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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
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Mar 8 • 5 tweets • 2 min read
Lack of sleep (<5 h) and excessive sleep (>9 h), both increase the risk of heart attack
1. Insomnia (lack of sleep) is not considered a traditional risk factor for heart attack.
A recent study examined the association between sleep duration and risk of heart attacks.
#MedTwitter
2. People with insomnia had 69% higher risk of myocardial infarction (MI, heart attack).
The risk of MI was higher among those who slept <5 hours or <6 hours as compared to those who slept 7-8 hours/night.
doi.org/10.1002/clc.23…
3. Excessive #sleep also increased the risk of #heartattack.
People who slept 9 hours or more had a higher risk of heart attack as compared to those who slept 6-8 hours per night.
Sleeping >9 hours and sleeping <5 hours , both increased the risk of heart attack.
#CardioTwitter
4. Lack of sleep is associated with chronic stress and increased cortisol levels in blood, which can increase the risk of atherosclerosis- a possible mechanism of association of less sleep and increased risk of myocardial infarction.
5. Take home message
*Insomnia is a modifiable risk factor for heart attack.
*People should be encouraged to maintain normal sleep duration of 7-9 hours per night (in addition to controlling BP, sugar, weight and cholesterol) to reduce the risk of heart attack.

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Mar 10
Lifelong endurance sport participation on top of a healthy lifestyle is not associated with a more favorable coronary plaque composition.

1. The dose response between long-term endurance exercises such as running or cycling & coronary artery disease (CAD) is a subject of debate
1a. A recent study looked at the association between long-term endurance exercises and prevalence of coronary artery plaques. Image
2. Three groups of people were selected:
Group 1 had started exercising below age 30,
group 2 started after age 30, and
3rd group maintained healthy lifestyle with minimal exercises.
#running #cycling #endurance #HeartAttack
Read 11 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Mar 8
The prevalence of diabetes and obesity has increased in young adults over the past decade

1. We are witnessing higher numbers of heart attack and stroke in young adults (aged 50 & below). We need to identify the risk factors so that heart attack & stroke can be prevented in them
2. In a recent study, the prevalence of #diabetes increased from 3.0% to 4.1% and #obesity from 32.7% to 40.9% during 2017-20, as compared to 2009-10, among young adults aged 20-44.

9.3% of young adults had #hypertension and 36% had #hyperlipidemia.

jamanetwork.com/journals/jama/…
3. Other issue of concern is that most of these young individuals are not aware of their cardiovascular risk factors, with 40-50% of them not on any treatment.
Additionally, among those who receive treatment, 30-40% have poor BP or sugar control.
Read 5 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Mar 7
The health-related benefits of #walking does not depend on the time or place of walking

1. Met a marketing professional whose work required travelling on 15-20 days a month, with early morning/late evening flights. He lamented there is no proper time or place to walk.
#fitness
2. I suggested that he could walk inside airport terminals (after security checks, while waiting to board flights).
Most people sit, read newspapers, gossip or have coffee/snacks, while waiting to board.
The pictures below show my evening walk at Mumbai airport (T1) last month.
3. Walking would result in similar benefits, irrespective of time or place chosen for walks. One often needs to wait for 30-40 min for boarding, & walking during that time is ideal.
Preferably use stairs instead of escalators.
I remember a similar post of @IamShajanSamuel
Read 4 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Mar 7
Migraine attacks can get triggered by sleeping less as well as oversleeping

1. 29-yr old presented with features of chronic #Migraine for 8 years. Among the triggers for headache, he mentioned lack of sleep as well as oversleeping (>9 hours/night).
#MedTwitter #Headache #sleep
2. Lack of sleep is a well-known trigger for migraine attacks.
People with migraine have a higher risk of insomnia and people with insomnia have a higher risk of developing migraine. Those with insomnia also have a higher migraine frequency & severity.
…alofheadacheandpain.biomedcentral.com/articles/10.11…
3. Oversleeping too can trigger migraine attacks. This is often referred to as "weekend migraine". The person wakes up in morning (after sleeping >9 hours) with headaches.
doi.org/10.3390%2Fijms…
Read 4 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Mar 5
When cheque bounced due to signature mismatch

1. 48-yr old Venky was surprised when two of the cheques issued by him bounced due to signature mismatch. On enquiry with bank staff, he was shown his original signature, which did not match with the current one.
#MedTwitter
2. It was noted that letters in the later half of his signature had reduced in height (as compared to height in his original signature). The legibility of his writing too had reduced. He tried writing at home & similar thing happened- letters became smaller as he wrote sentences.
3. Venky decided to consult a Neurologist for evaluation. I reviewed his history.
He showed me his writing. Attached below are the samples- (above is normal, the one below is what his writing looked like).
I also observed mild shivering of his right hand, while he spoke to me. Image
Read 11 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Mar 5
Any level of physical activity is associated with better later-life #cognition

1. The multiple benefits of #exercise on cognitive functions are well known. A recent research showed that it is never too late to start exercising, and any exercise is better than not exercising.
2. The investigators asked 1417 participants how much they had exercised at ages 36, 43, 60, and 69 years.
Activities included badminton, swimming, fitness exercises, yoga, dancing, football, mountain climbing, jogging, or brisk walks for 30 min or more.
#dementia #Alzheimers
3. They were also asked the number of times they had exercised in the previous month.
Most commonly reported activities at age 60 were walking (71%), swimming (33%), floor exercises (24%), and cycling (15%).
dx.doi.org/10.1136/jnnp-2…
Read 6 tweets

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