Abstract P155: Acute Stress From Elections and Hospitalization for Acute Myocardial Infarction

Background: A growing body of evidence suggests that stressors are associated with heightened cardiovascular risk within hours after the triggering event, and stress from election campaigns is associated with a heightened risk of pre-term birth. Hypothesis: Potential stress from the 2016 presidential election was associated with an increased hospitalization rate for acute myocardial infarction (AMI) in the following week. Methods: Among active members 18 years of age and older in Kaiser Permanente Southern California, AMI was defined as an inpatient hospitalization with a primary discharge diagnosis of ICD-10-CM codes I21.x or I22.x. In an ecological analysis, we calculated relative risks (RR) and 95% confidence intervals (CI) comparing rates of AMI per 100,000 person-years (PY) within one week following the date of the 2016 presidential election (risk window) to rates in the prior two weeks (control window) overall and within subgroups by age, sex, and race/ethnicity. We repeated the above analysis comparing rates of AMI within one week of the 2016 election date to rates in the prior week. Results: Compared to the rates of MI in the two weeks before the 2016 election (171.6 per 100,000 PY), the rate of AMI hospitalization in the week following election day (242.2 per 100,000 PY) was 1.41 times higher (95% CI 1.14, 1.75). (Table) Heightened AMI risk after the 2016 election was also observed among adults 55-74 years of age (RR 1.47, 95% CI 1.10, 1.98), men (RR 1.54, 95% CI 1.17, 2.02), and white individuals (RR 1.52, 95% CI 1.12, 2.06). However, there was no evidence of heterogeneity across age, sex, or race/ethnicity groups (p-values 0.98, 0.30, and 0.65, respectively). Using a one-week control window, similar results were observed. Conclusion: Increased AMI rates among subsets of the population coincident with the 2016 election is consistent with published data suggesting that acute sociopolitical stress may have adverse health effects.