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Kawachi I, Kyriopoulos I, Vandoros S. Economic uncertainty and cardiovascular disease mortality. HEALTH ECONOMICS 2023; 32:1550-1560. [PMID: 36952311 DOI: 10.1002/hec.4678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 06/04/2023]
Abstract
Previous studies have found a link between economic conditions, such as recessions and unemployment, and cardiovascular disease as well as other health outcomes. More recent research argues that economic uncertainty-independently of unemployment-can affect health outcomes. Using data from England and Wales, we study the association between fluctuations in economic uncertainty and cardiovascular disease mortality in the short term for the period 2001-2019. Controlling for several economic indicators (including unemployment), we find that economic uncertainty alone is strongly associated with deaths attributed to diseases of the circulatory system, ischemic heart disease and cerebrovascular disease. Our findings highlight the short-term link between economic conditions and cardiovascular health and reveal yet another health outcome that is associated with uncertainty.
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Affiliation(s)
- Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Ilias Kyriopoulos
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Sotiris Vandoros
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Department of Economics, King's Business School, King's College London, London, UK
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Li W, Chen J, He X, Wang J, Wei C, Tang X, Gao P. Stock volatility and hospital admissions for cardiovascular disease: results from the National Insurance Claims for Epidemiological Research (NICER) study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 31:100595. [PMID: 36879781 PMCID: PMC9985007 DOI: 10.1016/j.lanwpc.2022.100595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND The association between stock volatility and cardiovascular diseases (CVD) was described during the 2008 Global Stock Market Crash; however, whether the finding in an occasional stock market crash is spurious remains unclear. METHODS A time-series design was used to evaluate the association between short-term exposure to daily returns of two major indices and daily hospital admissions for CVD and its subtypes based on claims data from the National Insurance Claims for Epidemiological Research (NICER) study covering 174 major cities in China. The average percentage change in daily hospital admissions for cause-specific CVD per 1% change in daily index returns was calculated because the Chinese stock market policy limits its change by 10% of the previous day's closing price. A Poisson regression in a generalised additive model was used to assess the city-specific association; then, overall national estimations were pooled by random-effects meta-analysis. FINDINGS Totally 8,234,164 hospital admissions for CVD were recorded during 2014-2017. Points of the Shanghai closing indices ranged from 1991·3 to 5166·4. A U-shaped association was observed between daily index returns and CVD admissions. Changes of 1% in daily returns of the Shanghai index corresponded to 1·28%(95%CI: 1·04%-1·53%), 1·25%(0·99%-1·51%), 1·42%(1·13%-1·72%), and 1·14%(0·39%-1·89%) increases in hospital admissions for total CVD, ischaemic heart disease, stroke, or heart failure on the same day, respectively. Similar results were observed for the Shenzhen index. INTERPRETATION Stock market volatility is associated with an increased CVD admission. FUNDING Chinese Ministry of Science and Technology (2020YFC2003503) and National Natural Science Foundation of China (81973132, 81961128006).
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Affiliation(s)
- Wei Li
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China
| | - Jia Chen
- Peking University, Beijing, China
| | - Xianjie He
- School of Accountancy, Shanghai University of Finance and Economics, Shanghai, China
| | - Jinxi Wang
- Beijing HealthCom Data Technology, Beijing, China
| | - Chen Wei
- Beijing HealthCom Data Technology, Beijing, China
| | - Xun Tang
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China
- Center for Real-world Evidence evaluation, Peking University Clinical Research Institute, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
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Chen Z, James J. Put your FTSE down: Wealth shocks and road traffic collisions. Soc Sci Med 2022; 314:115488. [PMID: 36343462 DOI: 10.1016/j.socscimed.2022.115488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
This paper examines the impact of a key source of wealth (the stock market) on road traffic collisions. Using data on over 2 million road accidents we do not find a linear relationship between stock prices and road crashes (fatal or otherwise) in Great Britain. However, we do find a V-shaped effect - collisions respond to the absolute change in stock market returns. The results are robust to a series of falsification exercises that potentially support a causal interpretation. We also examine another source of wealth that has not previously been examined - house prices. Similarly, we do not find that changes in monthly house prices have an impact on accidents, but a symmetric V-shaped is also shown for slight and serious accidents.
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Affiliation(s)
- Zisen Chen
- University of Bath, Bath, BA2 7AY, United Kingdom
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Lian H, Ding X, Zhang H, Wang X. Short-term effect of stock volatility and cardiovascular mortality: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1317. [PMID: 33209897 PMCID: PMC7661879 DOI: 10.21037/atm-20-6557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Cardiovascular disease (CVD) and stroke are leading causes of death. It has several risk factors, including stress and pressure. Stock volatility can cause acute stress for stockholders so that it can cause CVD events. Recently, the spread of new coronaviruses worldwide has affected economic development greatly, leading to more severe stock market fluctuations, so we systematically quantify the short-term effect of stock volatility and CVD events. Methods Time-series analysis on the effect of stock volatility and cardiovascular events were concluded. We conducted a systematic literature search for studies published in PubMed, Embase, and Cochrane Data up to the date February 9, 2020. We assessed publication bias using Egger’s test. Overall analysis and sensitivity analysis were conducted separately. Results Four studies were finally included. Every 100-point increase in the stock market will bring about 1.01% increases in cardiovascular mortality [95% confidence intervals (CI), −0.18% to 2.21%]. The meta-analysis showed no statistical significance for cardiovascular mortality. Every 100-point increase in the stock market brought 1.01% increases in the cardiovascular mortality [95% CI, −0.18% to 2.21%]. In terms of stroke events, the estimated effect was 2.999% (95% CI, 0.325% to 5.673%). Different lag patterns also have effects on cardiovascular mortality. Every 100-point increase brought about 4.026% (95% CI, 1.516% to 6.536%) and 4.424% (95% CI, 1.145% to 7.703%) for lag 01 and 04 separately. Conclusions Though our study has a number of limitations due to the limited studies included, it suggested that stock volatility had a lagging effect on CVD mortality, which may last for several days. Also, it might increase the incidence of stroke.
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Affiliation(s)
- Hui Lian
- Health Care Department, Peking Union Medical College Hospital, Beijing, China
| | - Xin Ding
- Critical Care Department, Peking Union Medical College Hospital, Beijing, China
| | - Hongmin Zhang
- Critical Care Department, Peking Union Medical College Hospital, Beijing, China
| | - Xiaoting Wang
- Health Care Department, Peking Union Medical College Hospital, Beijing, China.,Critical Care Department, Peking Union Medical College Hospital, Beijing, China
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Yap J, Earnest A, Lee V, Sng G, Lam C, Yeo KK. Impact of stock market volatility on mortality and cardiovascular events. Int J Cardiol 2016; 223:318-319. [PMID: 27543701 DOI: 10.1016/j.ijcard.2016.08.206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 08/10/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Jonathan Yap
- Department of Cardiology, National Heart Centre, Singapore
| | - Arul Earnest
- Department of Epidemiology and Preventive Medicine, Monash University, Australia
| | - Vernon Lee
- Saw Swee Hock School of Public Health, National University of, Singapore; Public Health Group, Ministry of Health, Singapore
| | - Gerald Sng
- Department of Cardiology, National Heart Centre, Singapore
| | - Carolyn Lam
- Department of Cardiology, National Heart Centre, Singapore; Cardiovascular Research Institute, National University of Singapore, Singapore
| | - Khung Keong Yeo
- Department of Cardiology, National Heart Centre, Singapore; Duke-NUS Graduate Medical School, Singapore.
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Abstract
Using 10-year population data from 2000 through 2009 in Taiwan, this is the first paper to analyze the relationship between margin trading in stock markets and stroke hospitalizations. The results show that 3 and 6 days after an increase of margin trading in the Taiwan stock markets are associated with greater stoke hospitalizations. In general, a 1 % increase in total margin trading positions is associated with an increment of 2.5 in the total number of stroke hospitalizations, where the mean number of hospital admissions is 233 cases a day. We further examine the effects of margin trading by gender and age groups and find that the effects of margin trading are significant for males and those who are 45-74 years old only. In summary, buying stocks with money you do not have is quite risky, especially if the prices of those stocks fall past a certain level or if there is a sudden and severe drop in the stock market. There is also a hidden danger to one's health from margin trading. A person should be cautious before conducting margin trading, because while it can be quite profitable, danger always lurks just around the corner.
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Affiliation(s)
- Shu-Hui Lin
- Department of Finance, National Changhua University of Education, 2, Shi-Da Road, Changhua City, 500, Taiwan.
| | - Chien-Ho Wang
- Department of Economics, National Taipei University, 151, University Rd., San Shia, New Taipei City, 23741, Taiwan.
| | - Tsai-Ching Liu
- Department of Public Finance, National Taipei University, 151, University Rd., San Shia, New Taipei City, 23741, Taiwan.
| | - Chin-Shyan Chen
- Department of Economics, National Taipei University, 151, University Rd., San Shia, New Taipei City, 23741, Taiwan.
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Roth L, Rombouts M, Schrijvers DM, Lemmens K, De Keulenaer GW, Martinet W, De Meyer GRY. Chronic intermittent mental stress promotes atherosclerotic plaque vulnerability, myocardial infarction and sudden death in mice. Atherosclerosis 2015; 242:288-94. [PMID: 26233915 DOI: 10.1016/j.atherosclerosis.2015.07.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 06/18/2015] [Accepted: 07/13/2015] [Indexed: 01/24/2023]
Abstract
Vulnerable atherosclerotic plaques are prone to plaque rupture leading to acute cardiovascular syndromes and death. Elucidating the risk of plaque rupture is important to define better therapeutic or preventive strategies. In the present study, we investigated the effect of chronic intermittent mental stress on atherosclerotic plaque stability and cardiovascular mortality in apolipoprotein E-deficient (ApoE(-/-)) mice with a heterozygous mutation in the fibrillin-1 gene (Fbn1(C1039G+/)(-)). This mouse model displays exacerbated atherosclerosis with spontaneous plaque ruptures, myocardial infarction and sudden death, when fed a Western-type diet (WD). Female ApoE(-/-)Fbn1(C1039G+/-) mice were fed a WD for up to 25 weeks. After 10 weeks WD, mice were divided in a control (n = 27) and mental stress (n = 29) group. The chronic intermittent mental stress protocol consisted of 3 triggers: water avoidance, damp bedding and restraint stress, in a randomly assigned order lasting 6 h every weekday for 15 weeks. Chronic intermittent mental stress resulted in a significant increase in the amount of macrophages in atherosclerotic plaques of the proximal ascending aorta, whereas type I collagen and fibrous cap thickness were decreased. The coronary arteries of mental stress-treated mice showed larger plaques, more stenosis, and an increased degree of perivascular fibrosis. Moreover, myocardial infarctions occurred more frequently in the mental stress group. As compared to the control group, the survival of stressed ApoE(-/-)Fbn1(C1039G+/-) mice decreased from 67% to 52% at 25 weeks WD, presumably due to myocardial infarctions. In conclusion, chronic intermittent mental stress promotes plaque instability, myocardial infarctions, and mortality of ApoE(-/-)Fbn1(C1039G+/-) mice.
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Affiliation(s)
- Lynn Roth
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium.
| | - Miche Rombouts
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | | | - Katrien Lemmens
- Laboratory of Pharmacology, University of Antwerp, Antwerp, Belgium
| | | | - Wim Martinet
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
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Cotti C, Dunn RA, Tefft N. The Dow is Killing Me: Risky Health Behaviors and the Stock Market. HEALTH ECONOMICS 2015; 24:803-21. [PMID: 24803424 DOI: 10.1002/hec.3062] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 03/07/2014] [Accepted: 04/11/2014] [Indexed: 05/05/2023]
Abstract
We investigate how risky health behaviors and self-reported health vary with the Dow Jones Industrial Average (DJIA) and during stock market crashes. Because stock market indices are leading indicators of economic performance, this research contributes to our understanding of the macroeconomic determinants of health. Existing studies typically rely on the unemployment rate to proxy for economic performance, but this measure captures only one of many channels through which the economic environment may influence individual health decisions. We find that large, negative monthly DJIA returns, decreases in the level of the DJIA, and stock market crashes are widely associated with worsening self-reported mental health and more cigarette smoking, binge drinking, and fatal car accidents involving alcohol. These results are consistent with predictions from rational addiction models and have implications for research on the association between consumption and stock prices.
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Affiliation(s)
- Chad Cotti
- Department of Agricultural and Resource Economics, College of Agriculture and Natural Resources, University of Connecticut, Storrs, CT, USA
- Department of Economics, College of Business, University of Wisconsin-Oshkosh, Oshkosh, WI, USA
| | - Richard A Dunn
- Department of Agricultural Economics, College of Agriculture and Life Sciences, and Department of Economics, College of Liberal Arts, Texas A&M University, College Station, TX, USA
| | - Nathan Tefft
- Department of Health Services, School of Public Health, and Department of Economics, College of Arts and Sciences, University of Washington, Seattle, WA, USA
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Li Y, Rukshin I, Pan F, Sen S, Islam M, Yousif A, Rukshin V. The impact of the 2008-2009 economic recession on acute myocardial infarction occurrences in various socioeconomic areas of raritan bay region, new jersey. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2014; 6:215-8. [PMID: 24926446 PMCID: PMC4049054 DOI: 10.4103/1947-2714.132938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Psychosocial stress is one important risk factor for myocardial infarction. Aim: The study was to assess the impact of the 2008-2009 economic recession on myocardial infarction occurrences in different socioeconomic areas of Raritan Bay region, New Jersey. Materials and Methods: The patients, who were treated for acute myocardial infarction from January 2006 to June 2012, were grouped based on the average incomes of their residence districts in the Raritan Bay region. The Spearman Rank Correlation test was used to assess the correlation between the monthly occurrences of myocardial infarction and Dow Jones stock averages, as well as the correlation between the myocardial infarction occurrences and NJ State unemployment rates. Results: Among 1,491 cases that were identified, 990 cases resided in areas with income below the state average and 477 were from areas above the average. After the onset of the recession, the myocardial infarction occurrences trended up in the low-income area group but not in the high-income area group; and this increasing trend is correlated with the rise in NJ State unemployment rates but not with the changes in stock averages. Conclusion: Our findings suggest that unemployment contributed to an increased risk of myocardial infarction among the residents in low socioeconomic areas after the 2008-2009 economic recession.
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Affiliation(s)
- Yulong Li
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, USA
| | - Iris Rukshin
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, USA
| | - Fangfang Pan
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, USA
| | - Shuvendu Sen
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, USA
| | - Mohammed Islam
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, USA
| | - Abdalla Yousif
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, USA
| | - Vladimir Rukshin
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, USA
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Zhang Y, Wang X, Xu X, Chen R, Kan H. Stock volatility and stroke mortality in a Chinese population. J Cardiovasc Med (Hagerstown) 2013; 14:617-21. [DOI: 10.2459/jcm.0b013e32835ec51f] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lin H, Zhang Y, Xu Y, Liu T, Xiao J, Luo Y, Xu X, He Y, Ma W. Large daily stock variation is associated with cardiovascular mortality in two cities of Guangdong, China. PLoS One 2013; 8:e68417. [PMID: 23874619 PMCID: PMC3713028 DOI: 10.1371/journal.pone.0068417] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 05/28/2013] [Indexed: 11/18/2022] Open
Abstract
Objective The current study aimed to examine the effects of daily change of the Shenzhen Stock Exchange Index on cardiovascular mortality in Guangzhou and Taishan, China. Methods Daily mortality and stock performance data during 2006–2010 were collected to construct the time series for the two cities. A distributed lag non-linear model was utilized to examine the effect of daily stock index changes on cardiovascular mortality after controlling for potential confounding factors. Results We observed a delayed non-linear effect of the stock index change on cardiovascular mortality: both rising and declining of the stock index were associated with increased cardiovascular deaths. In Guangzhou, the 15–25 lag days cumulative relative risk of an 800 index drop was 2.08 (95% CI: 1.38–3.14), and 2.38 (95% CI: 1.31–4.31) for an 800 stock index increase on the cardiovascular mortality, respectively. In Taishan, the cumulative relative risk over 15–25 days lag was 1.65 (95% CI: 1.13–2.42) for an 800 index drop and 2.08 (95% CI: 1.26–3.42) for an 800 index rising, respectively. Conclusions Large ups and downs in daily stock index might be important predictor of cardiovascular mortality.
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Affiliation(s)
- Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yanjun Xu
- Guangdong Provincial Institute of Public Health, Guangzhou, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yuan Luo
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xiaojun Xu
- Guangdong Provincial Institute of Public Health, Guangzhou, China
| | - Yanhui He
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- * E-mail:
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Schwartz BG, Pezzullo JC, McDonald SA, Poole WK, Kloner RA. How the 2008 stock market crash and seasons affect total and cardiac deaths in Los Angeles County. Am J Cardiol 2012; 109:1445-8. [PMID: 22381159 DOI: 10.1016/j.amjcard.2012.01.354] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 01/02/2012] [Accepted: 01/02/2012] [Indexed: 11/25/2022]
Abstract
Various stressors trigger cardiac death. The objective was to investigate a possible relation between a stock market crash and cardiac death in a large population within the United States. We obtained daily stock market data (Dow Jones Industrial Average Index), death certificate data for daily deaths in Los Angeles County (LA), and annual LA population estimates for 2005 through 2008. The 4 years death rate curves (2005 through 2008) were averaged into a single curve to illustrate annual trends. Data were "deseasonalized" by subtracting from the daily observed value the average value for that day of year. There was marked seasonal variation in total and cardiac death rates. Even in the mild LA climate, death rates were higher in winter versus summer including total death (+17%), circulatory death (+24%), coronary heart disease death (+28%), and myocardial infarction death (+38%) rates (p <0.0001 for each). Absolute coronary heart disease death rates have decreased since 1985. After accounting for seasonal variation, the large stock market crash in October 2008 did not affect death rates in LA. Death rates remained at or below seasonal averages during the stock market crash. In conclusion, after correcting for seasonal variation, the stock market crash in October 2008 was not associated with an increase in total or cardiac death in LA. Annual coronary heart disease death rates continue to decrease. However, seasonal variation (specifically winter) remains a trigger for death and coronary heart disease death even in LA where winters are mild.
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Franklin BA, Lavie CJ. Triggers of acute cardiovascular events and potential preventive strategies: prophylactic role of regular exercise. PHYSICIAN SPORTSMED 2011; 39:11-21. [PMID: 22293764 DOI: 10.3810/psm.2011.11.1934] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is now considerable evidence to suggest that acute myocardial infarction, sudden cardiac death, and stroke can be triggered by physical, chemical, and psychological stressors, including heavy physical exertion and situations that create heightened emotional stress. The increased risk appears to be largely limited to a susceptible subset of the population, that is, individuals with known or occult cardiovascular (CV) disease. In this article, we summarize the evidence supporting the impact of selected triggers in the pathogenesis of acute CV events, as well as the potential role of various preventive strategies, especially regular exercise training and improvements in cardiorespiratory fitness to reduce the CV risk imposed by various triggers.
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Affiliation(s)
- Barry A Franklin
- Department of Cardiology, Preventive Cardiology and Rehabilitation, William Beaumont Hospital, Royal Oak, MI, USA.
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Brummett BH, Babyak MA, Siegler IC, Shanahan M, Harris KM, Elder GH, Williams RB. Systolic blood pressure, socioeconomic status, and biobehavioral risk factors in a nationally representative US young adult sample. Hypertension 2011; 58:161-6. [PMID: 21730296 PMCID: PMC3160108 DOI: 10.1161/hypertensionaha.111.171272] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the National Longitudinal Study of Adolescent Health, a US longitudinal study of >15 000 young adults, we examined the extent to which socioeconomic status is linked to systolic blood pressure (SBP) and whether biobehavioral risk factors mediate the association. More than 62% of the participants had SBP >120 mm Hg and 12% had SBP >140 mm Hg. More than 66% were classified as at least overweight (body mass index >25 kg/m(2)), with >36% meeting criteria for at least class I obesity (body mass index >30 kg/m(2)). Multivariate models showed that higher household income and being married were independently associated with lower SBP. Higher body mass index, greater waist circumference, smoking, and higher alcohol intake were each independently associated with higher SBP. Meditational analyses suggested that higher education level was associated with lower SBP by way of lower body mass, smaller waist circumference, and lower resting heart rate. When these indirect effects were accounted for, education was not significantly associated with SBP. In contrast, household income remained associated with SBP even with control for all of the covariates. Results reinforce current public health concerns about rates of obesity and high blood pressure among young adults and suggest that disparities in education level and household income may play an important role in the observed decrements in health. Identifying modifiable mechanisms that link socioeconomic status to SBP using data from a large representative sample may improve risk stratification and guide the development of effective interventions.
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Affiliation(s)
- Beverly H Brummett
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 2969, Durham, NC 27710, USA.
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Lavie CJ, Masvidal D, Milani RV, Franklin BA. Exercise training, cardiorespiratory fitness, and cardiovascular triggers. Am J Cardiol 2011; 107:1252. [PMID: 21457809 DOI: 10.1016/j.amjcard.2011.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 01/11/2011] [Indexed: 11/16/2022]
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