Background
Heavy physical exertion, emotional stress, heavy meals and respiratory infection transiently
increase the risk of myocardial infarction, sudden death and stroke, however it remains
uncertain how to use this information for disease prevention.
Aims
We determined the feasibility of taking targeted medication for the hazard duration
of a triggering activity to reduce risk.
Methods
After a run-in training period over 1 month, 17 healthy subjects recorded for 1 month
all episodes of physical and emotional stress, heavy meal and respiratory infection.
For each episode, they were instructed to take either aspirin 100 mg and propranolol 10 mg (for physical exertion and emotional stress) or aspirin 100 mg alone (for respiratory infection and heavy meal) and record adherence with taking
medication. Subjects performed exertion while wearing a heart rate monitor, once during
the run-in period, and once 30 min after taking propranolol and aspirin.
Results
Based on study diary subjects reliably documented triggers with 94% adherence. Designated
medication was also reliably taken, with 88% adherence. Propranolol taken prior to
exertion resulted in a lower peak heart rate (128 ± 38 versus 149 ± 21, p < 0.01) compared to similar exercise during the run-in period. Over two-thirds (71%)
of subjects considered that it was feasible to continue taking medication in this
manner.
Conclusions
The study indicates that potential triggers of acute cardiovascular disease can be
reliably identified, and it is feasible and acceptable to take targeted medication
at the time of these triggers. These findings encourage further investigation of the
potential role of this therapeutic strategy.
Keywords
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Article info
Publication history
Accepted:
February 17,
2009
Received in revised form:
October 23,
2008
Received:
July 23,
2008
Identification
Copyright
© 2009 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.
