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> We identified 364 hospitalizations for acute myocardial infarction that occurred within 1 year before and 1 year after a positive test result for influenza.

> We identified 364 hospitalizations for acute myocardial infarction that occurred within 1 year before and 1 year after a positive test result for influenza. Can somebody explain why they looked at hospitalizations for MI before having the flu as well as after? if the theory is that the flu causes heart issues why wouldn't they just look at MIs after hospitalizations?It seems to remove any explanatory ability.

nonbel 9y ago
Look at fig 1. They compared the number of people who had heart attacks from 1 -7 days after getting a positive lab test for influenza, and people who got heart attacks at any other time +/- 1 yr of the positive lab test. They saw that out of these people who had both a positive flu test and heart attack, there were more heart attacks in the 7 days subsequent to the positive lab test than at 8+ days after or beforehand. That abrupt cutoff at 7 days makes it sound like these people were being advised some kind of treatment that was increasing heart attack risk. This was in Ontario... they advise: >"-stay home and get plenty of rest -drink lots of fluids -avoid caffeine -speak to your doctor or nurse practitioner about over-the-counter medications that can help you feel better (basic pain or fever relievers), but do not give acetylsalicylic acid (ASA or Aspirin®) to children or teenagers under the age of 18 -treat muscle pain using a hot water bottle or heating pad — apply heat for short periods of time -take a warm bath -gargle with a glass of warm salt water or suck on hard candy or lozenges -use spray or saline drops for a stuffy nose -avoid alcohol and tobacco" https://www.ontario.ca/page/flu-facts#section-4 https://www.ontario.ca/page/flu-facts#section-4 My first guess would be ibuprofin: https://en.wikipedia.org/wiki/Ibuprofen#Cardiovascular_risk https://en.wikipedia.org/wiki/Ibuprofen#Cardiovascular_risk EDIT: More on the NSAID possibility (apparently it is not supposed to only be chronic use): "Taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction." http://www.bmj.com/content/357/bmj.j1909 http://www.bmj.com/content/357/bmj.j1909
- djbelieny 9y ago
  This may be a highly simplistic view but from your list the salt water gargle seemed like a simple explanation to me. ie. Excessive consumption/gargle of Salt Water leading to Elevated Blood Pressure leading to heart attack. could this be it ?
  - nonbel 9y ago
    I noted that too but gargling didn't seem likely to lead to that much increased sodium intake. I guess it could happen though...
    - djbelieny 9y ago
      Interesting fact..if you put a pinch of salt under your tong you will see and almost immediate rise in BP. This tactic has been used for decades as a home remedy to quick revert the effects of spell of low blood pressure.
- jnordwick 9y ago
  > Look at fig 1. They compared the number of people who had heart attacks from 1 -7 days after getting a positive lab test for influenza, and people who got heart attacks at any other time +/- 1 yr of the positive lab test. That makes total sense. Was there a link to the actual paper? Its really hard to understand these abstracts or have any meaningful discussion without it, sadly. > That abrupt cutoff at 7 days makes it sound like these people were being advised some kind of treatment that was increasing heart attack risk. It would have been nice to a group that had the flu but didn't have any of the standard treatments to see how they compared to the flu group with treatments because their test group seems like more than just the flu. Could you have a group too that did the treatments without the flu? That would seem a little unethical though ("here do this - we have this theory that you'll have a heart attack") All said, for those of you that have actually had influenza as an adult, a death actually sounds preferable.
  - nonbel 9y ago
    > "Was there a link to the actual paper?" The title link goes to the paper. It only shows the abstract by defualt though. You need to get access to it to read the rest. Perhaps someone else can help you there. >"It would have been nice to a group that had the flu but didn't have any of the standard treatments to see how they compared to the flu group with treatments because their test group seems like more than just the flu." It didn't look like they reported what treatments were involved, but I only glanced at the paper. It is possible they had this data and missed/ignored it though. > "Could you have a group too that did the treatments without the flu?" I'm sure there are many people on NSAIDs for headaches and such that could be included. The dosage regimen is probably important though. Eg, suddenly start taking them for a week then stop, etc. > "All said, for those of you that have actually had influenza as an adult, a death actually sounds preferable." This seems a little strong. I haven't heard before that people consider the flu to be worse than death...
- aruggirello 9y ago
  Ibuprofen is a hot topic on HN too: https://hn.algolia.com/?query=ibuprofen&sort=byPopularity&prefix&page=0&dateRange=all&type=story https://hn.algolia.com/?query=ibuprofen&sort=byPopularity&pr...

nonbel 9y ago

Look at fig 1. They compared the number of people who had heart attacks from 1 -7 days after getting a positive lab test for influenza, and people who got heart attacks at any other time +/- 1 yr of the positive lab test. They saw that out of these people who had both a positive flu test and heart attack, there were more heart attacks in the 7 days subsequent to the positive lab test than at 8+ days after or beforehand. That abrupt cutoff at 7 days makes it sound like these people were being advised some kind of treatment that was increasing heart attack risk. This was in Ontario... they advise: >"-stay home and get plenty of rest -drink lots of fluids -avoid caffeine -speak to your doctor or nurse practitioner about over-the-counter medications that can help you feel better (basic pain or fever relievers), but do not give acetylsalicylic acid (ASA or Aspirin®) to children or teenagers under the age of 18 -treat muscle pain using a hot water bottle or heating pad — apply heat for short periods of time -take a warm bath -gargle with a glass of warm salt water or suck on hard candy or lozenges -use spray or saline drops for a stuffy nose -avoid alcohol and tobacco" https://www.ontario.ca/page/flu-facts#section-4 https://www.ontario.ca/page/flu-facts#section-4 My first guess would be ibuprofin: https://en.wikipedia.org/wiki/Ibuprofen#Cardiovascular_risk https://en.wikipedia.org/wiki/Ibuprofen#Cardiovascular_risk EDIT: More on the NSAID possibility (apparently it is not supposed to only be chronic use): "Taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction." http://www.bmj.com/content/357/bmj.j1909 http://www.bmj.com/content/357/bmj.j1909

djbelieny 9y ago
This may be a highly simplistic view but from your list the salt water gargle seemed like a simple explanation to me. ie. Excessive consumption/gargle of Salt Water leading to Elevated Blood Pressure leading to heart attack. could this be it ?
- nonbel 9y ago
  I noted that too but gargling didn't seem likely to lead to that much increased sodium intake. I guess it could happen though...
  - djbelieny 9y ago
    Interesting fact..if you put a pinch of salt under your tong you will see and almost immediate rise in BP. This tactic has been used for decades as a home remedy to quick revert the effects of spell of low blood pressure.
jnordwick 9y ago
> Look at fig 1. They compared the number of people who had heart attacks from 1 -7 days after getting a positive lab test for influenza, and people who got heart attacks at any other time +/- 1 yr of the positive lab test. That makes total sense. Was there a link to the actual paper? Its really hard to understand these abstracts or have any meaningful discussion without it, sadly. > That abrupt cutoff at 7 days makes it sound like these people were being advised some kind of treatment that was increasing heart attack risk. It would have been nice to a group that had the flu but didn't have any of the standard treatments to see how they compared to the flu group with treatments because their test group seems like more than just the flu. Could you have a group too that did the treatments without the flu? That would seem a little unethical though ("here do this - we have this theory that you'll have a heart attack") All said, for those of you that have actually had influenza as an adult, a death actually sounds preferable.
- nonbel 9y ago
  > "Was there a link to the actual paper?" The title link goes to the paper. It only shows the abstract by defualt though. You need to get access to it to read the rest. Perhaps someone else can help you there. >"It would have been nice to a group that had the flu but didn't have any of the standard treatments to see how they compared to the flu group with treatments because their test group seems like more than just the flu." It didn't look like they reported what treatments were involved, but I only glanced at the paper. It is possible they had this data and missed/ignored it though. > "Could you have a group too that did the treatments without the flu?" I'm sure there are many people on NSAIDs for headaches and such that could be included. The dosage regimen is probably important though. Eg, suddenly start taking them for a week then stop, etc. > "All said, for those of you that have actually had influenza as an adult, a death actually sounds preferable." This seems a little strong. I haven't heard before that people consider the flu to be worse than death...
aruggirello 9y ago
Ibuprofen is a hot topic on HN too: https://hn.algolia.com/?query=ibuprofen&sort=byPopularity&prefix&page=0&dateRange=all&type=story https://hn.algolia.com/?query=ibuprofen&sort=byPopularity&pr...