Abstract
BackgroundPhysical exertion and caffeine consumption are associated with acute myocardial infarction (MI). However, physical exertion and caffeine consumption have not been examined as immediate triggers of MI in low and middle-income countries.ObjectiveUsing a self-matched case-crossover design, we examined the acute risk of MI in the hour following episodes of physical exertion, caffeinated coffee, and tea consumption among MI survivors in Thailand.MethodsA total of 506 Thai participants (women = 191, men = 315) were interviewed between 2014 and 2017 after sustaining an acute MI. We compared each subject’s exposure to physical exertion and consumption of caffeine- containing beverages in the hour preceding the onset of MI with the subject’s expected usual frequency in the prior year to calculate relative risks (RRs) and 95% confidence intervals (95%CIs).ResultsOf the 506 participants, 47 (9.3%) engaged in moderate or heavy physical exertion, 6 (1.2%) consumed tea, and 21 (4.2%) consumed coffee within the hour before MI. The relative risk of MI after moderate or heavy physical exertion was 3.0 (95% CI 2.2–4.2) compared to periods of no exertion, with a higher risk among more sedentary participants compared to active participants. Compared to times with no caffeinated beverage consumption, there was a higher risk of MI in the hour following consumption of caffeinated tea (RR = 3.7; 95%CI: 1.5–9.3) and coffee (RR = 2.3; 95%CI: 1.4–3.6).ConclusionPhysical exertion, coffee and tea consumption were associated with a higher risk of MI in the subsequent hour compared to times when the participants were sedentary or did not consume caffeinated beverages. Our study identifies high-risk populations for targeted screening and intervention to prevent acute MI.
Highlights
Cardiovascular disease (CVD) contributes to 30% of global mortality [1]
The relative risk of myocardial infarction (MI) after moderate or heavy physical exertion was 3.0 compared to periods of no exertion, with a higher risk among more sedentary participants compared to active participants
We examined whether the immediate risk of MI following moderate or heavy physical exertion or following coffee or tea consumption was different according to strata of sex, age (
Summary
Cardiovascular disease (CVD) contributes to 30% of global mortality [1]. According to estimates by the World Health Organization, 80% of premature death due to CVD occurs in low and middle-income countries [1,2,3]. Epidemiological evidences shows that short-term exposures trigger myocardial infarction (MI) including physical exertion [5,6], caffeine consumption [7], sexual activity [8], anger or emotional upset [9,10]. Many of these previous studies were conducted in occidental countries [5,6,9,10,11]. Physical exertion and caffeine consumption have not been examined as immediate triggers of MI in low and middle-income countries. University of Hawai’i at Manoa College of Tropical Agriculture and Human Resources, UNITED STATES
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