The authors conclude that there is
growing evidence to support aggressive risk factor modification in the context of an AF risk factor management
plan. There is evidence to support
a comprehensive strategy of weight
loss, exercise and fitness, screening
for OSA, and treatment of traditional
modifiable cardiovascular disease risk
factors. However, further research is
needed before making specific recommendations and guidelines on appropriate weight loss and fitness targets.
Miller JD, Aronis KN, Chrispin J, et al. JACC.
2015;doi:0.1016/j.jacc.2015.10.047.
Depression,
Subclinical CVD,
and the Protective
Effects of Physical
Activity
Exercise may prevent the cardiovascular risks associated with depression,
according to a research letter published Jan. 11 in JACC.
Physiological stress can trigger
many physiologic responses. Up to
20% of individuals hospitalized for
myocardial infarction report symptoms of depression, and patients
with cardiovascular disease (CVD)
are three times more likely to develop
depression compared with the general
population. Depression can also lead
to worse cardiovascular and noncardiovascular outcomes.
To determine the relationship between exercise and the cardiovascular
risks of depression, researchers evaluated the effects of regular physical
activity in 965 subjects who were free
of heart disease, cerebrovascular or
peripheral arterial disease, and without a prior diagnosis of an affective,
psychotic, and/or anxiety disorder.
Subjects completed a questionnaire
assessing depressive symptoms over
the previous 2 weeks. Researchers
determined if the subjects met the
2008 Physical Activity Guideline for
Americans, which recommends 150
or 75 minutes per week of moderateor vigorous-intensity physical activity,
respectively, or an equivalent combination of the two. Oxidative stress
and vascular function were assessed.
ACC.org/CSWN
Higher rates of depressive
symptoms correlated with a higher
augmentation index and C-reactive
protein (CRP) levels, as well as lower
subendocardial viability ratio (SEVR)
and total glutathione levels. Subjects
with worsening depressive symptoms
had progressively higher augmentation index and CRP, as well as lower
SEVR and glutathione.
Researchers found significant interaction effects between physical activity
and depressive symptoms for augmentation index, CRP, and SEVR. Vascular
stiffening and systemic inflammation,
which accompany worsening depressive symptoms, were more pronounced in sedentary subjects. These
relationships were diminished in
subjects who regularly participated in
moderate to vigorous physical activity.
According to the authors, while
physical exercise appears to prevent
the adverse cardiovascular consequences of depression, these findings need
to be confirmed by a randomized trial.
Mheid IA, Held E, Uphoff I, et al. JACC.
2015;doi:10.1016/j.jacc.2015.10.057.
Excess Weight in
Early Adulthood
May Increase Risk
of Cardiac Death
Being overweight or obese throughout
adulthood—especially during early
adulthood—may lead to an increased
risk of sudden cardiac death, according to a study published Nov. 25 in
JACC: Clinical Electrophysiology.
Researchers led by Stephanie
Chiuve, ScD, an assistant professor of
medicine at Harvard Medical School,
analyzed data from the Nurses’ Health
study, following 72,484 healthy women from 1980 to 2012. Over the study
period, researchers documented 445
cases of sudden cardiac death, 1,286
cases of fatal coronary heart disease,
and 2,272 non-fatal myocardial infarction (MI). Results showed women
who were overweight (body mass
index [BMI] 25-30) and obese (BMI
30 or greater) were 1.5 and 2 times
more likely, respectively, to experience
sudden cardiac death over the next 2
years compared with women that have
a healthy weight (BMI 21-23).
Further, women who were
overweight or obese at the start of
the study, or obese at age 18, had an
elevated risk of sudden cardiac death
over the entire course of the study.
Weight gain in early-to-mid adulthood was associated with a greater
risk of sudden cardiac death at age
18, regardless of BMI. Women with
a higher BMI were also at a greater
risk of fatal coronary heart disease
and non-fatal MI.
According to the researchers, their
results showed that the risks from
excess weight or weight gain in early
adulthood are not completely erased
by weight loss later in life. Additionally, nearly three-quarters of patients
who suffer from sudde