another persuasive study.

A total of 9,014 patients with a prior history of heart attack or unstable angina were enrolled in this study. Initially, half of the patients received a statin drug, Pravastatin, and the other half received a sugar pill (placebo). All patients were followed for 6 years, at which time all patients in the study were offered Pravastatin. The group receiving Pravastatin up front experienced an approximately 30% reduction in the risk of heart disease, stroke, and death due to heart disease. There were no significant complications associated with the use of Pravastatin in these patients.

DAIRY CONSUMPTION AND THE RISK OF PRE-DIABETES
The Insulin Resistance Syndrome (IRS) includes obesity, glucose intolerance, high blood pressure, and elevated cholesterol. Diet and exercise habits are thought to play a major role in the risk for developing IRS, and IRS is thought to be a precursor of diabetes. In a study reported in the current issue of the Journal of the American Medical Association, 3,157 volunteers between 18 and 30 years of age were followed for 10 years with diet surveys and medical exams. Quite unexpectedly, the study found that increased consumption of dairy products was associated with a 72% reduction in the risk of IRS, but only among obese volunteers. Among volunteers who were not obese, however, no association was found between dairy product consumption and the risk of IRS.

SMALLPOX VACCINE: GOOD TO THE LAST DROP?
According to the current issue of the New England Journal of Medicine, smallpox vaccine can be diluted to as little as one-tenth the standard dose and still retain its clinical effectiveness in most patients. As residual stocks of this vaccine are in short supply, this is very good news.

Dr. Robert A. Wascher