News in brief: Alcohol more of a HF risk than previously thought; Hospitals told to act on staff wellbeing; BP variability linked to mental state and autonomic dysfunction

Alcohol more of a HF risk than previously thought

Levels of alcohol consumption currently considered safe by some countries are linked with development of heart failure, according to European research

An analysis of  data from 744 adults over 40 years of age enrolled in the STOP-HF trial found that drinking more than 7Seven standard drinks (70 g of alcohol) per week was associated with worsening pre-heart failure or progression to symptomatic heart failure.

Compared with no alcohol use, moderate (7-14 units; up to two bottles of 12.5% wine or seven 500 mL cans of 4.5% beer) was associated with a 4.5-fold increased risk of worsening heart health.

Presenting the results at the ESC Heart Failure 2022 meeting, study author Dr. Bethany Wong of St. Vincent’s University Hospital, Dublin, said that to minimise HF risk  people should limit weekly alcohol consumption to less than one bottle of wine or less than three-and-a-half 500 ml cans of 4.5% beer.

“This study adds to the body of evidence that a more cautious approach to alcohol consumption is needed,” she said.

“Our results indicate that countries should advocate lower limits of safe alcohol intake in pre-heart failure patients.

Hospitals must act on staff wellbeing

Hospitals and other employers must take “proactive and meaningful steps” to care for the mental health and wellbeing of workers, a leading medical indemnity provider says.

The warning from Avant Mutual follows a decision last month by the High Court, which found in favour of a public prosecutor who sued her former employer for failing to protect her from workplace trauma.

She was ultimately awarded significant damages.

“The decision is a sad reminder to employers that they cannot adopt a ‘wait and see’ approach where the work of their employees inherently involves psychosocial hazards,” said Avant senior solicitor Frances Thomas.

She suggested employers conduct health and safety risk assessments to identify challenging situations, including violent, angry or distressed patients and extremely high workloads.

It was also likely that many staff had seen their mental health impacted through COVID-19, adding to the need for workplace health and safety systems to be agile and proactive, Ms Thomas added.

“We recommend that all practices have systems in place to manage psychosocial hazards,” she said.

AMA vice president Dr Chris Moy said more protections were needed, calling on all states and territories to enact legislation making hospital boards directly and explicitly responsible for the psychosocial wellbeing of their staff.

Laws that did so were currently only in place in South Australia, he said.

BP variability linked to mental state and autonomic dysfunction

Mental illnesses including depression, anxiety and panic disorder are associated with blood pressure variability (BPV), according to a systematic review of the evidence.

The review, which identified 12 relevant studies, said the evidence supported the hypothesis that young and middle-aged participants with mental illness have dysregulated autonomic function, as reflected by an increased blood pressure variability. The evidence in older patients was less clear.

Panic disorder was associated with reduced nocturnal BP dipping while depression was associated with diastolic BP dipping but not systolic BP dipping.

The study said early therapeutic intervention in mental illness may prevent diseases associated with autonomic dysregulation and reduce the likelihood of negative cardiac outcomes.

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