Roundup: ‘Burnout’ Linked to AFib; Blood Pressure in Women; and Timing of Knee Replacement Surgery

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January 17, 2020


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Mental and Physical Exhaustion, or ‘Burnout’, Linked to AFib Heart Condition, Study Says

If you feel mental and physical exhaustion regularly — also known as “burnout” — you could be at higher risk of atrial fibrillation (AFib), researchers have found.

AFib is an irregular heartbeat during which the heart muscles fail to contract in a strong and rhythmic way. When a heart is in AFib, it may not be pumping enough oxygen-rich blood out to the body.

Most significantly, AFib is associated with a five-times-greater risk for stroke. That’s because the abnormal rhythm can lead to blood pooling in the heart’s atria and form clots, blocking the arteries and depriving the brain of oxygen.

A new study published in the European Journal of Preventative Cardiology indicates that chronic stress, exhaustion, and possibly depression, could be key factors in developing Afib, which affects an estimated 33 million people worldwide. In the US, AFib is linked to about 130,000 deaths and 750,000 hospitalizations each year.

Researchers monitored nearly 12,000 men and women who did not have AFib over a 25-year period. The participants were evaluated on five separate occasions, measuring levels of anger, exhaustion, social support and antidepressant use. Those results were then analyzed in relation to the participants who developed AFib over that time period.

Only people who scored highest in “vital exhaustion,” a medical term referring to “burnout” or extreme physical and mental fatigue, were more likely to develop AFib.

Researchers concluded that “more research into the causal pathways linking stress and negative emotions to AFib. In addition, future research should test whether mental health treatments can contribute to AFib prevention.”

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Blood Pressure Seems to Rise Earlier in Life for Women, New Study Finds

Researchers have found that women’s blood vessels age at a faster rate than men’s. The findings suggest that women experience a steeper rise in blood pressure earlier, compared to men, that starts as soon as young adulthood.

The study from the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles could help explain why women tend to develop different types of cardiovascular disease and at different times than men. The findings were published this week in the journal JAMA Cardiology.

“Many of us in medicine have long believed that women simply ‘catch up’ to men in terms of their cardiovascular risk,” said Susan Cheng, M.D., senior author of the study and director of Public Health Research at the Smidt Heart Institute, in a statement. “Our research not only confirms that women have different biology and physiology than their male counterparts, but also illustrates why it is that women may be more susceptible to developing certain types of cardiovascular disease and at different points in life.”

Researchers looked community-based data from multiple sites across the country, representing nearly 145,000 blood pressure measurements, collected serially over a 43-year period, from 32,833 study participants ranging in age from 5 to 98 years old. Dr. Cheng and her team conducted sex-specific analyses of measured blood pressure – a critical indicator of cardiovascular risk. The study’s authors said they searched the data looking for “clues and patterns regarding how blood pressure starts to rise.”

“Our data showed that rates of accelerating blood pressure elevation were significantly higher in women than men, starting earlier in life,” said Dr. Cheng.

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Most Who Benefit from Knee Replacement Surgery are Waiting Too Long, Study Finds

Patients with osteoarthritis in the knee who are candidates for knee replacement surgery shot not delay having the surgery, new research indicates.

A study by Northwestern University, published in the Journal of Bone and Joint Surgery, found that the majority of patients iwho would benefit from knee replacement are taking too long to have surgery, and that’s hurting their ability to move without pain or discomfort.

The researchers monitored 8,002 people for up to eight years. They either suffered from knee osteoarthritis or were at high risk for the condition. Of those, 2,313 people were eligible for and/or received total knee replacement. Overall, researchers analyzed 3,417 knees, but only 1,114 of which were replaced.

About 90 percent, or 2,833, of the knees that were “potentially appropriate” for surgery did not have the procedure. Of these, more than 1,200 knees suffered “severe symptoms.”

“The osteoarthritis causes deterioration of their function,” said lead investigator Hassan Ghomrawi, associate professor of surgery at Northwestern University Feinberg School of Medicine, in a statement. “Some of them wouldn’t be able to straighten out their legs, affecting their walking and mobility.”

The ideal timing of knee replacement surgery is based on an algorithm that factors in pain, joint function, radiographic assessment, and age, researchers said.

Nearly 1 million knee replacement procedures are performed in the U.S. each year, with projections of a rapid increase by 2030, the study reports.

This is believed to be the first study to examine the timeliness of knee replacement among a large number of patients with knee osteoarthritis.

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