Stress, Smoking two primary contributors to cardiac events in Kashmir: IMHANS Study

Stress and smoking are two of the primary contributors to cardiac events among people in Kashmir, claims the new study carried out by Institute of Mental Health and Neurosciences (IMHANS) Srinagar and Superspeciality hospital Shireen Bagh.

The study titled as “Stressful life events in patients of first episode Acute Coronary Syndrome (ACS)” was carried at Superspeciality hospital Shireen Bagh where at least 300 patients were weighed on different stress related disorders, smoking and other health conditions like diabetes, hypertension.

The study was conducted by Dr Neelofar Jan, who is Resident doctor at IMHANS under the guidance of Dr Khalid Mohiuddin, HoD, Department of Cardiology at Government Medical College and Dr Yasir Rather, Professor at IMHANS.

According to the study, the history of exposure to stressful life events was significantly higher in those who suffered cardiac events.

As per the research, about 57 percent of patients reported the history of psychiatric illness before the occurrence of cardiac events with the most common diagnosis being depression (74 percent) followed by anxiety (20 percent).

Besides, 73 percent of cases had a history of smoking out of which 38 percent had smoking as the only risk factor for cardiac events while only 52 percent of controls had a history of smoking in the past.

The mean age of the study sample was 55.70 years. 24.7 percent of the cases have age lower than 45, and 35.4 percent below the age of 50 years.

The majority of participants (74.6 percent) were males with male to female ratio of 2.95:1.

As per the study, the majority of the study population was married (80 percent), while a minority were unmarried; the remaining participants were either widowed or separated.

The majority of our participants were hailing from rural areas: cases (64 percent), controls (72 percent), while the minority were from the urban area.

Besides that, most of the participants belonged to lower-middle and upper-lower socioeconomic status and 16% were from the upper-middle socioeconomic class.

The minority were from upper and lower socioeconomic classes. The table also shows that the majority of participants were living in nuclear families: cases, (46.7 percent), controls (44 percent) followed by extended family structure cases (33.3 percent), controls (37.3 percent) while only 20 percent of cases and 28.7 percent were living in joint families.

Dr Khalid Mohiuddin, HoD, Department of Cardiology at Government Medical College Srinagar told KIF that smoking is the dangerous risk factor for heart attacks. “Besides, chances of substance abuse are higher among stressed persons who have anxiety disorders and other neuropsychiatric disorders. So, stress, drug abuse, smoking addiction are also the reasons for heart attacks,” he said.

Dr Mohiuddin who was also the co-guide of the research said that there are other different risks for heart attacks like age, diabetes, high levels of cholesterol and hypertension.

Dr Neelofar Jan, Resident doctor at IMHANS said that out of 300 cases, majority of the cases were found to be stress and smokers.

However, Dr Yasir Hassan Rather, Professor at IMHANS told KIF that conventional wisdom has always linked stress and heart attacks.

He said that there is an abundance of research that confirms that psychological stress increases risk for a heart attack. In fact, the greater the stress, the greater the risk.

“Research has suggested that stress can cause increased levels of cortisol in the body. Over time, the increased levels of cortisol can lead to a cascade of unwanted effects, such as high blood pressure, obesity and greater insulin resistance. All of these effects can promote plaque build-up and arterial disease that increases the risk of a heart attack,” he said.

He said that the research also indicates that people who have type A personality, which means people who are overly ambitious, impatient, worry a lot or are aggressive have higher chances of heart attacks.

“People with chronic stress have unhealthy lifestyles such as sleeping poorly, lack of exercise and overeating. All of these lifestyle changes can put your heart health at risk,” he added.

He said that highlighting the mental health conditions of Kashmiris, we are already having a lot of psycho social stressors, environmental factors and due to the recent pandemic have witnessed a surge in stress levels which makes us more vulnerable to heart attacks. “Kashmiris as a whole are not very particular about a healthy lifestyle which can also be a risk factor for heart attacks,” he added.