Triple trouble: Mondays, muscles and menopause

4 minute read


Three bits of cardiovascular research bring a mixed bag of feelings with them.


Here’s a triple bunger for you, readers. If you wake up on a Monday morning, with hot flashes, carpal tunnel syndrome and chest pains, there is both good and bad news afoot.

First of all, Mondays suck.

We’ve all had that blissful moment of just waking, blinking at the ceiling, not quite realising where or when it is. Then the sad fact that actually, yes, it is Monday sinks our heart. I don’t care how much you love your job, the end of a weekend blows.

Now comes the even more depressing news that serious heart attacks are more likely to happen at the start of the working week than at any other time. Happy day, Monday.

It’s called the “Blue Monday” phenomenon and it remains a bit of a mystery, although the circadian rhythm has been a prime suspect.

Irish researchers recently analysed data of 10,528 patients admitted to hospital between 2013 and 2018 with the most serious type of heart attack – ST-segment elevation myocardial infarction. They found a spike in rates of STEMIs at the start of the working week, with rates highest on a Monday. There were also higher rates of STEMI than expected on a Sunday.

“This has been described before but remains a curiosity,” said cardiologist Dr Jack Laffan, who presumably wasn’t laughin’ that much (see what I did there? You’re welcome).

“The cause is likely multifactorial, however, based on what we know from previous studies, it is reasonable to presume a circadian element.”

British Heart Foundation medical director Professor Sir (yes!) Nilesh Samani stated the bleeding obvious: “We now need to unpick what it is about certain days of the week that makes them more likely.  Doing so could help doctors better understand this deadly condition so we can save more lives in future.” 

But the hits keep on coming, my friends.

If having a high risk of cardiovascular disease wasn’t enough, it turns out you’re more likely to develop carpal tunnel syndrome, tennis elbow, golf elbow, and rotator cuff tendinitis while trying to mitigate your risk with exercise.

Researchers at the University of Utah looked at data from a nine-year prospective cohort of 1,224 workers across various employment sectors in three US states and compared the development of musculoskeletal disorders to cardiovascular disease.

After adjusting for factors such as body mass index and the physical strain of participants’ jobs, they found that participants who were at 15% or higher risk of cardiovascular disease were four times more likely to develop one or more musculoskeletal disorders than those at low risk of cardiovascular disease; and were at 17 times greater risk of developing four or more musculoskeletal disorders than those at low risk of cardiovascular disease.

“We know that people need to engage in healthy behaviours so they don’t develop diseases that can shorten their lives,” said co-author Dr Matthew Thiese. “But this study shows that bad outcomes related to musculoskeletal disorders may also be waiting for people who aren’t taking care of their cardiovascular health.”

The big question of course is whether these kinds of musculoskeletal conditions are a potential early warning signal for cardiovascular disease. It gets you coming and going, folks.

To finish, some good news … well, mixed news, with a bit of potential.

The only things that suck more than Mondays are hot flashes. Trust me, I’m a woman of a certain age, I know of which I speak.

Researchers at UC San Francisco have tested the benefits of continual wearing of a nitroglycerin patch – more commonly used as a treatment for chest pain in coronary artery disease – for women who experience seven or more hot flashes a day.

They found that participants did experience short-term improvements in moderate to severe hot flashes, but the benefits of nitroglycerin compared to placebo did not extend past 12 weeks. Some women also experienced side effects, like headaches.

So … swings and roundabouts really. Back to cold showers and immoderate cursing for me.

Sending story tips to penny@medicalrepublic.com.au is protective against all of the above, in mice.

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