乌鸦传媒

The last U.S. presidential election may have set the stage for an increase in acute cardiovascular hospitalizations in California, a study showed.

The number of people ending up in the hospital because of heart attack, heart failure, or stroke in the 5 days after the election reached 760.5 per 100,000 person-years, significantly more than the number during the same 5-day period 2 weeks prior (RR 1.17, 95% CI 1.05-1.31), according to researchers led by Matthew Mefford, PhD, an epidemiologist at Kaiser Permanente Southern California (KPSC) in Pasadena.

This finding was driven by a jump in acute myocardial infarction (MI) hospitalizations (RR 1.42, 95% CI 1.13-1.79), as there was no significant change in heart failure or stroke admissions between the study periods.

The retrospective cohort study, based on more than 6.3 million adult patients at KPSC and Kaiser Permanente Northern California, was published in .

"There is a need for awareness of this higher risk of CVD [cardiovascular disease], and further research is warranted to identify strategies that mitigate cardiovascular risk during notable political events," the team wrote.

"More immediately, clinical visits for cardiovascular reasons may be an opportunity to assess psychological factors that can influence a patient's health maintenance and encourage stress reduction strategies. Mindfulness, meditation, yoga, and other relaxation techniques have also been suggested as ways to reduce stress," the investigators wrote.

They noted that the 2020 election and its aftermath surfaced claims of widespread voter fraud, troubles in counting ballots, and speculation that then-President Trump would not accept the results.

"Although speculative, it is plausible these factors combined created an emotionally charged atmosphere across the U.S. regardless of demographic or political affiliation," Mefford and co-authors said. They noted that they were unable to gather information on the political party affiliation of the study participants.

The researchers did find, however, that men in particular had an increase in cardiovascular hospitalizations after the election. In contrast, there was no significant interaction by race or age.

The study took patient records from two large integrated health systems in California. Cardiovascular outcomes of interest were drawn from admissions spanning Nov. 4-8 and Oct. 21-25, 2020.

A major limitation of the study, the team said, was the lack of information on patients' stress levels. This prevented investigators from drawing any direct connections between political stress, individual anxiety, and acute CVD risk.

"A wide array of potential stressors resulting from the COVID-19 pandemic, including health care disruptions; economic destabilization; uncertainty about working conditions, childcare, and schooling; and general fears of contracting COVID-19 were prominent in 2020 and we cannot rule out the potential influence of these circumstances on increasing CVD risk," Mefford and colleagues said.

"However," they added, "these stressors occurred over a much broader and prolonged period and are less likely to explain the transient risks observed in our defined risk and control windows that are in close proximity to the 2020 election."

Even so, the study had the additional caveat of limited generalizability to other health systems or geographic regions.

Nevertheless, Mefford's group cited their reporting a 62% higher risk of hospitalization for acute MI or stroke in the 2 days immediately following the 2016 presidential election versus 1 and 2 weeks prior.

"These [present] data support our findings from the 2016 election and are strengthened by the inclusion of an additional geographic region in California and an additional CVD end point," the team said.

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