Exhaustion may up heart attack risk in men

Men who experience vital exhaustion are more than twice as likely to have myocardial infarction (MI), with those who are divorced or never married being particularly at risk, according to a study presented at the ESC Acute CardioVascular Care (ACVC) 2021 Meeting.

“Vital exhaustion refers to excessive fatigue, feelings of demoralization and increased irritability,” explained presenting author Dr Dmitriy Panov from the Institute of Cytology and Genetics in Novosibirsk, Russia. “It is thought to be a response to intractable problems in people’s lives, particularly when they are unable to adapt to prolonged exposure to psychological stressors.”

Compared with men without vital exhaustion, as assessed using the Maastricht Vital Exhaustion Questionnaire (MQ), those who experienced moderate or high levels of exhaustion had a significantly increased risk of MI — by 2.7 times higher within 5 years, 2.25 times higher in 10 years, and 2.1 times in 14 years (p<0.05). [ESC ACVC 2021, abstract 20260]

The association remained significant after controlling for social factors and age, with MI being 16 percent more likely to occur in men with moderate or high exhaustion than those without over 14 years of follow-up (p<0.05).

In particular, the increase in MI risk with exhaustion was more pronounced in men who were never married, had been divorced, or who were widow compared with those who were married (hazard ratios [HRs], 3.7, 4.7, 7.0, respectively).

“Living alone indicates less social support, which we know from our prior studies is an independent risk factor for MI and stroke,” Panov pointed out.

Other factors influencing the association between exhaustion and MI included education levels and age. The risk of MI was 2.2-fold higher in exhausted men with education up to elementary level vs university degree. Similarly, the risk of MI increased by 3.8-fold and 5.9-fold in exhausted men aged 45–54 years and 55–64 years, respectively, compared with those aged 24–34 years. 

“Vital exhaustion is a predictor of higher risk of MI in middle-age men,” Panov noted.

The study used data of 657 men aged 25–64 years without a history of cardiovascular disease who were enrolled in the World Health Organization MONICA Project. They were categorized based on the level of vital exhaustion as assessed on the MQ. Overall, 67 percent of men experienced vital exhaustion, including 52 percent with a moderate level and 15 percent with a high level. Almost three-quarters of men (74 percent) who had high blood pressure showed vital exhaustion, with 58 percent being of high levels and 16 percent being moderate.

“Efforts to improve well-being and reduce stress at home and at work can help reduce vital exhaustion. Involvement in community groups is one way to increase social support and become less vulnerable to stress,” suggested Panov. “Together with a healthy lifestyle, these measures should be beneficial for heart health.”