In Ischemic Heart Disease, Reduced Sensitivity to Pressure at the Sternum Accompanies Lower Mortality after Five Years: Evidence from a Randomized Controlled Trial
<b>Background:</b> Autonomic nervous system dysfunction (ANSD) is associated with negative prognosis of ischemic heart disease (IHD). Elevated periosteal pressure sensitivity (PPS) at the sternum relates to ANSD and sympathetic hyperactivity. Two previous observational case–control studi...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-12-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/24/7585 |
| _version_ | 1797380530738561024 |
|---|---|
| author | Søren Ballegaard Jens Faber Christian Selmer Finn Gyntelberg Svend Kreiner Benny Karpatschof Tobias Wirenfeldt Klausen Åke Hjalmarson Albert Gjedde |
| author_facet | Søren Ballegaard Jens Faber Christian Selmer Finn Gyntelberg Svend Kreiner Benny Karpatschof Tobias Wirenfeldt Klausen Åke Hjalmarson Albert Gjedde |
| author_sort | Søren Ballegaard |
| collection | DOAJ |
| description | <b>Background:</b> Autonomic nervous system dysfunction (ANSD) is associated with negative prognosis of ischemic heart disease (IHD). Elevated periosteal pressure sensitivity (PPS) at the sternum relates to ANSD and sympathetic hyperactivity. Two previous observational case–control studies of the effect of reduction of PPS suggested lower all-cause mortality from IHD and stroke. We now used a specific daily, adjunct, non-pharmacological program of reduction of elevated PPS to test the hypothetical association between the intervention and reduced all-cause mortality in patients with stable IHD in a randomized controlled trial (RCT). <b>Methods:</b> We completed active (n = 106) and passive interventions (n = 107) and compared the five-year mortalities. We also compared the five-year individual all-cause mortality of each participant to approximately 35.000 members of the general population of Denmark. Pooling the mortality data from the active group of the RCT with the two preliminary studies, we registered the mortality following active intervention of 1.168 person-years, compared to 40 million person-years of the pooled general population. <b>Results:</b> We recorded fewer deaths of the active RCT intervention group than of the corresponding control group from the general population (<i>p</i> = 0.01), as well as of the passive RCT intervention group (<i>p</i> = 0.035). The meta-analysis of the three studies together demonstrated reduced 4.2-year all-cause mortality of 60% (<i>p</i> = 0.007). <b>Conclusions:</b> The test of the hypothetical effect of an intervention aimed at the attenuation of ANSD accompanied by a lowered PPS revealed reduced all-cause mortality in patients with stable IHD. |
| first_indexed | 2024-03-08T20:38:37Z |
| format | Article |
| id | doaj.art-293d44640ef0419e8d2f2f81e534d4d8 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T20:38:37Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-293d44640ef0419e8d2f2f81e534d4d82023-12-22T14:17:05ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011224758510.3390/jcm12247585In Ischemic Heart Disease, Reduced Sensitivity to Pressure at the Sternum Accompanies Lower Mortality after Five Years: Evidence from a Randomized Controlled TrialSøren Ballegaard0Jens Faber1Christian Selmer2Finn Gyntelberg3Svend Kreiner4Benny Karpatschof5Tobias Wirenfeldt Klausen6Åke Hjalmarson7Albert Gjedde8Endocrine Unit, Department of Medicine, Herlev-Gentofte University Hospitals, 2730 Herlev, DenmarkEndocrine Unit, Department of Medicine, Herlev-Gentofte University Hospitals, 2730 Herlev, DenmarkEndocrine Unit, Department of Medicine, Herlev-Gentofte University Hospitals, 2730 Herlev, DenmarkThe National Research Center for the Working Environment, 2100 Copenhagen, DenmarkInstitute of Biostatistics, University of Copenhagen, 1017 Copenhagen, DenmarkInstitute of Psychology, University of Copenhagen, 1017 Copenhagen, DenmarkEndocrine Unit, Department of Medicine, Herlev-Gentofte University Hospitals, 2730 Herlev, DenmarkDepartment of Cardiology, Sahlgrenska University Hospital, University of Gothenburg, 41345 Gothenburg, SwedenFaculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark<b>Background:</b> Autonomic nervous system dysfunction (ANSD) is associated with negative prognosis of ischemic heart disease (IHD). Elevated periosteal pressure sensitivity (PPS) at the sternum relates to ANSD and sympathetic hyperactivity. Two previous observational case–control studies of the effect of reduction of PPS suggested lower all-cause mortality from IHD and stroke. We now used a specific daily, adjunct, non-pharmacological program of reduction of elevated PPS to test the hypothetical association between the intervention and reduced all-cause mortality in patients with stable IHD in a randomized controlled trial (RCT). <b>Methods:</b> We completed active (n = 106) and passive interventions (n = 107) and compared the five-year mortalities. We also compared the five-year individual all-cause mortality of each participant to approximately 35.000 members of the general population of Denmark. Pooling the mortality data from the active group of the RCT with the two preliminary studies, we registered the mortality following active intervention of 1.168 person-years, compared to 40 million person-years of the pooled general population. <b>Results:</b> We recorded fewer deaths of the active RCT intervention group than of the corresponding control group from the general population (<i>p</i> = 0.01), as well as of the passive RCT intervention group (<i>p</i> = 0.035). The meta-analysis of the three studies together demonstrated reduced 4.2-year all-cause mortality of 60% (<i>p</i> = 0.007). <b>Conclusions:</b> The test of the hypothetical effect of an intervention aimed at the attenuation of ANSD accompanied by a lowered PPS revealed reduced all-cause mortality in patients with stable IHD.https://www.mdpi.com/2077-0383/12/24/7585autonomic nervous systemsympathetic hyperactivityautonomic nervous system dysfunctionischemic heart diseasemortalityperiosteal pressure sensitivity |
| spellingShingle | Søren Ballegaard Jens Faber Christian Selmer Finn Gyntelberg Svend Kreiner Benny Karpatschof Tobias Wirenfeldt Klausen Åke Hjalmarson Albert Gjedde In Ischemic Heart Disease, Reduced Sensitivity to Pressure at the Sternum Accompanies Lower Mortality after Five Years: Evidence from a Randomized Controlled Trial Journal of Clinical Medicine autonomic nervous system sympathetic hyperactivity autonomic nervous system dysfunction ischemic heart disease mortality periosteal pressure sensitivity |
| title | In Ischemic Heart Disease, Reduced Sensitivity to Pressure at the Sternum Accompanies Lower Mortality after Five Years: Evidence from a Randomized Controlled Trial |
| title_full | In Ischemic Heart Disease, Reduced Sensitivity to Pressure at the Sternum Accompanies Lower Mortality after Five Years: Evidence from a Randomized Controlled Trial |
| title_fullStr | In Ischemic Heart Disease, Reduced Sensitivity to Pressure at the Sternum Accompanies Lower Mortality after Five Years: Evidence from a Randomized Controlled Trial |
| title_full_unstemmed | In Ischemic Heart Disease, Reduced Sensitivity to Pressure at the Sternum Accompanies Lower Mortality after Five Years: Evidence from a Randomized Controlled Trial |
| title_short | In Ischemic Heart Disease, Reduced Sensitivity to Pressure at the Sternum Accompanies Lower Mortality after Five Years: Evidence from a Randomized Controlled Trial |
| title_sort | in ischemic heart disease reduced sensitivity to pressure at the sternum accompanies lower mortality after five years evidence from a randomized controlled trial |
| topic | autonomic nervous system sympathetic hyperactivity autonomic nervous system dysfunction ischemic heart disease mortality periosteal pressure sensitivity |
| url | https://www.mdpi.com/2077-0383/12/24/7585 |
| work_keys_str_mv | AT sørenballegaard inischemicheartdiseasereducedsensitivitytopressureatthesternumaccompanieslowermortalityafterfiveyearsevidencefromarandomizedcontrolledtrial AT jensfaber inischemicheartdiseasereducedsensitivitytopressureatthesternumaccompanieslowermortalityafterfiveyearsevidencefromarandomizedcontrolledtrial AT christianselmer inischemicheartdiseasereducedsensitivitytopressureatthesternumaccompanieslowermortalityafterfiveyearsevidencefromarandomizedcontrolledtrial AT finngyntelberg inischemicheartdiseasereducedsensitivitytopressureatthesternumaccompanieslowermortalityafterfiveyearsevidencefromarandomizedcontrolledtrial AT svendkreiner inischemicheartdiseasereducedsensitivitytopressureatthesternumaccompanieslowermortalityafterfiveyearsevidencefromarandomizedcontrolledtrial AT bennykarpatschof inischemicheartdiseasereducedsensitivitytopressureatthesternumaccompanieslowermortalityafterfiveyearsevidencefromarandomizedcontrolledtrial AT tobiaswirenfeldtklausen inischemicheartdiseasereducedsensitivitytopressureatthesternumaccompanieslowermortalityafterfiveyearsevidencefromarandomizedcontrolledtrial AT akehjalmarson inischemicheartdiseasereducedsensitivitytopressureatthesternumaccompanieslowermortalityafterfiveyearsevidencefromarandomizedcontrolledtrial AT albertgjedde inischemicheartdiseasereducedsensitivitytopressureatthesternumaccompanieslowermortalityafterfiveyearsevidencefromarandomizedcontrolledtrial |