New research on the seasonality of cardiovascular risk factors, cold weather and heart attacks, physical activity and SCD in unfit men and the role of music in treating CAD was presented on Sept. 1 as part of an "Everyday Life" session at the ESC Congress 2013 in Amsterdam.

In one study, which looked at more than 100,000 patients aged 35 to 80 years in seven countries, cardiovascular risk factors such as blood pressure, waist circumference and total cholesterol were found to be highest in winter and lowest in summer. Specifically, systolic blood pressure levels were on average 3.5 mmHg lower in summer than in winter, while waist circumference was on average 1 cm smaller in summer than in winter. Total cholesterol was on average 0.24 mmol/L lower in summer than in winter.

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"Our large scale study shows that some cardiovascular risk factors take holidays over the summer," said Pedro Marques-Vidal, MD, from Switzerland. "This may explain why deaths from cardiovascular disease are higher in winter than summer. People need to make an extra effort to exercise and eat healthily in the winter to protect their health."

A separate study out of Belgium focused on two of the most frequent environmental triggers for acute myocardial infarction (AMI) — temperature and air pollution. The study of nearly 16,000 AMI patients who underwent primary PCI in 32 Belgian PCI Centers between 2006 and 2009, found that AMI increased by 7 percent for each 10°C decrease in minimal temperature (odds ratio [OR]=1.07, 95% confidence interval [CI]=1.04-1.11). However, data showed no relationship to between heart attacks and air pollution.

"Better knowledge of the impact of environment on AMI will help medical care providers and policy makers to optimise prevention strategies for a target risk population," said Professor Marc Claeys from Belgium, who presented on the study.

In terms of physical activity, a Finnish study found that high leisure-time physical activity (LTPA) combined with cardiorespiratory fitness (CRF) reduced the risk of sudden cardiac death (SCD) in unfit men. Data showed a two-fold increased risk of SCD in men with low CRF and low LTPA compared to men with high CRF and high LTPA (hazard ratio [HR] 2.0, 95% confidence interval [CI] 1.3-2.9). The amount of LTPA did not affect the risk of SCD among the men with high CRF, suggesting that poor CRF is a risk factor for SCD.

"Our study shows that exercise training and LTPA may be especially important in individuals with low CRF," said Jari Laukkanen, MD, of Finland. "One possible explanation is that CRF can be improved with regular exercise training."

Finally, another study presented by Professor Marina Deljanin Ilic from Serbia suggests that listening to favorite music and exercise training improves endothelial function in patients with coronary artery disease (CAD). Seventy-four patients were randomized into three groups — exercise training only, music and exercise training, and music only — and evaluated over the course of three weeks on endothelial function through changes of circulating blood markers of endothelial function (nitric oxide (NOx), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA) and xanthine oxidase (XO)). At the end of the study period the music and exercise training group saw the greatest improvements. "Listening to joyful music for 30 minutes has been associated with improved endothelial function, possibly by β-endorphin mediated activation of endothelium derived nitric oxide. The vascular health benefits of music may be due to endorphins or endorphin like compounds released from the brain when we hear music we like," said Ilic.

Keywords: Odds Ratio, Coronary Artery Disease, Myocardial Infarction, Seasons, Blood Pressure, Risk Factors, Cold Temperature, Weather, Xanthine Oxidase, Nitric Oxide, Waist Circumference, Cholesterol, Temperature, Motor Activity, Endorphins, Confidence Intervals, Death, Sudden, Cardiac

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