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Santana MRD, Pontes YMDM, Benjamim CJR, Rodrigues GDS, Liberalino GA, Mangueira LB, Feitosa ME, Leal J, Akimoto A, Garner DM, Valenti VE. A Single Dose of Beer after Moderate Aerobic Exercise Did Not Affect the Cardiorespiratory and Autonomic Recovery in Young Men and Women: A Crossover, Randomized and Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13330. [PMID: 36293912 PMCID: PMC9603129 DOI: 10.3390/ijerph192013330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 06/16/2023]
Abstract
Background: Beer is a choice beverage worldwide and is often consumed after sports for social interaction. Beer has been suggested for hydration after exercise, but the effects on cardiovascular and autonomic systems in men and women after effort are unknown. Objectives: We assessed the effect of beer absorption immediately after moderate exercise on heart rate (HR) variability (HRV) and cardiovascular recovery after effort in women and men separately. Methods: This is a crossover, randomized and controlled trial performed on 15 healthy female and 17 male adults submitted to two protocols on two randomized days: (1) Water (350 mL) and (2) Beer (350 mL). The subjects underwent 15 minutes seated at rest, followed by aerobic exercise on a treadmill (five minutes at 50-55% of maximum HR and 25 min 60-65% of maximum HR) and then remained 3 min stood on treadmill and 57 min seated for recovery from the exercise. Water or beer was consumed between four and ten minutes after exercise cessation. Blood pressure, HR and HRV were evaluated before exercise, during exercise and during recovery from exercise. Results: Systolic and diastolic blood pressure, HRV and HR changes during and following recovery from exercise were similar when women consumed beer or water. HR, systolic and diastolic blood pressures also returned to baseline levels in the beer and water protocols in males. Yet, parasympathetic indices of HRV recovery from exercise were comparable between protocols in males. Conclusions: Ingestion of 300 mL of beer did not significantly affect HRV and cardiovascular parameters following effort. Our data indicate that beer was safe for this population.
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Affiliation(s)
- Milana R. Drumond Santana
- Nucleus of Studies in Physiological and Pharmaceutical Sciences, School of Juazeiro do Norte, Juazeiro do Norte 63010-475, Brazil
| | - Yasmim M. de Moares Pontes
- Nucleus of Studies in Physiological and Pharmaceutical Sciences, School of Juazeiro do Norte, Juazeiro do Norte 63010-475, Brazil
| | - Cicero Jonas R. Benjamim
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Guilherme da Silva Rodrigues
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Gabriela A. Liberalino
- Nucleus of Studies in Physiological and Pharmaceutical Sciences, School of Juazeiro do Norte, Juazeiro do Norte 63010-475, Brazil
| | - Luana B. Mangueira
- Nucleus of Studies in Physiological and Pharmaceutical Sciences, School of Juazeiro do Norte, Juazeiro do Norte 63010-475, Brazil
| | - Maria E. Feitosa
- Nucleus of Studies in Physiological and Pharmaceutical Sciences, School of Juazeiro do Norte, Juazeiro do Norte 63010-475, Brazil
| | - Jessica Leal
- Nucleus of Studies in Physiological and Pharmaceutical Sciences, School of Juazeiro do Norte, Juazeiro do Norte 63010-475, Brazil
| | - Amanda Akimoto
- Autonomic Nervous System Center (CESNA), Sao Paulo State University (UNESP), Marilia 17525-900, Brazil
| | - David M. Garner
- Autonomic Nervous System Center (CESNA), Sao Paulo State University (UNESP), Marilia 17525-900, Brazil
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Gipsy Lane, Oxford OX3 0BP, UK
| | - Vitor E. Valenti
- Autonomic Nervous System Center (CESNA), Sao Paulo State University (UNESP), Marilia 17525-900, Brazil
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Krittanawong C, Isath A, Rosenson RS, Khawaja M, Wang Z, Fogg SE, Virani SS, Qi L, Cao Y, Long MT, Tangney CC, Lavie CJ. Alcohol Consumption and Cardiovascular Health. Am J Med 2022; 135:1213-1230.e3. [PMID: 35580715 PMCID: PMC9529807 DOI: 10.1016/j.amjmed.2022.04.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Studies evaluating alcohol consumption and cardiovascular diseases have shown inconsistent results. METHODS We performed a systematic review of peer-reviewed publications from an extensive query of Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception to March 2022 for all studies that reported the association between alcohol consumption in terms of quantity (daily or weekly amounts) and type of beverage (wine, beer or spirit) and cardiovascular disease events. RESULTS The study population included a total of 1,579,435 individuals based on 56 cohorts from several countries. We found that moderate wine consumption defined as 1-4 drinks per week was associated with a reduction in risk for cardiovascular mortality when compared with beer or spirits. However, higher risk for cardiovascular disease mortality was typically seen with heavier daily or weekly alcohol consumption across all types of beverages. CONCLUSIONS It is possible that the observational studies may overestimate the benefits of alcohol for cardiovascular disease outcomes. Although moderate wine consumption is probably associated with low cardiovascular disease events, there are many confounding factors, in particular, lifestyle, genetic, and socioeconomic associations with wine drinking, which likely explain much of the association with wine and reduced cardiovascular disease events. Further prospective study of alcohol and all-cause mortality, including cancer, is needed.
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Affiliation(s)
- Chayakrit Krittanawong
- The Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Cardiology, Baylor College of Medicine, Houston, Texas.
| | - Ameesh Isath
- Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla
| | - Robert S Rosenson
- Cardiometabolic Unit, Mount Sinai Hospital, Mount Sinai Heart, New York, NY; Mayo Clinic Evidence-based Practice Center, Rochester, Minn
| | - Muzamil Khawaja
- Section of Cardiology, Baylor College of Medicine, Houston, Texas
| | - Zhen Wang
- Cardiometabolic Unit, Mount Sinai Hospital, Mount Sinai Heart, New York, NY; Mayo Clinic Evidence-based Practice Center, Rochester, Minn; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery; Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn
| | - Sonya E Fogg
- Library and Learning Resource Center, Texas Heart Institute, Houston
| | - Salim S Virani
- The Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Cardiology, Baylor College of Medicine, Houston, Texas
| | - Lu Qi
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, La
| | - Yin Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Mo
| | - Michelle T Long
- Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Mass
| | - Christy C Tangney
- Department of Clinical Nutrition, Rush University Medical Center, Chicago, Ill
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, La
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Dominguez-Balmaseda D, Diez-Vega I, Larrosa M, San Juan AF, Issaly N, Moreno-Pérez D, Burgos S, Sillero-Quintana M, Gonzalez C, Bas A, Roller M, Pérez-Ruiz M. Effect of a Blend of Zingiber officinale Roscoe and Bixa orellana L. Herbal Supplement on the Recovery of Delayed-Onset Muscle Soreness Induced by Unaccustomed Eccentric Resistance Training: A Randomized, Triple-Blind, Placebo-Controlled Trial. Front Physiol 2020; 11:826. [PMID: 32848820 PMCID: PMC7396658 DOI: 10.3389/fphys.2020.00826] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/19/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There is an increasing interest in the use of eccentric muscle exercise to improve physical condition, especially with regards to its health-related benefits. However, it is known that unaccustomed eccentric exercise causes muscle damage and delayed pain, commonly defined as "delayed onset muscle soreness" (DOMS). The efficacy of herbal preparations in subjects suffering from DOMS has been reported in a few previous studies with small or moderate outcome measures related to muscle recovery. The present study aimed to evaluate the effects of a polyherbal mixture containing whole Zingiber officinale Roscoe and Bixa orellana L., powders called ReWin(d), in young male athletes suffering from DOMS induced by a 1 h session of plyometric exercises. METHODS Thirty-three young male athletes participated in this randomized, Triple-blind, placebo-controlled trial: 17 of them assigned to the ReWin(d) group and 16 of them to the placebo group. Creatine kinase (CK) was measured as a muscle damage marker, pain was assessed using the Visual Analog Scale (VAS), muscle performance was measured through half-squat exercise (HS) monitored with an accelerometer (Encoder), and heart rate variability (HRV) was monitored for 5 min with the subjects in the supine position. All determinations were performed before and after the eccentric session and 24, 48, and 72 h after the session. RESULTS The eccentric exercise session caused an increase in CK at 24 and 48 h after exercise intervention in both groups (p < 0.001). There was no interaction between groups regarding muscle damage. The pain increased after the training session in both groups (p < 0.001), and a significant interaction was observed between groups at 48 h after exercise (p = 0.004). Lower limb muscular power showed a significant interaction between groups 24 h after exercise (p = 0.049); the placebo group showed a reduction in muscle power compared to the ReWin(d) group. The LF/HF ratio decreased significantly at 72 h after exercise in the herbal group but not in the placebo group. CONCLUSION The herbal supplement maintained the maximum power of the lower limbs and attenuated muscle pain. CLINICAL TRIAL REGISTRATION www.ClinicalTrials.gov, identifier NCT03961022.
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Affiliation(s)
- Diego Dominguez-Balmaseda
- Research Group on Nutrition, Physical Activity and Health, Faculty of Biomedical Sciences Universidad Europea, Madrid, Spain
| | - Ignacio Diez-Vega
- Research Group on Exercise, Health and Applied Biomarkers, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Mar Larrosa
- Research Group on Nutrition, Physical Activity and Health, Faculty of Biomedical Sciences Universidad Europea, Madrid, Spain
| | - Alejandro F. San Juan
- Faculty of Physical Activity and Sport Sciences-INEF, Universidad Polit cnica de Madrid, Madrid, Spain
| | | | - Diego Moreno-Pérez
- Departamento de Educación, Métodos de Investigación y Evaluación, Universidad Pontificia de Comillas, Instituto Católico de Artes e Industrias-Instituto Católico de Administración y Dirección de Empresas, Madrid, Spain
| | - Silvia Burgos
- Research Group on Exercise, Health and Applied Biomarkers, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Manuel Sillero-Quintana
- Faculty of Physical Activity and Sport Sciences-INEF, Universidad Polit cnica de Madrid, Madrid, Spain
| | - Cristina Gonzalez
- Research Group on Exercise, Health and Applied Biomarkers, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Andrea Bas
- Research Group on Exercise, Health and Applied Biomarkers, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Margarita Pérez-Ruiz
- Research Group on Exercise, Health and Applied Biomarkers, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
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Gao L, Li P, Hu C, To T, Patxot M, Falvey B, Wong PM, Scheer FAJL, Lin C, Lo MT, Hu K. Nocturnal heart rate variability moderates the association between sleep-wake regularity and mood in young adults. Sleep 2020; 42:5307029. [PMID: 30722058 DOI: 10.1093/sleep/zsz034] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/03/2019] [Accepted: 01/29/2019] [Indexed: 01/06/2023] Open
Abstract
STUDY OBJECTIVES Sleep-wake regularity (SWR) is often disrupted in college students and mood disorders are rife at this age. Disrupted SWR can cause repetitive and long-term misalignment between environmental and behavioral cycles and the circadian system which may then have psychological and physical health consequences. We tested whether SWR was independently associated with mood and autonomic function in a healthy adult cohort. METHODS We studied 42 college students over a 3 week period using daily sleep-wake diaries and continuous electrocardiogram recordings. Weekly SWR was quantified by the interdaily stability of sleep-wake times (ISSW) and mood was assessed weekly using the Beck Depression Inventory-II. To assess autonomic function, we quantified the high-frequency (HF) power of heart rate variability (HRV). Linear mixed effects models were used to assess the relationship between repeated weekly measures of mood, SWR, and HF. RESULTS Low weekly ISSW predicted subsequent poor mood and worsening mood independently of age, sex, race, sleep duration, and physical activity. Although no association was found between ISSW and HF, the ISSW-mood association was significantly moderated by nocturnal HF, i.e. reported mood was lowest after a week with low ISSW and high HF. Prior week mood scores did not significantly predict the subsequent week's ISSW. CONCLUSIONS Irregular sleep-wake timing appears to precede poor mood in young adults. Further work is needed to understand the implications of high nocturnal HRV in those with low mood and irregular sleep-wake cycles.
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Affiliation(s)
- Lei Gao
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA
| | - Peng Li
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Chelsea Hu
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Tommy To
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Melissa Patxot
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Brigid Falvey
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Patricia M Wong
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Frank A J L Scheer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Chen Lin
- Institute of Translational and Interdisciplinary Medicine and Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan
| | - Men-Tzung Lo
- Institute of Translational and Interdisciplinary Medicine and Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan
| | - Kun Hu
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
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Abstract
As the influence of diet on health may take place over a period of decades, there is a need for biomarkers that help to identify those aspects of nutrition that have either a positive or a negative influence. The evidence is considered that heart-rate variability (HRV) (the time differences between one beat and the next) can be used to indicate the potential health benefits of food items. Reduced HRV is associated with the development of numerous conditions for example, diabetes, cardiovascular disease, inflammation, obesity and psychiatric disorders. Although more systematic research is required, various aspects of diet have been shown to benefit HRV acutely and in the longer term. Examples include a Mediterranean diet, omega-3 fatty acids, B-vitamins, probiotics, polyphenols and weight loss. Aspects of diet that are viewed as undesirable, for example high intakes of saturated or trans-fat and high glycaemic carbohydrates, have been found to reduce HRV. It is argued that the consistent relationship between HRV, health and morbidity supports the view that HRV has the potential to become a widely used biomarker when considering the influence of diet on mental and physical health.
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Mostofsky E, Chahal HS, Mukamal KJ, Rimm EB, Mittleman MA. Alcohol and Immediate Risk of Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis. Circulation 2016; 133:979-87. [PMID: 26936862 DOI: 10.1161/circulationaha.115.019743] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although considerable research describes the cardiovascular effects of habitual moderate and heavy alcohol consumption, the immediate risks following alcohol intake have not been well characterized. Based on its physiological effects, alcohol may have markedly different effects on immediate and long-term risk. METHODS AND RESULTS We searched CINAHL, Embase, and PubMed from inception to March 12, 2015, supplemented with manual screening for observational studies assessing the association between alcohol intake and cardiovascular events in the following hours and days. We calculated pooled relative risks and 95% confidence intervals for the association between alcohol intake and myocardial infarction, ischemic stroke, and hemorrhagic stroke using DerSimonian and Laird random-effects models to model any alcohol intake or dose-response relationships of alcohol intake and cardiovascular events. Among 1056 citations and 37 full-text articles reviewed, 23 studies (29 457 participants) were included. Moderate alcohol consumption was associated with an immediately higher cardiovascular risk that was attenuated after 24 hours, and even protective for myocardial infarction and hemorrhagic stroke (≈2-4 drinks: relative risk=30% lower risk) and protective against ischemic stroke within 1 week (≈6 drinks: 19% lower risk). In contrast, heavy alcohol drinking was associated with higher cardiovascular risk in the following day (≈6-9 drinks: relative risk=1.3-2.3) and week (≈19-30 drinks: relative risk=2.25-6.2). CONCLUSIONS There appears to be a consistent finding of an immediately higher cardiovascular risk following any alcohol consumption, but, by 24 hours, only heavy alcohol intake conferred continued risk.
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Affiliation(s)
- Elizabeth Mostofsky
- From Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.M., H.S.C., M.A.M.); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (E.M., E.B.R., M.A.M.); Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada (H.S.C.); Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.).
| | - Harpreet S Chahal
- From Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.M., H.S.C., M.A.M.); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (E.M., E.B.R., M.A.M.); Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada (H.S.C.); Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Kenneth J Mukamal
- From Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.M., H.S.C., M.A.M.); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (E.M., E.B.R., M.A.M.); Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada (H.S.C.); Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Eric B Rimm
- From Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.M., H.S.C., M.A.M.); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (E.M., E.B.R., M.A.M.); Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada (H.S.C.); Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Murray A Mittleman
- From Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.M., H.S.C., M.A.M.); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (E.M., E.B.R., M.A.M.); Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada (H.S.C.); Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
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7
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Huang C, Zhan J, Liu YJ, Li DJ, Wang SQ, He QQ. Association between alcohol consumption and risk of cardiovascular disease and all-cause mortality in patients with hypertension: a meta-analysis of prospective cohort studies. Mayo Clin Proc 2014; 89:1201-10. [PMID: 25091872 DOI: 10.1016/j.mayocp.2014.05.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/13/2014] [Accepted: 05/05/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To conduct a meta-analysis summarizing the risk of cardiovascular disease (CVD) and all-cause mortality (ACM) in relation to alcohol consumption in patients with hypertension, focusing on clarifying dose-response associations. PATIENTS AND METHODS PubMed and EMBASE were searched for eligible prospective cohort studies from December 3, 1949, through January 18, 2014. The semi-parameter method and dose-response analysis were used. RESULTS Nine studies (11 cohorts) were included in the meta-analysis. Compared with the lowest alcohol level (abstainers/occasional drinkers), the pooled relative risk (RR) was 0.72 (95% CI, 0.68-0.77) for the third highest category (median, 10 g/d), 0.81 (95% CI, 0.71-0.93) for the second highest category (median, 20 g/d), and 0.60 (95% CI, 0.54-0.67) for the highest category (median, 30 g/d). A J-shaped relationship between alcohol use and ACM was observed, and the nadir (RR, 0.82; 95% CI, 0.76-0.88) was found to be at a dose of 8 to 10 g of alcohol consumption per day. CONCLUSION Findings of this meta-analysis suggest that low-to-moderate alcohol consumption was inversely significantly associated with the risk of CVD and ACM in patients with hypertension.
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Affiliation(s)
- Chao Huang
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Jian Zhan
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Yu-Jian Liu
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - De-Jia Li
- School of Public Health, Wuhan University, Wuhan, P. R. China; Global Health Institute, Wuhan University, Wuhan, P. R. China
| | - Su-Qing Wang
- School of Public Health, Wuhan University, Wuhan, P. R. China; Global Health Institute, Wuhan University, Wuhan, P. R. China
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, P. R. China; Global Health Institute, Wuhan University, Wuhan, P. R. China.
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8
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Shi P, Chen Y, Guo MM, Yu HL. ACUTE EFFECTS OF ALCOHOL ON HEART RATE VARIABILITY: TIME-RELATED CHANGES AND GENDER DIFFERENCE. BIOMEDICAL ENGINEERING-APPLICATIONS BASIS COMMUNICATIONS 2014. [DOI: 10.4015/s1016237214500483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objectives: Alcohol consumption is associated with a broad array of physiologic and behavioral effects including changes in cardiac autonomic activity. In the present study, time-related acute effects of alcohol have been characterized and compared between genders. Methods: A total of 30 healthy subjects (15 males and 15 females) were enrolled in this study. The red wine was given to each subject at a dosage of 0.27 g of pure ethanol per kilogram of body weight. 5-min electrocardiograms (ECGs) were collected before (BR) and at 15 min (P15), 30 min (P30), 45 min (P45) and 60 min (P60) after alcohol intake. Time- and frequency-domain analysis of heart rate variability (HRV) was performed. The time-domain HRV indices include mean RR interval, pNN50, SDNN and RMSSD. The low- (LF: 0.04 to 0.15 Hz) and high-frequency (HF: 0.15 to 0.4 Hz) components along with LF/HF ratio were calculated for frequency-domain analysis of HRV. HRV was also analyzed by mathematical models, e.g. Poincaré plot, which uses a nonlinear geometric representation of change in interbeat heart rate. Poincaré plots indices, SD1, SD2, SD1/SD2 ratio and r RR , were applied in this study for HRV assessment. Results: Alcohol intake was associated with decreased HRV in both time and frequency domains. The lowest HRV was observed 30–40 min after the intake of alcohol. The alcohol intake also caused the decrease of Poincaré plots indices (SD1 and SD1/SD2 in P30, P40 and P60, and r RR in P45), accompanied with a narrower plot area. The changes of HRV indices differed by gender. The male subjects demonstrated a greater decrease of parameters measured in this study compared to the female subjects. Conclusion: Acute effects of alcohol ingestion resulted in reductions in HRV, indicating impaired cardiac autonomic nervous activity. Autonomic nervous activity in the females was less dampened by the alcohol compared to the males.
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Affiliation(s)
- Ping Shi
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Ying Chen
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Ming-Ming Guo
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Hong-Liu Yu
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
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9
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Schrieks IC, Stafleu A, Kallen VL, Grootjen M, Witkamp RF, Hendriks HFJ. The biphasic effects of moderate alcohol consumption with a meal on ambiance-induced mood and autonomic nervous system balance: a randomized crossover trial. PLoS One 2014; 9:e86199. [PMID: 24465955 PMCID: PMC3897660 DOI: 10.1371/journal.pone.0086199] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/04/2013] [Indexed: 01/07/2023] Open
Abstract
Background The pre-drinking mood state has been indicated to be an important factor in the mood effects of alcohol. However, for moderate alcohol consumption there are no controlled studies showing this association. Also, the mood effects of consuming alcohol combined with food are largely unknown. The aim of this study was to investigate the effects of moderate alcohol combined with a meal on ambiance-induced mood states. Furthermore effects on autonomic nervous system activity were measured to explore physiological mechanisms that may be involved in changes of mood state. Methods In a crossover design 28 women (age 18–45 y, BMI 18.5–27 kg/m2) were randomly allocated to 4 conditions in which they received 3 glasses of sparkling white wine (30 g alcohol) or alcohol-free sparkling white wine while having dinner in a room with either a pleasant or unpleasant created ambiance. Subjects filled out questionnaires (B-BAES, POMS and postprandial wellness questionnaire) at different times. Skin conductance and heart rate variability were measured continuously. Results Moderate alcohol consumption increased happiness scores in the unpleasant, but not in the pleasant ambiance. Alcohol consumption increased happiness and stimulation feelings within 1 hour and increased sedative feelings and sleepiness for 2.5 hour. Skin conductance was increased after alcohol within 1 hour and was related to happiness and stimulation scores. Heart rate variability was decreased after alcohol for 2 hours and was related to mental alertness. Conclusion Mood inductions and autonomic nervous system parameters may be useful to evaluate mood changes by nutritional interventions. Moderate alcohol consumption elevates happiness scores in an unpleasant ambiance. However, drinking alcohol during a pleasant mood results in an equally positive mood state. Trial Registration Clinicaltrials.gov NCT01426022.
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Affiliation(s)
- Ilse C. Schrieks
- The Netherlands Organization for Applied Scientific Research, TNO, Zeist, The Netherlands
- Wageningen University, Wageningen, The Netherlands
- * E-mail:
| | - Annette Stafleu
- The Netherlands Organization for Applied Scientific Research, TNO, Zeist, The Netherlands
| | - Victor L. Kallen
- The Netherlands Organization for Applied Scientific Research, TNO, Zeist, The Netherlands
| | | | | | - Henk F. J. Hendriks
- The Netherlands Organization for Applied Scientific Research, TNO, Zeist, The Netherlands
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Karpyak VM, Romanowicz M, Schmidt JE, Lewis KA, Bostwick JM. Characteristics of Heart Rate Variability in Alcohol-Dependent Subjects and Nondependent Chronic Alcohol Users. Alcohol Clin Exp Res 2013; 38:9-26. [DOI: 10.1111/acer.12270] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 07/11/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Victor M. Karpyak
- Department of Psychiatry and Psychology; Mayo Clinic College of Medicine; Rochester Minnesota
| | - Magdalena Romanowicz
- Department of Psychiatry and Psychology; Elliot Behavioral Health Sciences; Elliot Hospital; Manchester New Hampshire
| | - John E. Schmidt
- Biobehavioral Medicine in Oncology Program; University of Pittsburgh Cancer Institute; Pittsburgh Pennsylvania
- Department of Medicine; University of Pittsburgh; Pittsburgh Pennsylvania
| | - Kriste A. Lewis
- Department of Psychiatry and Psychology; Mayo Clinic College of Medicine; Rochester Minnesota
| | - John M. Bostwick
- Department of Psychiatry and Psychology; Mayo Clinic College of Medicine; Rochester Minnesota
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Quintana DS, Guastella AJ, McGregor IS, Hickie IB, Kemp AH. Moderate alcohol intake is related to increased heart rate variability in young adults: Implications for health and well-being. Psychophysiology 2013; 50:1202-8. [DOI: 10.1111/psyp.12134] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 07/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel S. Quintana
- SCAN Research & Teaching Unit, School of Psychology; University of Sydney; Sydney Australia
- Brain and Mind Research Institute; University of Sydney; Sydney Australia
| | - Adam J. Guastella
- Brain and Mind Research Institute; University of Sydney; Sydney Australia
| | - Iain S. McGregor
- Psychopharmacology Laboratory, School of Psychology; University of Sydney; Sydney Australia
| | - Ian B. Hickie
- Brain and Mind Research Institute; University of Sydney; Sydney Australia
| | - Andrew H. Kemp
- SCAN Research & Teaching Unit, School of Psychology; University of Sydney; Sydney Australia
- Psychopharmacology Laboratory, School of Psychology; University of Sydney; Sydney Australia
- Discipline of Psychiatry, Northern Clinical School; University of Sydney; Sydney Australia
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Zamora-Ros R, Urpi-Sarda M, Lamuela-Raventós RM, Martínez-González MÁ, Salas-Salvadó J, Arós F, Fitó M, Lapetra J, Estruch R, Andres-Lacueva C. High urinary levels of resveratrol metabolites are associated with a reduction in the prevalence of cardiovascular risk factors in high-risk patients. Pharmacol Res 2012; 65:615-20. [PMID: 22465220 DOI: 10.1016/j.phrs.2012.03.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 03/13/2012] [Accepted: 03/14/2012] [Indexed: 10/28/2022]
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Krenz M, Korthuis RJ. Moderate ethanol ingestion and cardiovascular protection: from epidemiologic associations to cellular mechanisms. J Mol Cell Cardiol 2012; 52:93-104. [PMID: 22041278 PMCID: PMC3246046 DOI: 10.1016/j.yjmcc.2011.10.011] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 10/11/2011] [Accepted: 10/15/2011] [Indexed: 12/13/2022]
Abstract
While ethanol intake at high levels (3-4 or more drinks), either in acute (occasional binge drinking) or chronic (daily) settings, increases the risk for myocardial infarction and stroke, an inverse relationship between regular consumption of alcoholic beverages at light to moderate levels (1-2 drinks per day) and cardiovascular risk has been consistently noted in a large number of epidemiologic studies. Although initially attributed to polyphenolic antioxidants in red wine, subsequent work has established that the ethanol component contributes to the beneficial effects associated with moderate intake of alcoholic beverages regardless of type (red versus white wine, beer, spirits). Concerns have been raised with regard to interpretation of epidemiologic evidence for this association including heterogeneity of the reference groups examined in many studies, different lifestyles of moderate drinkers versus abstainers, and favorable risk profiles in moderate drinkers. However, better controlled epidemiologic studies and especially work conducted in animal models and cell culture systems have substantiated this association and clearly established a cause and effect relationship between alcohol consumption and reductions in tissue injury induced by ischemia/reperfusion (I/R), respectively. The aims of this review are to summarize the epidemiologic evidence supporting the effectiveness of ethanol ingestion in reducing the likelihood of adverse cardiovascular events such as myocardial infarction and ischemic stroke, even in patients with co-existing risk factors, to discuss the ideal quantities, drinking patterns, and types of alcoholic beverages that confer protective effects in the cardiovascular system, and to review the findings of recent experimental studies directed at uncovering the mechanisms that underlie the cardiovascular protective effects of antecedent ethanol ingestion. Mechanistic interrogation of the signaling pathways invoked by antecedent ethanol ingestion may point the way towards development of new therapeutic approaches that mimic the powerful protective effects of socially relevant alcohol intake to limit I/R injury, but minimize the negative psychosocial impact and pathologic outcomes that also accompany consumption of ethanol.
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Affiliation(s)
- Maike Krenz
- Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO 65212, USA
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Bau PF, Moraes RS, Bau CH, Ferlin EL, Rosito GA, Fuchs FD. Acute ingestion of alcohol and cardiac autonomic modulation in healthy volunteers. Alcohol 2011; 45:123-9. [PMID: 21131160 DOI: 10.1016/j.alcohol.2010.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2010] [Revised: 07/21/2010] [Accepted: 08/12/2010] [Indexed: 10/18/2022]
Abstract
Arrhythmogenic effects of alcohol may be intermediated by its effects over heart rate variability (HRV). Most studies about the effects of alcohol over HRV were observational and did not explore the temporal influence of alcohol ingestion over autonomic modulation. The aim of this study was to verify if an acute ingestion of alcohol has a time-dependent influence over time-domain indices of HRV. The effect of the ingestion of 60 g of ethanol or placebo over autonomic modulation was compared in healthy men (35 per group), with 18-25 years of age, before and during 17 h after ingestion. Alcohol promoted a fall in the standard deviation of all normal R-R intervals, root mean square of successive differences, and percentage of pairs of adjacent R-R intervals differing by more than 50 ms and in two indices of the three-dimensional return map, by a period up to 10 h after the ingestion of alcohol, accompanied by an increase in heart rate. The indices returned to values similar of the control group 10 h after ingestion. The effects over HRV indices were attenuated by adjustment for heart rate. The ingestion of alcohol induces a broad cardiovascular adaptation secondary to vagal withdrawal and sympathetic activation that may be responsible for arrhythmogenic effects of alcohol ingestion.
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Association of health behaviour with heart rate variability: a population-based study. BMC Cardiovasc Disord 2010; 10:58. [PMID: 21108803 PMCID: PMC3004825 DOI: 10.1186/1471-2261-10-58] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 11/25/2010] [Indexed: 11/15/2022] Open
Abstract
Background Reduced heart rate variability (HRV), a non-invasive marker of autonomic dysfunction, and an unhealthy lifestyle are associated with an increased morbidity and mortality of cardiovascular diseases (CVD). The autonomic dysfunction is a potential mediator of the association of behavioural risk factors with adverse health outcomes. We studied the association of HRV with behavioural risk factors in an elderly population. Methods This analysis was based on the cross-sectional data of 1671 participants (age range, 45-83 years) of the prospective, population-based Cardiovascular Disease, Living and Ageing in Halle (CARLA) Study. Physical activity, smoking habits, alcohol consumption and dietary patterns were assessed in standardized interviews. Time and frequency domain measures of HRV were computed from 5-min segments of highly standardized 20-min electrocardiograms. Their association with behavioural risk factors was determined by linear and non-parametric regression modelling. Results There were only weak and inconsistent associations of higher physical activity, moderate consumption of alcohol, and non-smoking with higher time and frequency domain HRV in both sexes, and no association with dietary pattern. Results changed only marginally by excluding subjects with CVD, diabetes mellitus and use of cardioactive medication. Conclusion We hypothesized that HRV is associated with behavioural factors and therefore might be a mediator of the effect of behavioural risk factors on CVD, but this hypothesis was not confirmed by our results. These findings support the interpretation that there may be no true causal association of behavioural factors with HRV.
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Spaak J, Tomlinson G, McGowan CL, Soleas GJ, Morris BL, Picton P, Notarius CF, Floras JS. Dose-related effects of red wine and alcohol on heart rate variability. Am J Physiol Heart Circ Physiol 2010; 298:H2226-31. [PMID: 20418480 DOI: 10.1152/ajpheart.00700.2009] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In healthy subjects a standard drink of either red wine (RW) or ethanol (EtOH) has no effect on muscle sympathetic nerve activity or on heart rate (HR), whereas two drinks increase both. Using time- and frequency-domain indexes of HR variability (HRV), we now tested in 12 subjects (24-47 yr, 6 men) the hypotheses that 1) this HR increase reflects concurrent dose-related augmented sympathetic HR modulation and 2) RW with high-polyphenol content differs from EtOH in its acute HRV effects. RW, EtOH, and water were provided on 3 days, 2 wk apart according to a randomized, single-blind design. Eight-minute segments were analyzed. One alcoholic drink increased blood concentrations to 36 + or - 2 mg/dl (mean + or - SE), and 2 drinks to 72 + or - 4 (RW) and 80 + or - 2 mg/dl (EtOH). RW quadrupled plasma resveratrol (P < 0.001). HR fell after both water drinks. When compared with respective baselines, one alcoholic drink had no effect on HR or HRV, whereas two glasses of both increased HR (RW, +5.4 + or - 1.2; and EtOH, +5.7 + or - 1.2 min(-1); P < 0.001), decreased total HRV by 28-33% (P < 0.05) and high-frequency spectral power by 32-42% (vagal HR modulation), and increased low-frequency power by 28-34% and the ratio of low frequency to high frequency by 98-119% (sympathetic HR modulation) (all, P < or = 0.01). In summary, when compared with water, one standard drink lowered time- and frequency-domain markers of vagal HR modulation. When compared with respective baselines, two alcoholic drinks increased HR by diminished vagal and augmented sympathetic HR modulation. Thus alcohol exerts dose-dependent HRV responses, with RW and EtOH having a similar effect.
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Affiliation(s)
- Jonas Spaak
- University Health Network and Mount Sinai Hospital Division of Cardiology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
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17
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Beyond antioxidants: the cellular and molecular interactions of flavonoids and how these underpin their actions on the brain. Proc Nutr Soc 2010; 69:244-60. [DOI: 10.1017/s0029665110000054] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The consumption of flavonoid-rich foods and beverages has been suggested to limit the neurodegeneration associated with a variety of neurological disorders and to prevent or reverse normal or abnormal deteriorations in cognitive performance. Flavonoids mediate these effects via a number of routes, including a potential to protect neurons against injury induced by neurotoxins, an ability to suppress neuroinflammation and a potential to promote memory, learning and cognitive function. Originally, it was thought that such actions were mediated by the antioxidant capacity of flavonoids. However, their limited absorption and their low bioavailability in the brain suggest that this explanation is unlikely. Instead, this multiplicity of effects appears to be underpinned by three separate processes: first, through their interactions with important neuronal and glial signalling cascades in the brain, most notably the phosphatidylinositol 3-kinase/Akt and mitogen-activated protein kinase pathways that regulate pro-survival transcription factors and gene expression; second, through an ability to improve peripheral and cerebral blood flow and to trigger angiogenesis and neurogenesis in the hippocampus; third, by their capacity to directly react with and scavenge neurotoxic species and pro-inflammatory agents produced in the brain as a result of both normal and abnormal brain ageing. The present review explores the potential inhibitory or stimulatory actions of flavonoids within these three systems and describes how such interactions are likely to underlie neurological effects.
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Liu J, Fujimiya T. Abrupt termination of an ethanol regimen provokes ventricular arrhythmia and enhances susceptibility to the arrhythmogenic effects of epinephrine in rats. Alcohol Clin Exp Res 2009; 34 Suppl 1:S45-53. [PMID: 19094192 DOI: 10.1111/j.1530-0277.2008.00851.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Pathologists examining victims of sudden unexpected death encounter alcoholics more often than expected; alcohol may play a role in sudden arrhythmic death. Here we determine whether a pattern of alcohol consumption, chronic ethanol intake, and withdrawal increases the incidence of malignant ventricular arrhythmia and modulates susceptibility to the arrhythmogenic potential of sympathetic stimulation from an epinephrine test in rats. METHODS Male Wistar rats were treated with a continuous ethanol liquid diet for 7 weeks, and then subjected to 1-day withdrawal or 21-day abstinence. Ventricular ectopy was evaluated by 24-hour electrocardiographic telemetry recording; whole-body sympathetic activation, cardiac sympathovagal balance, and susceptibility to ventricular arrhythmia induced by sympathetic stimulation were evaluated based on blood noradrenalin metabolite concentrations, heart rate variability, and a 3-step epinephrine test. RESULTS Ventricular arrhythmia and related death were observed only in rats at 1 day of withdrawal, but not in nonalcoholic, continuous ethanol intake or 21-day abstinence rats. One-day withdrawal after a 7-week continuous ethanol regimen elevated circulating noradrenalin metabolite levels and induced cardiac sympathovagal imbalance. Deaths related to the epinephrine test and ventricular arrhythmia induced by low doses of epinephrine were observed only in 1-day withdrawal rats. However, all anomalies were normalized by 21-day abstinence. CONCLUSIONS Abrupt termination of a 7-week continuous ethanol regimen is sufficient to enhance the whole-body sympathetic activation and cardiac sympathovagal imbalance that contribute to ventricular arrhythmia and sudden death in alcoholic rats. Those providing medical care for alcoholics, including in cases of legal imprisonment, should be aware of the possibility of enhanced susceptibility to sudden arrhythmic death due to the abrupt termination of a chronic ethanol regimen.
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Affiliation(s)
- Jinyao Liu
- Department of Legal Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.
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Greiser KH, Kluttig A, Schumann B, Swenne CA, Kors JA, Kuss O, Haerting J, Schmidt H, Thiery J, Werdan K. Cardiovascular diseases, risk factors and short-term heart rate variability in an elderly general population: the CARLA study 2002–2006. Eur J Epidemiol 2009; 24:123-42. [DOI: 10.1007/s10654-009-9317-z] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Accepted: 01/19/2009] [Indexed: 11/28/2022]
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21
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Chang KS, Lee K, Lim HS. The Status of Diabetes Mellitus and Effects of Related Factors on Heart Rate Variability in a Community. KOREAN DIABETES JOURNAL 2009. [DOI: 10.4093/kdj.2009.33.6.537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Kyeong-Soon Chang
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Kwan Lee
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Hyun-Sul Lim
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
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Anger expression and prognosis after a coronary event in women. Int J Cardiol 2008; 140:60-5. [PMID: 19036464 DOI: 10.1016/j.ijcard.2008.10.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Accepted: 10/29/2008] [Indexed: 11/22/2022]
Abstract
BACKGROUND Suggestive evidence supports that anger is associated with increased cardiovascular morbidity and mortality. However, the knowledge regarding the impact of anger on prognosis after a coronary event, especially among women is limited. We investigated whether anger expression increases the risk of recurrent events in women with coronary heart disease (CHD). METHODS Women (n=203) hospitalized for an acute cardiac event were assessed for the four scales of the Framingham Anger Questionnaire, demographic, biomedical and lifestyle factors and were followed for 6.4+/-1 years for total mortality and the combination of cardiovascular death and non-fatal acute myocardial infarction (AMI). RESULTS After adjustment for confounders such as age, inclusion diagnosis and smoking in the proportional hazard models the tendency to suppress angry feelings was associated with the combination of cardiac death and recurrent AMI (hazard ratio (HR): 1.19, 95% confidence interval (CI): 0.99-1.42) and with all-cause mortality (HR:1.29, 95% CI: 1.03-1.60). Each unit increase in the outward expression of anger increased by 42% the risk for cardiac death or a new AMI (95% CI: 1.01-2.00). Among the potential biological mediators only inflammatory markers attenuated somewhat the relationship. Anger symptoms and discussion of anger were not related to prognosis. CONCLUSIONS The outward expression and the suppression of anger seem to be associated with prognosis in women with CHD. Future studies need to confirm these findings and to test whether behavioural intervention programs aiming to reduce detrimental anger behaviour in women can influence CHD prognosis.
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Stark T, Lang R, Keller D, Hensel A, Hofmann T. Absorption ofN-phenylpropenoyl-L-amino acids in healthy humans by oral administration of cocoa (Theobroma cacao). Mol Nutr Food Res 2008; 52:1201-14. [DOI: 10.1002/mnfr.200700447] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Georgiades A, Janszky I, Blom M, László KD, Ahnve S. Financial strain predicts recurrent events among women with coronary artery disease. Int J Cardiol 2008; 135:175-83. [PMID: 18619689 DOI: 10.1016/j.ijcard.2008.03.093] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2007] [Revised: 12/14/2007] [Accepted: 03/29/2008] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although a number of epidemiological studies have found an association between socioeconomic status (SES) indices such as income and education and coronary morbidity and mortality, few have looked at health consequences arising from actually experiencing financial shortcomings. The objective of the present study was to examine whether financial strain predicts recurrent coronary artery disease (CAD) events among women with established CAD. METHODS Two hundred two women (mean age 62+/-9 years) hospitalized for an acute coronary event were followed over a period of 3.5 years. Demographic, socioeconomic, lifestyle-related, psychosocial and biological characteristics were obtained by means of questionnaires and clinical examination. Data on recurrent cardiac events were collected from the Swedish discharge and death registers. RESULTS Women experiencing financial strain over the past year had an increased risk for recurrent events, i.e. the combination of all-cause mortality, new acute myocardial infarction and unstable angina pectoris during the follow-up with an unadjusted hazard ratio (HR) of 3.2 (95% CI 1.6-6.6), and a HR of 2.76 (95% CI 1.02-7.50) after controlling for education, household income, age, cohabiting status, inclusion diagnosis and rehabilitation therapy. Adjustment for potential mediators, i.e. psychosocial factors, lipids, diabetes mellitus, smoking, body-mass index, blood pressure, physical activity, alcohol consumption, participation in other cardiac rehabilitation programs did not alter the results significantly. CONCLUSIONS Financial strain was a predictor for recurrent events among women with CAD, independently of commonly used SES indicators such as education and household income. Future studies will have to explore the mechanism behind this association.
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Affiliation(s)
- Anastasia Georgiades
- Preventive Medicine, Department of Public Health Sciences, Karolinska Institutet and Center of Public Health, Stockholm County Council, Stockholm, Sweden
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O'Keefe JH, Bybee KA, Lavie CJ. Alcohol and cardiovascular health: the razor-sharp double-edged sword. J Am Coll Cardiol 2007; 50:1009-14. [PMID: 17825708 DOI: 10.1016/j.jacc.2007.04.089] [Citation(s) in RCA: 288] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2007] [Revised: 04/19/2007] [Accepted: 04/30/2007] [Indexed: 12/16/2022]
Abstract
An extensive body of data shows concordant J-shaped associations between alcohol intake and a variety of adverse health outcomes, including coronary heart disease, diabetes, hypertension, congestive heart failure, stroke, dementia, Raynaud's phenomenon, and all-cause mortality. Light to moderate alcohol consumption (up to 1 drink daily for women and 1 or 2 drinks daily for men) is associated with cardioprotective benefits, whereas increasingly excessive consumption results in proportional worsening of outcomes. Alcohol consumption confers cardiovascular protection predominately through improvements in insulin sensitivity and high-density lipoprotein cholesterol. The ethanol itself, rather than specific components of various alcoholic beverages, appears to be the major factor in conferring health benefits. Low-dose daily alcohol is associated with better health than less frequent consumption. Binge drinking, even among otherwise light drinkers, increases cardiovascular events and mortality. Alcohol should not be universally prescribed for health enhancement to nondrinking individuals owing to the lack of randomized outcome data and the potential for problem drinking.
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Affiliation(s)
- James H O'Keefe
- Mid America Heart Institute, University of Missouri, Kansas City, Missouri, USA.
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Shively CA, Mietus JE, Grant KA, Goldberger AL, Bennett AJ, Willard SL. Effects of chronic moderate alcohol consumption and novel environment on heart rate variability in primates (Macaca fascicularis). Psychopharmacology (Berl) 2007; 192:183-91. [PMID: 17297637 DOI: 10.1007/s00213-007-0709-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2006] [Accepted: 01/10/2007] [Indexed: 12/19/2022]
Abstract
RATIONALE The effects of chronic moderate alcohol consumption on cardiac function are not understood. Acute stress may affect cardiac function by shifting autonomic cardiac regulation in favor of the sympathetic nervous system. Although alcohol consumption often increases at times of stress, the interactive effects of stress and chronic moderate alcohol consumption on cardiac regulation have not been studied. OBJECTIVES AND METHODS The objective was to assess the effects of long-term (1-2 years) moderate (a two-drink/day equivalent, 5 days/week) alcohol consumption on heart rate (HR) variability under normal and acutely stressful conditions in small stable groups of ovariectomized adult cynomolgus monkeys (Macaca fascicularis). Monkeys were trained to voluntarily drink their daily alcohol dose (<30 min), and blood levels were determined an hour later. The animals were acutely stressed by removal from the home cage to a novel environment for 30 min. HR in freely moving subjects was recorded via telemetry in the home cage and the novel environment. RESULTS Acute stress increased HR, decreased HR variability, and decreased the high frequency component of the power spectrum suggesting reduced parasympathetic cardiac modulation. Chronic moderate alcohol consumption decreased HR variability and the low frequency components of the power spectrum. When stressed, monkeys with a history of chronic moderate alcohol consumption had higher HRs than the controls. CONCLUSIONS HR dynamics in monkeys rapidly respond to acute stress. Chronic moderate alcohol consumption may be deleterious to cardiac function. HR response to stress may be exaggerated when accompanied by a history of chronic moderate alcohol consumption.
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Affiliation(s)
- Carol A Shively
- Department of Pathology (Comparative Medicine), Wake Forest University School of Medicine, Winston-Salem, NC 27157-1040, USA.
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Schroeter H, Heiss C, Balzer J, Kleinbongard P, Keen CL, Hollenberg NK, Sies H, Kwik-Uribe C, Schmitz HH, Kelm M. (-)-Epicatechin mediates beneficial effects of flavanol-rich cocoa on vascular function in humans. Proc Natl Acad Sci U S A 2006; 103:1024-9. [PMID: 16418281 PMCID: PMC1327732 DOI: 10.1073/pnas.0510168103] [Citation(s) in RCA: 721] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Indexed: 01/22/2023] Open
Abstract
Epidemiological and medical anthropological investigations suggest that flavanol-rich foods exert cardiovascular health benefits. Endothelial dysfunction, a prognostically relevant key event in atherosclerosis, is characterized by a decreased bioactivity of nitric oxide (NO) and impaired flow-mediated vasodilation (FMD). We show in healthy male adults that the ingestion of flavanol-rich cocoa was associated with acute elevations in levels of circulating NO species, an enhanced FMD response of conduit arteries, and an augmented microcirculation. In addition, the concentrations and the chemical profiles of circulating flavanol metabolites were determined, and multivariate regression analyses identified (-)-epicatechin and its metabolite, epicatechin-7-O-glucuronide, as independent predictors of the vascular effects after flavanol-rich cocoa ingestion. A mixture of flavanols/metabolites, resembling the profile and concentration of circulating flavanol compounds in plasma after cocoa ingestion, induced a relaxation in preconstricted rabbit aortic rings ex vivo, thus mimicking acetylcholine-induced relaxations. Ex vivo flavanol-induced relaxation, as well as the in vivo increases in FMD, were abolished by inhibition of NO synthase. Oral administration of chemically pure (-)-epicatechin to humans closely emulated acute vascular effects of flavanol-rich cocoa. Finally, the concept that a chronic intake of high-flavanol diets is associated with prolonged, augmented NO synthesis is supported by data that indicate a correlation between the chronic consumption of a cocoa flavanol-rich diet and the augmented urinary excretion of NO metabolites. Collectively, our data demonstrate that the human ingestion of the flavanol (-)-epicatechin is, at least in part, causally linked to the reported vascular effects observed after the consumption of flavanol-rich cocoa.
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Affiliation(s)
- Hagen Schroeter
- Department of Nutrition, University of California, Davis, CA 95616, USA.
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Greiser KH, Kluttig A, Schumann B, Kors JA, Swenne CA, Kuss O, Werdan K, Haerting J. Cardiovascular disease, risk factors and heart rate variability in the elderly general population: design and objectives of the CARdiovascular disease, Living and Ageing in Halle (CARLA) Study. BMC Cardiovasc Disord 2005; 5:33. [PMID: 16283930 PMCID: PMC1299322 DOI: 10.1186/1471-2261-5-33] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2005] [Accepted: 11/11/2005] [Indexed: 12/19/2022] Open
Abstract
Background The increasing burden of cardiovascular diseases (CVD) in the ageing population of industrialized nations requires an intensive search for means of reducing this epidemic. In order to improve prevention, detection, therapy and prognosis of cardiovascular diseases on the population level in Eastern Germany, it is necessary to examine reasons for the East-West gradient of CVD morbidity and mortality, potential causal mechanisms and prognostic factors in the elderly. Psychosocial and nutritional factors have previously been discussed as possible causes for the unexplained part of the East-West gradient. A reduced heart rate variability appears to be associated with cardiovascular disease as well as with psychosocial and other cardiovascular risk factors and decreases with age. Nevertheless, there is a lack of population-based data to examine the role of heart rate variability and its interaction with psychosocial and nutritional factors regarding the effect on cardiovascular disease in the ageing population. There also is a paucity of epidemiological data describing the health situation in Eastern Germany. Therefore, we conduct a population-based study to examine the distribution of CVD, heart rate variability and CVD risk factors and their associations in an elderly East German population. This paper describes the design and objectives of the CARLA Study. Methods/design For this study, a random sample of 45–80 year-old inhabitants of the city of Halle (Saale) in Eastern Germany was drawn from the population registry. By the end of the baseline examination (2002–2005), 1750 study participants will have been examined. A multi-step recruitment strategy aims at achieving a 70 % response rate. Detailed information is collected on own and family medical history, socioeconomic, psychosocial, behavioural and biomedical factors. Medical examinations include anthropometric measures, blood pressure of arm and ankle, a 10-second and a 20-minute electrocardiogram, a general physical examination, an echocardiogram, and laboratory analyses of venous blood samples. On 200 participants, a 24-hour electrocardiogram is recorded. A detailed system of quality control ensures high data quality. A follow-up examination is planned. Discussion This study will help to elucidate pathways to CVD involving autonomic dysfunction and lifestyle factors which might be responsible for the CVD epidemic in some populations.
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Affiliation(s)
- Karin H Greiser
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 27, 06097 Halle (Saale), Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 27, 06097 Halle (Saale), Germany
| | - Barbara Schumann
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 27, 06097 Halle (Saale), Germany
| | - Jan A Kors
- Department of Medical Informatics, Erasmus Medical Center Rotterdam, PO Box 1738, Rotterdam, The Netherlands
| | - Cees A Swenne
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Oliver Kuss
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 27, 06097 Halle (Saale), Germany
| | - Karl Werdan
- Department of Medicine III, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06097 Halle (Saale), Germany
| | - Johannes Haerting
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 27, 06097 Halle (Saale), Germany
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