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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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Behavioral economics: who are the investors with the most sustainable stock happiness, and why? Low aspiration, external control, and country domicile may save your lives—monetary wisdom. ASIAN JOURNAL OF BUSINESS ETHICS 2022. [PMCID: PMC9666999 DOI: 10.1007/s13520-022-00156-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AbstractSlight absolute changes in the Shanghai Stock Exchange Index (SHSE) corresponded to the city’s immediate increases in coronary heart disease deaths and stroke deaths. Significant fluctuations in the Shenzhen Stock Exchange Index (SZSE) corresponded to the country’s minor, delayed death rates. Investors deal with money, greed, stock volatility, and risky decision-making. Happy people live longer and better. We ask the following question: Who are the investors with the highest and most sustainable stock happiness, and why? Monetary wisdom asserts: Investors apply their deep-rooted values (avaricious love-of-money aspiration and locus of control, Level 2) as a lens to frame critical concerns in the proximal-immediate (Shanghai Stock Exchange Index changes, Level 1) and the omnibus-distal contexts (domicile: city vs. country, Level 2) to maximize expected utility (portfolio changes, Level 1) and ultimate serenity (stock happiness, Level 1). We collected multilevel data—the longitudinal SHSE and 227 private investors’ daily stock happiness and portfolio changes for 36 consecutive trading days in four regions of China. Investors had an average liquid asset of $76,747.41 and $54,660.85 in stocks. This study is not a “one-shot” game with “nothing at stake.” We classified Shanghai and Beijing as the city and Shenzhen and Chongqing as the country. Our cross-level 3-D visualization reveals that regardless of SHSE volatility, investors with low aspiration, external control, and country domicile enjoy the highest and most sustainable stock happiness with minimum fluctuations. Independently, investors with low aspiration, external control, and country domicile tend to make fewer portfolio changes than their counterparts. Behaviorally, less is more, debunking the myth—risky decisions excite stock happiness. Our longitudinal study expands prospect theory, incorporates attitude toward money, and makes robust contributions to behavioral economics and business ethics. We help investors and ordinary citizens make happy, healthy, and wealthy decisions. Most importantly, the life you save may be your own.
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La Rovere MT, Gorini A, Schwartz PJ. Stress, the autonomic nervous system, and sudden death. Auton Neurosci 2021; 237:102921. [PMID: 34823148 DOI: 10.1016/j.autneu.2021.102921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/07/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
The existence of an important relationship between stress, the autonomic nervous system, and sudden cardiac death (SCD) has been long recognized. In the present essay we review the large number of conditions, acting at individual or at population level, that have been causally associated to SCD and discuss the mechanistic and translational value of the studies exploring such associations. These conditions include external stressors (earthquakes, wars) and internal stressors (anger, fear, loss of a loved one) and emotions of even opposite sign. Most situations confirm the time-honored view that increases in sympathetic activity are proarrhythmic whereas increases in vagal activity are protective; however, we will also show and discuss a condition in which the culprit appears to be the excess of vagal activity. The physiologic rationale underlying the most typical situations is on one hand the profibrillatory effect of the increase in the heterogeneity of repolarization secondary to the release of norepinephrine, and on the other the combined effect of acetylcholine to lower heart rate and to antagonize the cardiac effects of norepinephrine at ventricular level. An interesting facet of this potentially lethal relationship is that the elements involved are by no means always exceptional, and they can actually represent part of our everyday life.
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Affiliation(s)
- Maria Teresa La Rovere
- Department of Cardiology, IRCCS Istituti Clinici Scientifici Maugeri, Montescano, Pavia, Italy.
| | - Alessandra Gorini
- Department of Oncology and Hemato-Oncology, University of Milan, Italy.
| | - Peter J Schwartz
- Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Istituto Auxologico Italiano, IRCCS, Milan, Italy.
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Mohammad MA, Koul S, Olivecrona GK, Gӧtberg M, Tydén P, Rydberg E, Scherstén F, Alfredsson J, Vasko P, Omerovic E, Angerås O, Fröbert O, Calais F, Völz S, Ulvenstam A, Venetsanos D, Yndigegn T, Oldgren J, Sarno G, Grimfjärd P, Persson J, Witt N, Ostenfeld E, Lindahl B, James SK, Erlinge D. Incidence and outcome of myocardial infarction treated with percutaneous coronary intervention during COVID-19 pandemic. Heart 2020; 106:1812-1818. [PMID: 33023905 PMCID: PMC7677488 DOI: 10.1136/heartjnl-2020-317685] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022] Open
Abstract
Objective Most reports on the declining incidence of myocardial infarction (MI) during the COVID-19 have either been anecdotal, survey results or geographically limited to areas with lockdowns. We examined the incidence of MI during the COVID-19 pandemic in Sweden, which has remained an open society with a different public health approach fighting COVID-19. Methods We assessed the incidence rate (IR) as well as the incidence rate ratios (IRRs) of all MI referred for coronary angiography in Sweden using the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR), during the COVID-19 pandemic in Sweden (1 March 2020–7 May 2020) in relation to the same days 2015–2019. Results A total of 2443 MIs were referred for coronary angiography during the COVID-19 pandemic resulting in an IR 36 MIs/day (204 MIs/100 000 per year) compared with 15 213 MIs during the reference period with an IR of 45 MIs/day (254 MIs/100 000 per year) resulting in IRR of 0.80, 95% CI (0.74 to 0.86), p<0.001. Results were consistent in all investigated patient subgroups, indicating no change in patient category seeking cardiac care. Kaplan-Meier event rates for 7-day case fatality were 439 (2.3%) compared with 37 (2.9%) (HR: 0.81, 95% CI (0.58 to 1.13), p=0.21). Time to percutaneous coronary intervention (PCI) was shorter during the pandemic and PCI was equally performed, indicating no change in quality of care during the pandemic. Conclusion The COVID-19 pandemic has significantly reduced the incidence of MI referred for invasive treatment strategy. No differences in overall short-term case fatality or quality of care indicators were observed.
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Affiliation(s)
- Moman A Mohammad
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Sasha Koul
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Göran K Olivecrona
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Matthias Gӧtberg
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Patrik Tydén
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Erik Rydberg
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Fredrik Scherstén
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | | | - Peter Vasko
- Department of Medicine, Växjö Hospital, Växjö, Sweden
| | - Elmir Omerovic
- Department of Cardiology, Department of Molecular and Clinical Medicine, Department of Cardiology, Sahlgrenska University Hospital, Institute of Medicine, Department of Molecular and Clinical Medicine,Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Oskar Angerås
- Department of Cardiology, Department of Molecular and Clinical Medicine, Department of Cardiology, Sahlgrenska University Hospital, Institute of Medicine, Department of Molecular and Clinical Medicine,Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ole Fröbert
- Department of Cardiology, Faculty of Health, Örebro University, Örebro, Sweden
| | - Fredrik Calais
- Department of Cardiology, Faculty of Health, Örebro University, Örebro, Sweden
| | - Sebastian Völz
- Department of Cardiology, Department of Molecular and Clinical Medicine, Department of Cardiology, Sahlgrenska University Hospital, Institute of Medicine, Department of Molecular and Clinical Medicine,Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | | | | | - Troels Yndigegn
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Jonas Oldgren
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Giovanna Sarno
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Per Grimfjärd
- Department of Internal Medicine, Västmanlands Sjuk, Lund, Sweden
| | - Jonas Persson
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockolm, Sweden
| | - Nils Witt
- Dvision of Cardiology, Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden
| | - Ellen Ostenfeld
- Department of Clinical Physiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden
| | - Bertil Lindahl
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Stefan K James
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - David Erlinge
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
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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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Mohammad MA, Karlsson S, Haddad J, Cederberg B, Jernberg T, Lindahl B, Fröbert O, Koul S, Erlinge D. Christmas, national holidays, sport events, and time factors as triggers of acute myocardial infarction: SWEDEHEART observational study 1998-2013. BMJ 2018; 363:k4811. [PMID: 30541902 PMCID: PMC6289164 DOI: 10.1136/bmj.k4811] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To study circadian rhythm aspects, national holidays, and major sports events as triggers of myocardial infarction. DESIGN Retrospective observational study using the nationwide coronary care unit registry, SWEDEHEART. SETTING Sweden. PARTICIPANTS 283 014 cases of myocardial infarction reported to SWEDEHEART between 1998 and 2013. Symptom onset date was documented for all cases, and time to the nearest minute for 88%. INTERVENTIONS Myocardial infarctions with symptom onset on Christmas/New Year, Easter, and Midsummer holiday were identified. Similarly, myocardial infarctions that occurred during a FIFA World Cup, UEFA European Championship, and winter and summer Olympic Games were identified. The two weeks before and after a holiday were set as a control period, and for sports events the control period was set to the same time one year before and after the tournament. Circadian and circaseptan analyses were performed with Sunday and 24:00 as the reference day and hour with which all other days and hours were compared. Incidence rate ratios were calculated using a count regression model. MAIN OUTCOME MEASURES Daily count of myocardial infarction. RESULTS Christmas and Midsummer holidays were associated with a higher risk of myocardial infarction (incidence rate ratio 1.15, 95% confidence interval 1.12 to 1.19, P<0.001, and 1.12, 1.07 to 1.18, P<0.001, respectively). The highest associated risk was observed for Christmas Eve (1.37, 1.29 to 1.46, P<0.001). No increased risk was observed during Easter holiday or sports events. A circaseptan and circadian variation in the risk of myocardial infarction was observed, with higher risk during early mornings and on Mondays. Results were more pronounced in patients aged over 75 and those with diabetes and a history of coronary artery disease. CONCLUSIONS In this nationwide real world study covering 16 years of hospital admissions for myocardial infarction with symptom onset documented to the nearest minute, Christmas, and Midsummer holidays were associated with higher risk of myocardial infarction, particularly in older and sicker patients, suggesting a role of external triggers in vulnerable individuals.
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Affiliation(s)
- Moman A Mohammad
- Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden
| | - Sofia Karlsson
- Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden
| | - Jonathan Haddad
- Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden
| | - Björn Cederberg
- Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden
| | - Tomas Jernberg
- Department of clinical sciences, Danderyd's University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Bertil Lindahl
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Ole Fröbert
- Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden
| | - Sasha Koul
- Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden
| | - David Erlinge
- Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden
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Abstract
Anger and other negative emotions can precipitate sudden death, as shown in studies of population stressors. Clinical studies of patients with implantable defibrillators demonstrate that anger can trigger ventricular arrhythmias. Long-term negative emotions also increase vulnerability to arrhythmias. Mechanisms linking anger and arrhythmias include autonomic changes, which alter repolarization, possibly enhanced in patients with sympathetic denervation, which in turn trigger potentially lethal polymorphic ventricular tachycardias. Interventions which decrease negative emotions and resultant autonomic responses may be therapeutic in patients with implantable cardioverter defibrillators.
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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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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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Kiyohara K, Kitamura T, Iwami T, Nishiyama C, Kawamura T. Impact of the Great East Japan earthquake on out-of-hospital cardiac arrest with cardiac origin in non-disaster areas [corrected]. J Epidemiol Community Health 2014; 69:185-8. [PMID: 25240062 DOI: 10.1136/jech-2014-204380] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND To examine changes in the incidence of out-of-hospital cardiac arrest (OHCA) with cardiac origin in the non-disaster areas of Japan before and after the Great East Japan Earthquake of 11 March 2011. METHODS The 35 prefectures in Japan with no dead or missing caused directly by the earthquake were defined as the non-disaster areas. Data of adult OHCA patients in the non-disaster areas from March 4 to 24 each year from 2005 to 2011 were obtained from the All-Japan Utstein Registry. Risk ratios (RRs) of OHCA incidence and 95% CIs were estimated for three specific weeks in 2011 (1 week before and 2 weeks after the earthquake) by applying multivariable Poisson regression model. Incidence in the corresponding periods of March 4-24 from 2005 to 2010 was set as the baseline risk. RESULTS In the analyses from a total of 17,353 OHCA patients, the incidence statistically significantly increased in the first week after the earthquake in all adults (adjusted-RR=1.13, 95% CI=1.05 to 1.22, p=0.001) and in elderly women (adjusted-RR=1.23, 95% CI=1.11 to 1.37, p<0.001). CONCLUSIONS The Great East Japan Earthquake caused the increase of OHCA among elderly women even in the non-disaster areas.
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Affiliation(s)
- Kosuke Kiyohara
- Department of Public Health, Tokyo Women's Medical University, Shinjuku-ku, Tokyo
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka
| | - Taku Iwami
- Kyoto University Health Service, Kyoto, Kyoto
| | - Chika Nishiyama
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Kyoto
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14
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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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Abstract
Cardiovascular disease is the most prevalent disease mainly in the Western society and becoming the leading cause of death worldwide. Standard methods by which healthcare providers screen for cardiovascular disease have only minimally reduced the burden of disease while exponentially increasing costs. As such, more specific and individualized methods for functionally assessing cardiovascular threats are needed to identify properly those at greatest risk, and appropriately treat these patients so as to avoid a fate such as heart attack, stroke, or death. Currently, endothelial function testing-in both the coronary and peripheral circulation-is well established as being associated with the disease process and future cardiovascular events. Improving such testing can lead to a reduction in the risk of future events. Combining this functional assessment of vascular fitness with other, more personalized, testing methods should serve to identify those at the greatest risk of cardiovascular disease earlier and subsequently reduce the affliction of such diseases worldwide.
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Affiliation(s)
- R. Jay Widmer
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN, USA
| | - Amir Lerman
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN, USA
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Cookson S, Salloum S. Markets down? Call the crash team. Am J Cardiol 2012; 110:1384; author reply p.1384. [PMID: 23059387 DOI: 10.1016/j.amjcard.2012.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 07/23/2012] [Indexed: 11/15/2022]
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Schwartz et al Reply. Am J Cardiol 2012. [DOI: 10.1016/j.amjcard.2012.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Schwartz BG, French WJ, Mayeda GS, Burstein S, Economides C, Bhandari AK, Cannom DS, Kloner RA. Emotional stressors trigger cardiovascular events. Int J Clin Pract 2012; 66:631-9. [PMID: 22698415 DOI: 10.1111/j.1742-1241.2012.02920.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
AIMS To describe the relation between emotional stress and cardiovascular events, and review the literature on the cardiovascular effects of emotional stress, in order to describe the relation, the underlying pathophysiology, and potential therapeutic implications. MATERIALS AND METHODS Targeted PUBMED searches were conducted to supplement the authors' existing database on this topic. RESULTS Cardiovascular events are a major cause of morbidity and mortality in the developed world. Cardiovascular events can be triggered by acute mental stress caused by events such as an earthquake, a televised high-drama soccer game, job strain or the death of a loved one. Acute mental stress increases sympathetic output, impairs endothelial function and creates a hypercoagulable state. These changes have the potential to rupture vulnerable plaque and precipitate intraluminal thrombosis, resulting in myocardial infarction or sudden death. CONCLUSION Therapies targeting this pathway can potentially prevent acute mental stressors from initiating plaque rupture. Limited evidence suggests that appropriately timed administration of beta-blockers, statins and aspirin might reduce the incidence of triggered myocardial infarctions. Stress management and transcendental meditation warrant further study.
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Affiliation(s)
- B G Schwartz
- Heart Institute, Good Samaritan Hospital, Los Angeles, CA, USA
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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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