Variation in admission rates of acute coronary syndrome patients in coronary care unit according to different seasons

Environmental stresses, especially extreme cold and hot weathers, have tendency to have more admissions for acute coronary syndromes. Due to scarcity of local data, we studied the variation in patient admission rates with acute coronary syndrome according to different seasons. Descriptive study. Coronary Care Unit, Civil Hospital and Pakistan Steel Hospital, Karachi, from January 2011 to December 2011. The study group comprised consecutive patients with acute coronary syndrome [unstable angina, Non STElevation Myocardial Infarction [NSTEMI], ST-Elevation Myocardial Infarction [STEMI] admitted to the coronary care unit. Patients with stable angina and valvular heart disease were excluded. Data was analyzed for admission according to different seasons, [winter, spring, summer and autumn]. The mean age of the 428 cases was 48.5 +/- 10.4 years [range 27 to 73 years]. Among the study group, 261 [61%] and 167 [39%] cases were male and female respectively. ST-elevation myocardial infarction, non ST-elevation myocardial infarction and unstable angina were present in 206 [48%], 128 [30%] and 94 [22%] respectively. Among the 428 patients, 184 [43%] cases had hypertension, 133 [31%] cases were smokers, 103 [24%] cases had dyslipidemia and diabetes mellitus and 08 [2%] cases had history of premature coronary artery disease. The number of patients admissions with acute coronary syndrome tended to change with sudden change in season. It increased in Winter 158 [36.9%] and Summer 130 [30.3%] in comparison to Spring 80 [18.69%] and Autumn 60 [14.02%] season. It was found variation in admission rates of acute coronary syndrome patients according to different seasons. The number of admissions not only increased in the cold season [winter] but also in hot season [summer] with sudden changes in temperature

Stress and multiple risk factors of cardiovascular diseases is there a link between them?

The relationship of stress associated with occupational responsibilities to hypertension as well as hyperlipidemia and coronary atherosclerosis remains controversial. This comparison study carried out in employed men in T and T department and general population examined the strength of association between them. Patients mental stress was determined by interview. In this analysis hypertension was found in 55 +/- 6% in T and T workers, 20 +/- 5% in general population of same age, weight and height matched group. Average age adjusted, values of systolic and diastolic BP were highest in study group 162/105 mmHg, and lowest in general population 150/100 mmHg. Higher values were found in younger age group of study. Mean cholesterol level was 353 mg% and 223 mg% in T and T employees and general population respectively. Increased triglycerides [mean 361 mg%] and higher LDL/HDL ratio > 5 was observed in study group than control group and incidence of coronary artery was 50% hypertensive T and T workers versus 20% in general population. History of Familial HBP and DM was found in 64%, 32% in study group versus 30% and 6% in control group, other risk factors such as smoking, DM, alcohol were found almost same in both groups. Analysis of this study shows that increased incidence of HBP and prevalence of hyperlipidemla are due to the over work and stressful job responsibilities raise hypertension specially more in subjects having Familial HBP, Hyperlipidemia and DM