[돼지독감] 인플루엔자 감염 시 심장마비 위험 증가 (연구결과)

건강과대안 — Tue, 22 Sep 2009 23:01:46 +0000

인플루엔자에 감염되었을 경우 심장마비의 위험이 증가한다는 최근 연구결과가 랜싯지에 실렸다는 AFP통신의 뉴스입니다.

오늘 국내에서 40대 신종플루 감염 뇌사환자가 사망했다는 소식이 있었는데, 플루가 심장질환과의 관련성이 있다는 연구결과까지 나왔습니다.

심장질환이 있는 사람들은 계절성 독감 백신과 돼지독감 백신을 모두 접종받는 것이 중요할 것 같습니다.

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Flu boosts heart-attack risk: study

출처 : AFP통신 Sep 22 2009

PARIS (AFP) – Heart problems may account for a huge share of deaths from influenza, according to a study published on Tuesday that recommends cardiac patients be vaccinated against flu.

The paper, published in the journal The Lancet Infectious Diseases, reviews mortality figures for acute myocardial infarction — a sudden heart attack — and cardiovascular disease during outbreaks of flu between 1932 and 2008.

The current pandemic H1N1 virus was not included in the snapshot.

Between 35 and 50 percent of the increase in deaths recorded during influenza outbreaks could be attributed to cardiovascular problems, it says.

The authors, led by infectious disease epidemiologists Charlotte Warren-Gash and Andrew Hayward at University College London, say the flu virus causes inflammation and acts on the molecular pathways that control blood coagulation.

These effects could destabilise fatty deposits that line the arterial wall and cause clots that block coronary arteries, they say.

Only a few investigations have been carried out into whether flu vaccination helps protect cardiac patients, but the little evidence available suggests it does, the paper says.

“We believe influenza vaccination should be encouraged wherever indicated, especially in those people with existing cardiovascular disease,” it says.

At present, vaccines for “seasonal” flu are recommended in many countries for individuals with chronic medical conditions. They generally include cardiovascular disease but not other cardiac problems such as hypertension.

Relatively few people at risk take up the vaccine, though. In Britain, only 47.2 percent of people with chronic conditions received the jab for seasonal flu, according to figures quoted in the study.

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Study: Flu viruses can spark heart attacks

By MARIA CHENG, AP Medical Writer Maria Cheng, Ap Medical Writer

출처 – AP통신 Mon Sep 21, 8:48 pm ET

LONDON – Heart patients who catch the flu may have more to worry about than just a fever or the sniffles: the virus could also spark a heart attack, new research shows.

Amid the global outbreak of swine flu, experts say it’s crucial that heart patients get vaccinated against both regular flu and swine flu to avoid medical problems. Doctors said swine flu isn’t any more dangerous than regular flu, but it’s important for heart patients to get vaccinated because more flu viruses will be circulating this year.

British researchers analyzed 39 previous studies of heart patients and found a consistent link between flu and heart attacks. Up to half of all unexpected flu deaths were due to heart disease, the researchers found.

The study was published online Tuesday in the British medical journal, The Lancet Infectious Diseases.

“The message here is so strong and so logical that it’s hard for us to ignore,” said Dr. Ralph Brindis, vice president of the American College of Cardiology. “If we can convince cardiac patients to get a flu vaccine, that could ultimately save lives.”

Only about one-third of heart patients in the U.S. regularly get vaccinated.

Doctors have long known that flu viruses can worsen existing medical conditions and that heart patients are especially vulnerable during flu pandemics. Flu viruses cause inflammation in the body, usually in the lungs. But they can also cause swelling in the heart itself or in the coronary arteries, which could lead to dangerous clots breaking off and causing a heart attack.

Once heart patients get the flu, they are also more vulnerable to complications like pneumonia and other infections.

“We know influenza vaccine is effective in preventing influenza and therefore in theory, ought to be effective in preventing the complications of influenza,” said Andrew Hayward of University College London, one of the study authors. He said two of the studies analyzed showed heart patients who got a flu shot had fewer heart attacks than those who didn’t.

Hayward said flu viruses might merely act as triggers for heart attacks in cardiovascular patients.

“Influenza may be bringing forward an event that might have happened anyway,” he said, adding there is evidence that when the virus peaks, so too do heart attacks.

Experts are unsure whether the study results apply to otherwise healthy people with no history of heart disease. But they say flu viruses could potentially trigger heart attacks in people with no apparent heart disease, if they have risk factors like high blood pressure or are overweight.

For heart patients, doctors said the evidence is clear.

“Flu has too often been off the radar screen,” said Dr. Harlan Krumholz, a spokesman for the American Heart Association and professor of medicine at Yale University. “But flu is as important to think about as cholesterol or blood pressure.”

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On the Net:

http://www.lancet.com

[경제위기와 건강] The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis

건강과대안 — Mon, 13 Jul 2009 01:08:53 +0000

The Lancet 2009년 7월 8일자에 경제위기 시 공중보건의 영향에 관한 연구결과가 실렸습니다.

예전에 연구소 월례모임에서 다루었던 내용과 비슷한데요… 경제위기가 닥치면 자살과 살인, 심장마비에 의한 사망 건수가 늘어나는 반면, 교통사고는 줄어든다는 결론입니다.

영국 옥스퍼드대와 런던대 연구자들이 1970년부터 2007년까지 유럽연합(EU) 26개국의 자료를 분석한 내용입니다. 65세 이하의 자살자 수는 실업률이 1% 상승할 때마다 0.79%씩 늘어났습니다. 살인도 증가했구요… 교통사고사 건수는 1.39% 감소했습니다.

따라서 정부가 정부가 실험보험 등 공공지출을 증가함으로써 실업과 관련된 자살을 0.038% 감소시킬 수 있다고 합니다.

제3세계 가난한 국가들에 대한 자료분석은 빠져 있구요… 경제위기 시스트레스, 불안, 영양 감소 등이 건강에 미치는 영향은 5~7년 정도의 시차를 두고 나타나기 때문에 분석이 쉽지는 않겠지만… 이번 연구는 정부 예산을 투입을 통한 공공지출 확대가 중요하다는 사실을 보여주고 있다는 생각입니다.

자세한 내용은 이번 논문과 다음 논문도 참고하시기 바랍니다.

Managing the health effects of climate change / Prof Anthony Costello FRCPCH, Mustafa Abbas , Adriana Allen PhD, Sarah Ball BSc, Sarah Bell PhD, Prof Richard Bellamy PhD and others / The Lancet, vol. 373 No. 9676 pp 1693-1733 / May 16, 2009

Global health equity and climate stabilisation: a common agenda / Dr Sharon Friel PhD, Michael Marmot PhD, Anthony J McMichael PhD, Tord Kjellstrom PhD, Denny Vågerö PhD / The Lancet, Vol. 372 No. 9650 pp 1677-1683 / Nov 08, 2008

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The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis

David Stuckler PhD a b , Sanjay Basu PhD c d, Marc Suhrcke PhD e f, Adam Coutts PhD g, Martin McKee MD b h

출처 : The Lancet, Early Online Publication, 8 July 2009 doi:10.1016/S0140-6736(09)61124-7

Background

There is widespread concern that the present economic crisis, particularly its effect on unemployment, will adversely affect population health. We investigated how economic changes have affected mortality rates over the past three decades and identified how governments might reduce adverse effects.

Methods

We used multivariate regression, correcting for population ageing, past mortality and employment trends, and country-specific differences in health-care infrastructure, to examine associations between changes in employment and mortality, and how associations were modified by different types of government expenditure for 26 European Union (EU) countries between 1970 and 2007.

Findings

We noted that every 1% increase in unemployment was associated with a 0·79% rise in suicides at ages younger than 65 years (95% CI 0·16—1·42; 60—550 potential excess deaths [mean 310] EU-wide), although the effect size was non-significant at all ages (0·49%, −0·04 to 1·02), and with a 0·79% rise in homicides (95% CI 0·06—1·52; 3—80 potential excess deaths [mean 40] EU-wide). By contrast, road-traffic deaths decreased by 1·39% (0·64—2·14; 290—980 potential fewer deaths [mean 630] EU-wide). A more than 3% increase in unemployment had a greater effect on suicides at ages younger than 65 years (4·45%, 95% CI 0·65—8·24; 250—3220 potential excess deaths [mean 1740] EU-wide) and deaths from alcohol abuse (28·0%, 12·30—43·70; 1550—5490 potential excess deaths [mean 3500] EU-wide). We noted no consistent evidence across the EU that all-cause mortality rates increased when unemployment rose, although populations varied substantially in how sensitive mortality was to economic crises, depending partly on differences in social protection. Every US$10 per person increased investment in active labour market programmes reduced the effect of unemployment on suicides by 0·038% (95% CI −0·004 to −0·071).

Interpretation

Rises in unemployment are associated with significant short-term increases in premature deaths from intentional violence, while reducing traffic fatalities. Active labour market programmes that keep and reintegrate workers in jobs could mitigate some adverse health effects of economic downturns.

Funding

Centre for Crime and Justice Studies, King’s College, London, UK; and Wates Foundation (UK).

건강과 대안 » 심장마비