February 24, 2011

expert reaction to study published in the Lancet on trigger factors for heart attacks

The study examined a range of possible trigger factors for heart attacks.

Dr Tim Chico, Clinician Scientist and Honorary Consultant Cardiologist, University of Sheffield, said:

“We know a lot about why people suffer heart attacks (for example smoking, high cholesterol, obesity) but not much about why they occur on a particular day and time.

“This study helps give an idea of the amount that certain factors (like exposure to traffic) play in triggering a heart attack. However, what triggers the heart attack should be considered the ‘last straw’. The foundations of heart disease that lead to a heart attack are laid down over many years. If someone wants to avoid a heart attack they should focus on not smoking, exercising, eating a healthy diet and maintaining their ideal weight.”

Prof David Spiegelhalter, Winton Professor Of The Public Understanding Of Risk, University of Cambridge, said:

“The study helps show why the major benefit of stopping smoke pollution in public places is reducing triggers for heart attacks. Speaking personally, my own risk factors are getting angry while riding a Boris bike in London. The suggestion that heart attacks could be reduced by 2% if everyone stopped having sex is unlikely to be a popular public health message.”

Judy O’Sullivan, Senior Cardiac Nurse, British Heart Foundation, said:

“”It’s important to remember this study looked at the triggers and not the causes of heart attacks.

“The ‘triggers’ mentioned are already well known, including the fact that air pollution can trigger heart attacks and strokes in people who already have heart and circulatory disease, so this new analysis of previous research has not identified new triggers.

“However, given the large number of people living in the UK with heart disease and the likelihood of their exposure to air pollution, this study highlights how important it is that UK governments ensure they meet European Commission targets to improve air quality.

“More research is also needed to identify the constituent parts of polluted air that contribute to heart disease in the first place. We are currently funding research on how air pollution causes abnormalities in the blood vessels, which may help explain the link between heart disease and pollution.

“Finally, the benefits of exercising outdoors outweigh the risks associated with air pollution for most people so people shouldn’t be put off running, walking or cycling in towns and cities. However, people with heart disease should avoid spending long periods outdoors near busy roads or where traffic pollution is likely to be high. Local air quality reports could help people to understand when they might be most at risk.”

Public health importance of triggers of myocardial infarction: a comparative risk assessment, by Tim Nawrot et al., published in the Lancet on 0001H UK time Thursday 24 February 2011.