Association of Episodic Physical and Sexual Activity With Triggering of Acute Cardiac Events

Dahabreh, Issa J

doi:10.1001/jama.2011.336

Cited by 174 publications

(128 citation statements)

References 56 publications

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“…Acute triggers, stimuli that provoke these physiological and pathophysiological processes in the hours preceding the coronary event, may contribute to this process. The best established acute trigger is physical exertion (19), though other factors such as air pollution and upper respiratory infection also contribute (79).…”

Section: Acute Cardiac Eventsmentioning

confidence: 99%

Stress and Cardiovascular Disease: An Update on Current Knowledge

Steptoe

Kivimäki

2013

Annu. Rev. Public Health

647

443

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Considerable progress has been made during the past decade in research on cardiovascular effects of stress. Early-life stressors, such as childhood abuse and early socioeconomic adversity, are linked to increased cardiovascular morbidity in adulthood. Our updated meta-analyses of prospective studies published until 2011 show a 1.5-fold (95% confidence interval 1.2-1.9) increased risk of coronary heart disease among adults experiencing social isolation and a 1.3-fold (1.2-1.5) excess risk for workplace stress; adverse metabolic changes are one of the underlying plausible mechanisms. Stress, anger, and depressed mood can act as acute triggers of major cardiac events; the pooled relative risk of acute coronary syndrome onset being preceded by stress is 2.5 (1.8-3.5) in case-crossover studies. Stress is also implicated in the prognosis of cardiovascular disease and in the development of stress (takotsubo) cardiomyopathy. A major challenge over the next decade is to incorporate stress processes into the mainstream of cardiovascular pathophysiological research and understanding.

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Section: Acute Cardiac Eventsmentioning

confidence: 99%

Stress and Cardiovascular Disease: An Update on Current Knowledge

Steptoe

Kivimäki

2013

Annu. Rev. Public Health

647

443

View full text Add to dashboard Cite

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“…Acute clinical events, such as acute myocardial infarction (MI), unstable angina, ventricular fibrillation, or sudden coronary death are generally due to plaque destabilization and thrombosis but may also occur when acute ischemia is imposed on an electrically unstable myocardial substrate, precipitating ventricular fibrillation. As an illustration of precipitating risk factors, there is a clear increase in the risk of acute coronary syndromes when fighting fires (874), while shoveling snow after a snowstorm (843), or after other strenuous exertion, but primarily in those otherwise unaccustomed to vigorous exercise (373,1219). Earthquakes have been reported to trigger sudden cardiac death (1007).…”

Section: Overview Of Atherogenesismentioning

confidence: 99%

Molecular Biology of Atherosclerosis

Hopkins

2013

Physiological Reviews

388

344

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At least 468 individual genes have been manipulated by molecular methods to study their effects on the initiation, promotion, and progression of atherosclerosis. Most clinicians and many investigators, even in related disciplines, find many of these genes and the related pathways entirely foreign. Medical schools generally do not attempt to incorporate the relevant molecular biology into their curriculum. A number of key signaling pathways are highly relevant to atherogenesis and are presented to provide a context for the gene manipulations summarized herein. The pathways include the following: the insulin receptor (and other receptor tyrosine kinases); Ras and MAPK activation; TNF-␣ and related family members leading to activation of NF-B; effects of reactive oxygen species (ROS) on signaling; endothelial adaptations to flow including G protein-coupled receptor (GPCR) and integrin-related signaling; activation of endothelial and other cells by modified lipoproteins; purinergic signaling; control of leukocyte adhesion to endothelium, migration, and further activation; foam cell formation; and macrophage and vascular smooth muscle cell signaling related to proliferation, efferocytosis, and apoptosis. This review is intended primarily as an introduction to these key signaling pathways. They have become the focus of modern atherosclerosis research and will undoubtedly provide a rich resource for future innovation toward intervention and prevention of the number one cause of death in the modern world.

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“…106 Thus, exercise ability discerned by review of patient history may guide the physician to an estimate of cardiovascular risk associated with sexual activity. Exercise tolerance should be established before the initiation of ED therapy in all men regardless of cardiovascular risk.…”

Section: Exercise Ability and Sexual Activity Risk Stratificationmentioning

confidence: 99%

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Nehra

Jackson

Miner

et al. 2012

Mayo Clinic Proceedings

420

341

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The Princeton Consensus (Expert Panel) Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The third Princeton Consensus met November 8 to 10, 2010, and had 2 primary objectives. The first objective focused on the evaluation and management of cardiovascular risk in men with erectile dysfunction (ED) and no known cardiovascular disease (CVD), with particular emphasis on identification of men with ED who may require additional cardiologic work-up. The second objective focused on reevaluation and modification of previous recommendations for evaluation of cardiac risk associated with sexual activity in men with known CVD. The Panel's recommendations build on those developed during the first and second Princeton Consensus Conferences, first emphasizing the use of exercise ability and stress testing to ensure that each man's cardiovascular health is consistent with the physical demands of sexual activity before prescribing treatment for ED, and second highlighting the link between ED and CVD, which may be asymptomatic and may benefit from cardiovascular risk reduction. T he Princeton Consensus Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The first conference convened in June 1999 to develop recommendations for clinical management of sexual dysfunction in men and women with known cardiovascular disease (CVD). This conference also provided a multidisciplinary forum for evaluation of the potential cardiovascular risk posed by sexual activity in atrisk patients. The first Princeton Consensus Conference recommendations 1 included stratification of patients by level of cardiac risk associated with sexual activity based on existing CVD. Those at low risk could initiate or resume sexual activity and be treated for sexual dysfunction. For those at high risk, sexual activity was deferred until the cardiac condition was stabilized. The second Princeton Consensus Conference convened in June 2004 and expanded the recommendations of the first conference to emphasize risk factor evaluation and lifestyle management for all men with erectile dysfunction (ED). 2 The second conference recommendations also incorporated new information on the appropriate use of phosphodiesterase type 5 (PDE5) inhibitors in men with ED and concomitant CVD.The third Princeton Consensus Conference took place November 8 to 10, 2010, in Miami Beach, Florida. The group revisited and updated their 2005 recommendations regarding the cardiovascular risk associated with sexual activity in men with known CVD. 2 In addition, the third conference focused on the predictive value of vasculogenic ED in assigning cardiovascular risk in men of all ages, with the primary objective being development of an approach to cardiovascular risk assessment in younger men with ED and no known CVD. The role of testosterone in erectile function and cardiovascular health and the utility of testosterone replacement...

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Association of Episodic Physical and Sexual Activity With Triggering of Acute Cardiac Events

Cited by 174 publications

References 56 publications

Stress and Cardiovascular Disease: An Update on Current Knowledge

Stress and Cardiovascular Disease: An Update on Current Knowledge

Molecular Biology of Atherosclerosis

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

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