Effects of Alcohol Consumption and Smoking on the Onset of Hypertension in a Long-Term Longitudinal Study in a Male Workers’ Cohort

Aim: To determine the effects of alcohol consumption and smoking on the onset of hypertension in a long-term longitudinal study. Methods: 7511 non-hypertensive male workers were enrolled. This cohort study was performed over an 8-year period using the results of the annual workers-health screening. The end-point was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or use of antihypertensive drugs. For alcohol consumption, weekly alcohol intake (g ethanol/week) was estimated (1 “gou” = 22 g ethanol). Annual survey data were analyzed by pooled logistic regression that included alcohol consumption, smoking, age, body mass index, job schedule types, habitual exercise, and blood test measurements into the statistical model. Results: A significant positive dose–response relationship between alcohol consumption and onset of hypertension was observed, with synergistic health effects present. Compared with abstainers and nonsmokers, the adjusted odds ratios (95% confidence interval) for the onset of hypertension were: 1.51 (1.27–1.79) for 154 g ethanol/week and nonsmokers, and 1.81 (1.54–2.11) for 154 g ethanol/week and smokers. An interaction between alcohol and smoking was confirmed. Conclusions: This study provided information useful to the prevention of hypertension. By reducing alcohol consumption and smoking simultaneously, the risk of hypertension may be considerably lowered.

Habitual exercise provides better prognosis for cardiac arrest with coronary artery disease

Background Although regular physical activity has beneficial cardiovascular effects, exercise can trigger sudden cardiac arrest (SCA). Coronary artery disease (CAD) was identified as the most common cause of an exercise-related out-of-hospital cardiac arrest (OHCA). Regular exercise has been reported to reduce the risk of plaque rupture in animal studies and basic research. Therefore, we compared the coronary artery findings in CAD-OHCA patients with and without habitual exercise. There have been few reports on whether regular exercise changes the prognosis in OHCA due to CAD (CAD-OHCA). We investigated the association between the better clinical outcome and the regular exercise in patients with CAD-OHCA. Methods This is a single-center retrospective analysis from 2006 to 2019. The consecutive 397 patients with OHCA due to myocardial ischemia underwent coronary angiography (CAG). After excluding 73 patients with vasospastic angina, the remaining 324 patients with CAD were enrolled in this study. We divided these patients into two groups according to whether they were habitually exercising (Exercise group: N=37) or not/unknown (Non-Exercise group: N=287). Clinical outcome was a 30-day survival with minimal neurologic impairment represented by a Glasgow-Pittsburgh Cerebral Performance Categories Scale value 1 or 2. Results The patients in the Exercise Group were significantly younger (exercise vs. non-exercise, 57±12 vs. 64±12 years; P<0.01) than those in the non-exercise group. The Exercise group had a lower incidence of diabetes mellitus (22% vs. 42%; P=0.02) and a higher incidence of dyslipidemia (81% vs. 62%; P=0.02) than the non-exercise group. The time from collapse to cardiopulmonary resuscitation (1.4±4.0 vs. 3.0±4.8min) and from collapse to return of spontaneous circulation (11.9±10.0 vs. 28.0±25.3min) were shorter in Exercise group (all p<0.05). The ST-segment elevation was recorded on electrocardiography in fewer of the Exercise group (22% vs. 63%; P<0.01). The finding of culprit lesion in the coronary arteries on arrival resulted significant differences between the 2groups (good collateral and/or TIMI3 flow: 62% vs. 25%, the plaque rupture and/or thrombus: 22% vs. 73%) (all p<0.01) (Figure 1). Kaplan-Meier curve showed Exercise group has better neurological outcome at 30days compared than Non-Exercise (95% vs 51%; P<0.001, log-rank test) (Figure 2). Multivariable Cox proportional hazards models revealed that a habitual exercise was one of the predictors of a good neurological outcome (HR 0.21, 95% CI 0.05–0.92; P=0.039). Conclusions The patients with habitual exercise had less plaque rupture, less coronary thrombosis than non-exercise. The patients with regular exercise had better clinical outcomes than non-exercise after CAD-OHCA. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Tokyo Metropolitan Goverment Figure 1. Findings of the culprit lesion in coronar arteries Figure 2. Kaplan-Meier analysis

Effect of Pelvic Floor Muscle Training on Urinary Incontinence in Gynecologic Cancer: A Review

PURPOSE: Menopause is associated with increased carotid–femoral pulse wave velocity (cfPWV), an indicator of arterial stiffness, which is an independent marker of cardiovascular risk. This study aimed to investigate the cfPWV, blood pressure, and body composition with habitual exercise for at least 1 year in postmenopausal women performing habitual aquatic walking versus age-matched sedentary postmenopausal and premenopausal women.METHODS: A total of 115 postmenopausal and premenopausal women were divided into the following groups: (1) postmenopausal women performing habitual aquatic walking (HAW; n=57), (2) sedentary postmenopausal women (SPO; n=41), and (3) sedentary premenopausal women (SPR, n=17). The HAW group participated 3 days per week, 60 minutes per day, for at least 1 year, whereas the SPO and SPR groups performed no regular exercise, for less than 2 days per week, 30 minutes per day, for at least 1 year. The cfPWV, BP, and body composition were assessed in all groups.RESULTS: The cfPWV (p<.05), augmentation pressure (p<.05), and DBP were significantly lower in the SPR group than in the SPO group. AIx@75, BMI, %BF, and SBP were significantly lower in the SPR group than in the SPO and HAW groups. Lean body mass was higher in the SPR group than in the SPO and HAW groups (p<.05). The cfPWV, AP, AIx@75, SBP, and %BF were lower in the HAW group than in the SPO group (p<.05). Furthermore, the cfPWV was significantly correlated with aging and SBP.CONCLUSIONS: This cross-sectional study indicates that sedentary postmenopausal women may be at a higher risk of cardiovascular disease than postmenopausal women who participate in habitual aquatic walking.

AI and Phronesis

We argue that the growing prevalence of statistical machine learning in everyday decision making – from creditworthiness to police force allocation – effectively replaces many of our humdrum practical judgments and that this will eventually undermine our capacity for making such judgments. We lean on Aristotle’s famous account of how phronesis and moral virtues develop to make our case. If Aristotle is right that the habitual exercise of practical judgment allows us to incrementally hone virtues, and if AI saves us time by taking over some of those practical judgments, or if its pattern recognition capacities are very good at learning that kind of behavior – we risk innovating ourselves out of moral competence with the introduction of AI.