Marriage
reduces heart attack risk
Being unmarried increases the
risk of fatal and non-fatal heart attack in both men and women whatever their age, according to
a large population-based study from Finland.
Conversely, said the study investigators, especially among
middle-aged couples, being married and cohabiting are associated with
"considerably better prognosis of acute cardiac events both before
hospitalization and after reaching the hospital alive".
The study was based on the FINAMI myocardial infarction register data from the years 1993 to 2002. It included information on people over the age of 35 living in four geographical regions of Finland.
All fatal and non-fatal cardiac events - known as "acute cardiac syndromes", ACS - were included and cross-referred to the population database. "Our aim," said the researchers, "was to study the differences in the morbidity and prognosis of incident acute coronary syndromes according to socio-demographic characteristics (marital status and household size)."
The register recorded 15,330 ACS events over the study period of ten years, with just over half (7703) resulting in death within 28 days. Events occurred almost equally among men and women. However, the analysis also showed that the age-standardised incidences of these ACS events were approximately 58-66 percent higher among unmarried men and 60-65 percent higher in unmarried women, than among married men and women in all age groups.
The differences in 28-day mortality rate were even greater. These 28-day mortality rates were found to be 60-168 percent higher in unmarried men and 71-175 per cent higher in unmarried women, than among married men and women.
Consistent with this finding, the case fatality rate of 35-64-year-old single men and women was higher than that of those living with one or more people.
According to the researchers, being unmarried or living alone is known to increase total and cardiovascular mortality and cardiovascular disease incidence. However, many of these previous studies have included only men in their analysis, with missing data on women and older age groups.
Married people may be better off, have better health habits, and enjoy higher levels of social support than the unmarried, which will all promote their overall health.
The study has been published in the European Journal of Preventive Cardiology.
18.02.2013
Docs can
feel their patients’ pain
Led by researchers at Massachusetts General Hospital (MGH) and the Program in Placebo
Studies and Therapeutic Encounter (PiPS) at Beth Israel Deaconess Medical
Center/Harvard Medical School, the new findings help to illuminate one of the
more intangible aspects of health care - the doctor/patient relationship.
"Our findings showed that the same brain regions that have previously been shown to be activated when patients receive placebo therapies are similarly activated in the brains of doctors when they administer what they think are effective treatments," explained first author Karin Jensen, PhD, an investigator in the Department of Psychiatry and Martinos Center for Biomedical Imaging at MGH and member of the PiPS.
Notably, she added, the findings also showed that the physicians who reported greater ability to take things from the patients' perspective, that is, to empathize with patients' feelings, experienced higher satisfaction during patients' treatments, as reflected in the brain scans.
Previous investigations have demonstrated that a brain region associated with pain relief (right ventrolateral prefrontal cortex, VLPFC) and a region associated with reward (rostral anterior cingulate cortex, rACC) are activated when patients experience the placebo effect, which occurs when patients show improvement from treatments that contain no active ingredients. The placebo effect accounts for significant portions of clinical outcomes in many illnesses -- including pain, depression and anxiety.
Jensen and her colleagues hypothesized that the same brain regions that are activated during patients' placebo responses - the VLPFC and rACC -- would similarly be activated in the brains of physicians as they treated patients. They also hypothesized that a physician's perspective-taking skills would influence the outcomes.
To test these hypotheses, the scientists developed a unique equipment arrangement that would enable them to conduct functional magnetic resonance imaging (fMRI) of the physicians' brains while the doctors had face-to-face interactions with patients, including observing patients as they underwent pain treatments.
As predicted, the researchers found that while treating patients, the physicians activated the right VLPFC region of the brain, a region previously implicated in the placebo response.
Furthermore, Jensen added, the physicians' ability to take the patients' viewpoints correlated to brain activations and subjective ratings; physicians who reported high perspective-taking skills were more likely to show activation in the rACC brain region, which is associated with reward.
The results will appear on-line in Molecular Psychiatry.
18.02.2013
If you have no
critics you'll likely have no success
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