21 October 2004

--- A Connection, Finally

You and I have long suspected this. Among the top guesses one can venture on the causes of heart attacks or myocardial infarctions is exposure to vehicular traffic.

Today's issue of the New England Journal of Medicine carries a study done to test any association between the two.

Exposure to Traffic and the Onset of Myocardial Infarction

Background: An association between exposure to vehicular traffic in urban areas and the exacerbation of cardiovascular disease has been suggested in previous studies. This study was designed to assess whether exposure to traffic can trigger myocardial infarction.

Methods: We conducted a case-crossover study in which cases of myocardial infarction were identified with the use of data from the Cooperative Health Research in the Region of Augsburg Myocardial Infarction Registry in Augsburg, in southern Germany, for the period from February 1999 to July 2001. There were 691 subjects for whom the date and time of the myocardial infarction were known who had survived for at least 24 hours after the event, completed the registry's standardized interview, and provided information on factors that may have triggered the myocardial infarction.

  • An association was found between exposure to traffic and the onset of a myocardial infarction within one hour afterward (odds ratio, 2.92; 95 percent confidence interval, 2.22 to 3.83; P<0.001).

  • The time the subjects spent in cars, on public transportation, or on motorcycles or bicycles was consistently linked with an increase in the risk of myocardial infarction.

  • The subject's use of a car was the most common source of exposure to traffic; nevertheless, there was also an association between time spent on public transportation and the onset of a myocardial infarction one hour later.
[New England Journal of Medicine, Volume 351:1721-1730, No. 17, Oct 21 2004]

The author led by Dr. Annette Peters gave their final verdict:


Transient exposure to traffic may increase the risk of myocardial infarction in susceptible persons.

[New England Journal of Medicine, Volume 351:1721-1730, No. 17, Oct 21 2004]

Exposure to vehicular traffic is an environmental stressor that makes most of us angry and anxious, especially when we are in a hurry.

Solutions to this problem can be approached two ways. One, of course, is for the traffic authorities to do their jobs well, and second, is for vulnerable persons to make some behavioral and habitual adjustments. Waking up early, using music and meditation to divert your attention from the gruesome traffic conditions, or having a companion to talk to while driving might be of help.

So, the next time you drive and you get caught in a traffic jam, take it easy. We do not want your heart to get affected.

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