Research Focuses on Impacts of Coffee, Naps, TV Watching and Depression on HTN and CV Events

New research addressing lifestyle habits ranging from prolonged TV watching to coffee drinking and their respective impacts on hypertension and cardiovascular disease was presented on Aug. 29 as part of ESC Congress 2015 in London.

In one study, prolonged television was found to increase risk of fatal pulmonary embolism, a condition associated with long-haul flights. Results from the 18-year study of more than 86,000 people showed that watching an average of five or more hours of television per day was associated with twice the risk of fatal pulmonary embolism compared to watching less than two and a half hours daily.

Toru Shirakawa, public health research fellow in the Department of Social Medicine at Osaka University in Japan, noted that public awareness of the risk of pulmonary embolism from lengthy leg immobility is essential. "More research is needed to assess the risks of prolonged use of new technologies on pulmonary embolism morbidity and mortality," he says.

A separate study found that coffee drinking may be associated with increased risk of cardiovascular events (mainly myocardial infarctions) in young adults (ages 18-45) with mild hypertension. The 12-year study of more than 1,200 patients found that heavy coffee drinkers had a four-fold increased risk while moderate drinkers tripled their risk. Future prediabetes attenuated the associations suggesting that the effect of coffee on cardiovascular events may be mediated by its long-term influence on blood pressure (BP) and glucose metabolism.

"Drinking coffee increases the risk of prediabetes in young adults with hypertension who are slow caffeine metabolisers," said Lucio Mos, MD, from the Hospital of San Daniele del Friuli in Udine, Italy. "Slow caffeine metabolisers have longer exposure to the detrimental effects of caffeine on glucose metabolism. The risk is even greater if they are overweight or obese, and if they are heavy coffee drinkers. Thus, the effect of coffee on prediabetes depends on the amount of daily coffee intake and genetic background."

Meanwhile, Manolis Kallistratos, MD, from Asklepieion Voula General Hospital in Athens, Greece, presented a third study showing that midday naps may be associated with reduced BP levels and prescription of fewer antihypertensive medications. "Although William Blake affirms that it is better to think in the morning, act at noon, eat in the evening and sleep at night, noon sleep seems to have beneficial effects," he explains.

After adjusting for other factors that could influence BP such as age, gender, body mass index, smoking status, salt, alcohol, exercise and coffee, Kallistratos and his fellow researchers found that midday sleepers had a 5 percent lower average 24-hour ambulatory systolic BP (6 mmHg) compared to patients who did not sleep at all midday. Their average systolic BP readings were 4 percent lower when they were awake (5 mmHg) and 6 percent lower while they slept at night (7 mmHg) than non-midday sleepers. Additionally, the longer the midday sleep the lower the systolic BP levels.

Depressive symptoms and extremes of BP predict the highest rates of harmful vascular events in patients with existing cardiovascular disease, diabetes or stroke, according to another study of more than 35,000 patients. Researchers found that the risk of further stroke or myocardial infarction, heart failure or dying due to cardiovascular disease at four years was 83 percent higher in depressed patients with high BP and 36 percent higher in depressed patients with low BP, compared to those with normal BP and no depressive symptoms.

"Our findings suggest that focusing resources on monitoring BP and providing treatment in patients with associated depressive symptoms could improve health outcomes by reducing the risk of further strokes or [myocardial infarctions], having heart failure or dying from cardiovascular disease," said Bhautesh Jani, MD, from the Institute of Health and Wellbeing, University of Glasgow, UK. "They also indicate that patients with high or low BP might benefit from screening and treatment for depression. To date there are no studies showing that treatment of depression changes or improves cardiovascular outcomes and more research is needed in this area. Studies are also needed to further understand how BP and depression interact."

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Heart Failure and Cardiomyopathies, Prevention, Vascular Medicine, CHD and Pediatrics and Prevention, Acute Heart Failure, Hypertension, Smoking

Keywords: Antihypertensive Agents, Blood Pressure Determination, Blood Pressure, Body Mass Index, Caffeine, Coffee, Depression, Glucose, Habits, Heart Failure, Hypertension, Life Style, Myocardial Infarction, Overweight, Prediabetic State, Public Health, Smoking, Pulmonary Embolism, Social Medicine, Stroke, Television, Adult, Young Adult, ESC Congress

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