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Heart attack risk doubles for e-cigarette users

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Daily use of e-cigarettes can nearly double the odds of a heart attack, according to a new analysis of a survey of nearly 70,000 people, led by researchers at UC San Francisco.

In addition, the research also found that dual use of e-cigarettes and conventional cigarettes — the most common use pattern among e-cigarette users — appears to be more dangerous than using either product alone.

It increases the odds of a heart attack by 4.6 times, according to researchers at the University of California San Francisco, who published their findings in the American Journal of Preventive Medicine on Wednesday.

The study was the first to examine the relationship between e-cigarette use and heart attacks.

The risk of heart attack, however, drops immediately after people stop smoking or refrain from using e-cigarettes.

“Most adults who use e-cigarettes continue to smoke cigarettes,” Dr. Stanton Glantz, a UCSF professor of medicine and director of the UCSF Center for Tobacco Control Research and Education, said in a press release.

“While people may think they are reducing their health risks, we found that the heart attack risk of e-cigarettes adds to the risk of smoking cigarettes,” Dr. Stanton added.

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E-cigarettes deliver lower levels of carcinogens than conventional cigarettes, however both contain ultrafine particles and other toxins that have been linked to increased cardiovascular and non-cancer lung disease risks.

Researchers analyzed medical data on 69,452 smokers aged 18 and older who participated in the National Health Interview Survey in 2014 and 2016. The US Census Bureau conducts the surveys.

Of 9,352 current and former e-cigarette users in the study, 3.6 percent had experienced a heart attack at some point. The highest percentage — 6.1 percent — was among those who used e-cigarettes daily.

One quarter of the 2,259 people who currently used e-cigarettes were former conventional smokers — and about 66 percent of current e-cigarette users were also current cigarette smokers.

The total odds of a heart attack were about the same for those who continued to smoke cigarettes daily and those who switched to daily e-cigarette use.

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Suicide can’t be predicted by asking about suicidal thoughts : Study

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Most people who died of suicide deny they experience suicidal thoughts when asked by doctors in the weeks and months leading up to their death, a major Australian study has found.

The findings, co-authored by clinical psychiatrist and Professor Matthew Large from UNSW’s School of Psychiatry, Sydney that published in the journal BJPsych Open The meta-analysis challenge the widely-held assumption that psychiatrists can predict who will suicide by asking if they are preoccupied with thoughts of killing themselves.

The study showed that 80% of patients who were not undergoing psychiatric treatment and who died of suicide reported not to have suicidal thoughts when asked by their psychiatrist or GP.

“If you meet someone who has suicidal ideation there is a 98 per cent chance that they are not going to suicide,” said Professor Large, an international expert on suicide risk assessment who also works in the emergency department of a major Sydney hospital.

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“But what we didn’t know was how frequently people who go on to suicide have denied having suicidal thoughts when asked directly,” he added.

“This study proves we can no longer ration psychiatric care based on the presence of suicidal thoughts alone. We need to provide high-quality, patient-centred care for everyone experiencing mental illness, whether or not they reveal they are experiencing suicidal thoughts,” Professor Large said.

About one in 10 people will have suicidal ideation in their lifetime. But the study showed suicidal ideation alone was not rational grounds for deciding who gets treatment and who does not, Professor Large said.

“We know that suicide feeling is pretty common and that suicide is actually a rare event, even among people with severe mental illness,” Professor Large added.

Suicidal ideation tells us an awful lot about how a person is feeling, their psychological distress, sometimes their diagnosis and their need for treatment but it’s not a meaningful test of future behaviour.

Suicidal feelings can fluctuate rapidly and people may suicide very impulsively after only a short period of suicidal thoughts.

But, people had good reasons not to disclose thoughts of suicide, fearing stigma, triggering over-reactions or upsetting family and friends, and being involuntarily admitted for psychiatric treatment, Professor Large said.

Professor Large emphasized that clinicians should not assume that patients experiencing mental distress without reporting suicidal ideas were not at elevated risk of suicide.

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