Arrhythmia Risk During the 2016 US Presidential Election. The Cost of Stressful Politics
Anger and extreme stress can cause fatal cardiovascular events in susceptible individuals.Political elections, such as the 2016 US presidential election, are significant stressors. It is unclear whether they trigger myocardial infarction.
Originally published20 May 2021https://doi.org/10.1161/JAHA.120.020559Journal of the American Heart Association.;0:e020559
Commentary
This retrospective case-crossover study of 2436 patients with implanted cardiac devices linked device data, electronic medical records, and past voter registration records to compare the incidence of arrhythmias during the election period with the control period using Poisson regression. The results reported that 2592 arrhythmias occurred in 655 patients during the hazard period compared to 1533 in 472 patients during the control period. The incidence of the combined outcome of supraventricular arrhythmia (IRR, 1.82 [95% CI, 1.36-2.43]) and ventricular arrhythmia (IRR, 1.60 [95% CI, 1.22-2.10]) as the type of arrhythmia was significantly increased during the election period compared to the control period. There was also an increase in certain types of arrhythmias, such as atrial fibrillation, supraventricular tachycardia, nonsustained ventricular tachycardia, and daily atrial fibrillation load. (P<0.001)
No significant interactions were found for gender, race/ethnicity, device type, age 65 years and older, hypertension, coronary artery disease, heart failure, political party affiliation, or personal party affiliation with county-level election results.
Thus, comparing the 2015 and 2016 control periods, we observed a significantly higher burden of atrial fibrillation in these individuals during the election period, but this study was not designed to examine long-term clinical outcomes, and whether arrhythmias caused by social events are associated with long-term medical conditions However, this study was not designed to examine long-term clinical outcomes and whether arrhythmias caused by social events are associated with long-term medical conditions, so caution should be exercised in accepting these results.
