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Welcome to the European Society of Cardiology. Our mission: to reduce the burden of cardiovascular disease in Europe
 

The impact of stress on myocardial diseases 

Comment by J. de Sutter and E. Solberg

Date: 11 Feb 2011
United States Stock Market Performance and Acute Myocardial Infarction Rates in 2008–2009 (from the Duke Databank for Cardiovascular Disease)
M. Fiuzat,  L. K. Shaw, L.Thomas, G. Michael Felker, C. M. O'Connor
Am J Cardiol 2010; Advance online publication

Stressful events (such as earthquakes, wartime, terrorist attacks, experiences of losses) may be a trigger for AMI due to persistent mental stress.  In the present, Fiuzat et al evaluated for the first time a potential relation between stock market changes and cardiovascular events.

The authors explored the Duke Databank for Cardiovascular disease  and evaluated all patients with AMI from January 2006 to July 2009.  AMI rates were then compared to stock market values (NASDAQ) during the same period.  Strikingly, time series analysis showed a significant increase in AMI rates during the period of serious stock market decrease from October 2008 to April 2009 (reaching their lowest levels since the 1930s).  Importantly, this relationship remained statistically significant when adjusted for seasonal variations in cardiovascular event rates and was stronger when using a one month time lag between the drop in stock market values and AMI rates.

This study clearly indicates that changes in economic burden can influence cardiovascular event rates and perhaps that not only a lack but also a loss of money  can significantly affect AMI rates.

Johan De Sutter
On behalf of the EACPR Prevention, Epidemiology and Population Science section



The classic risk factors for coronary artery disease have been dyslipidemia, hypertension, diabetes, physical inactivity and overweight, and smoking. In recent years, stress, measured in various ways, has been demonstrated as a central risk factor too. 

Several articles, starting with increase in number of myocardial infarction during the Gulf war in 1991, have shown that a variety of severe life events affecting many people in a society increase the number of myocardial infarction. Also, this register-based study showed that number of myocardial infarction during the financial crisis in US, October 2008-April 2009, was higher than for a comparable period. Time series analysis between the NASDAQ stock market and myocardial infarction rate was conducted.

Probably, more events will hit society in the future. Doctors need to be aware of the impact of stress on myocardial diseases. There is a need to develop better stress management strategies, even though severe events affecting society might be inevitable.

Erik E. Solberg
On behalf of the EACPR Sports Cardiology section