LIVING NEAR MAJOR ROADS MAY INCREASE SUDDEN CARDIAC DEATH IN WOMEN

Living close to a major road may increase women's risk of dying from sudden cardiac death, according to new research in the American Heart Association journal Circulation.

 

"It's important for healthcare providers to recognize that environmental exposures may be under-appreciated risk factors for diseases such as sudden cardiac death and fatal coronary heart disease," said Jaime E. Hart, Sc.D., study lead author and an instructor in medicine at Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts. "On a population level, living near a major roadway was as important a risk factor as smoking, diet or obesity."

While researchers previously found a modest increase in coronary heart disease risk among people who live near major roadways, the new study may be the first to examine the impact of roadway proximity to the risk of sudden cardiac death. Researchers note that roadway proximity could be a marker for exposure to air pollution.

The researchers studied data from 107,130 women (predominately white, average age 60) who were part of the Nurses' Health Study from 1986-2012. Calculating residential distance to roadways and after adjusting for a large number of other factors including age, race, calendar time, cigarette smoking, physical activity, and diet, researchers found:

In 523 cases of sudden cardiac death, living within 50 meters (164 feet) of a major road increased the risk of sudden cardiac death by 38 percent, compared to living at least 500 meters (.3 miles) away.

Each 100 meters (328 feet) closer to roadways was associated with a 6 percent increased risk for sudden cardiac death.

In the 1,159 cases of fatal coronary heart disease, risk increased 24 percent.

The public's exposure to major roadways is comparable to major sudden cardiac death risk factors, researchers said.

Researchers weren't able to measure all possible risk factors associated with living near a major road. They also said more research is needed among men and among women of different ages, races and income levels because nearly all participants were middle-age to elderly, white and of middle- to upper-socioeconomic class.

The Environmental Protection Agency estimated that 35 million people in the United States lived within 300 meters (984 feet) of a major road in 2009, and a growing number lived in close proximity to major roads worldwide.

"Regardless of where you live, adopting heart-healthy habits, such as maintaining a healthy weight, being physically active, eating nutritious foods, quitting smoking, and managing stress, can help decrease your risk of heart and blood vessel disease," said Hart, who is also an instructor at the Harvard School of Public Health.

"Our next step is to try to determine what specific exposures, such as air pollution, are driving the association between heart disease and major roadway proximity."

CARBONATED DRINKS LINKED WITH OUT OF HOSPITAL CARDIAC ARREST OF CARDIAC ORIGIN

Carbonated beverages are associated with out-of-hospital cardiac arrests of cardiac origin, according to results from the All-Japan Utstein Registry presented for the first time today at ESC Congress. The study in nearly 800,000 patients suggests that limiting consumption of carbonated beverages may be beneficial for health.

"Some epidemiologic studies have shown a positive correlation between the consumption of soft drinks and the incidence of cardiovascular disease (CVD) and stroke, while other reports have demonstrated that the intake of green tea and coffee reduced the risk and mortality of CVD," said principal investigator Professor Keijiro Saku, Dean and professor of cardiology at Fukuoka University in Japan. "Carbonated beverages, or sodas, have frequently been demonstrated to increase the risk of metabolic syndrome and CVD, such as subclinical cardiac remodeling and stroke. However, until now the association between drinking large amounts of carbonated beverages and fatal CVD, or out-of-hospital cardiac arrests (OHCA) of cardiac origin, was unclear."

The study compared the age-adjusted incidence of OHCAs to the consumption of various beverages per person between 2005 and 2011 in the 47 prefectures of Japan. It included 797 422 patients who had OHCAs of cardiac and non-cardiac origin from the All-Japan Utstein Registry of the Fire and Disaster Management Agency. Data on the consumption of the various beverages per person was obtained from the Ministry of Health, Labour and Welfare of Japan, using expenditure on beverages as a proxy measure.

The analysis focused on the 785 591 OHCA cases that received resuscitation, of which 435 064 (55.4%) were of cardiac origin and 350 527 (44.6%) were of non-cardiac origin. Those of non-cardiac origin included cerebrovascular disease, respiratory disease, malignant tumour, and exogenous disease (4.8%, 6.1%, 3.5%, and 18.9%, respectively).

The researchers found that expenditures on carbonated beverages were significantly associated with OHCAs of cardiac (r=0.30, p=0.04), but not non-cardiac origin (r=-0.03, p=0.8).

Expenditures on other beverages, including green tea, black tea, coffee, cocoa, fruit or vegetable juice, fermented milk beverage, milk and mineral water were not significantly associated with OHCAs of cardiac origin.

"Carbonated beverage consumption was significantly and positively associated with OHCAs of cardiac origin in Japan, indicating that beverage habits may have an impact on fatal CVD," said Professor Saku. "The acid in carbonated beverages might play an important role in this association."

Professor Saku concluded: "Our data on carbonated beverage consumption is based on expenditure and the association with OHCA is not causal. But the findings do indicate that limiting consumption of carbonated beverages could be beneficial for health."