Stress Increases IHD Risk in Women

Medical News: Work Stress Adds to Women’s Heart Disease Risk – in Cardiovascular, Prevention from MedPage Today

On-the-job pressure significantly increases the likelihood that women will develop ischemic heart disease, a large Danish study found.

Compared with women who felt their workplace pressure was suitable, those who reported that the pressure was much too high had a nearly 50% increased risk of developing ischemic heart disease (HR 1.47, 95% CI 1.14 to 1.88), according to Karen Allesøe, PhD, and colleagues from Glostrup University Hospital.

OA in One Large Joint Means OA in the Other

Medical News: OA in One Large Joint Signals OA in the Other – in Rheumatology, Arthritis from MedPage Today

The diagnosis of radiographic osteoarthritis in one knee or hip likely signals the involvement of the contralateral joint, a cross-sectional analysis determined.

In a patient with moderate-to-severe osteoarthritis in one knee, the odds ratio for having a similar degree of involvement of the other knee was 62.7 (95% CI 42.3 to 93.1), according to Eric C. Sayre, PhD, of the University of British Columbia in Vancouver, and colleagues.

Ouch.

Lp-PLA2 Predicts Non-Vascular Death

Medical News: Lp-PLA2 Predicts Non-Vascular Death – in Cardiovascular, Atherosclerosis from MedPage Today

High levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) were an independent risk factor for non-vascular mortality as well as for cardiovascular death, stroke, and coronary heart disease in a large meta-analysis.

For each standard deviation above the mean for Lp-PLA2 among nearly 80,000 participants in 32 prospective studies, the risk of non-vascular death increased by 10% after adjusting for conventional risk factors, reported Alexander Thompson, of the University of Cambridge in England, and 14 other members of the Lp-PLA2 Studies Collaboration in the May 1 Lancet.

Anticonvulsant Meds and Suicide Risk

JAMA — Abstract: Anticonvulsant Medications and the Risk of Suicide, Attempted Suicide, or Violent Death, April 14, 2010, Patorno et al. 303 (14): 1401

Results: The study identified 26 completed suicides, 801 attempted suicides, and 41 violent deaths in 297 620 new episodes of treatment with an anticonvulsant (overall median follow-up, 60 days). The incidence of the composite outcomes of completed suicides, attempted suicides, and violent deaths for anticonvulsants used in at least 100 treatment episodes ranged from 6.2 per 1000 person-years for primidone to 34.3 per 1000 person-years for oxcarbazepine. The risk of suicidal acts was increased for gabapentin (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.11-1.80), lamotrigine (HR, 1.84; 95% CI, 1.43-2.37), oxcarbazepine (HR, 2.07; 95% CI, 1.52-2.80), tiagabine (HR, 2.41; 95% CI, 1.65-3.52), and valproate (HR, 1.65; 95% CI, 1.25-2.19), compared with topiramate. The analyses including violent death produced similar results. Gabapentin users had increased risk in subgroups of younger and older patients, patients with mood disorders, and patients with epilepsy or seizure when compared with carbamazepine.

Conclusion: This exploratory analysis suggests that the use of gabapentin, lamotrigine, oxcarbazepine, and tiagabine, compared with the use of topiramate, may be associated with an increased risk of suicidal acts or violent deaths.

Lifestyle Underwriting – Update 4/27/10

Arch Intern Med — Abstract: Influence of Individual and Combined Health Behaviors on Total and Cause-Specific Mortality in Men and Women: The United Kingdom Health and Lifestyle Survey, April 26, 2010, Kvaavik et al. 170 (8): 711

The effect of combined health behaviors was strongest for other deaths and weakest for cancer mortality. Those with 4 compared with those with no poor health behaviors had an all-cause mortality risk equivalent to being 12 years older.