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Press Release
Heavy meals could trigger heart attacks
For immediate release October 30, 2000
For people with heart disease, an unusually heavy meal could trigger a heart attack, according to study presented by a Department of Veterans Affairs (VA) researcher on Nov. 14 at the annual scientific meeting of the American Heart Association in New Orleans.
"People at risk for heart attack should be careful not only about the total caloric intake they eat every day, but about the size of individual meals," said Francisco Lopez-Jimenez, M.D., M.Sc., of the Boston VA Healthcare System and Harvard Medical School.
Dr. Lopez-Jimenez and colleagues interviewed nearly 2,000 patients shortly after their heart attacks. The researchers asked about possible and proven triggers of heart attack, including "unusually heavy meals." According to Dr. Lopez-Jimenez, patients who reported eating big meals were four times more likely than other patients to suffer a heart attack soon after eating.
Of the 158 patients who reported eating an unusually heavy meal during the 26 hours before their attack, 25 of them had the meal in the two hours right before the attack. Only 6 patients had their big meal in the corresponding two-hour period the previous day. By comparing the two time-slots-24 hours apart-the study controlled for the possibility that time of day, and not the meal itself, was the trigger. The remaining patients in the group of 158 had their heavy meal at various other times in the 26 hours before the heart attack, but no other time-slot emerged as significant.
The study was funded by the National Heart, Lung and Blood Institute. It took place at 45 different hospitals, including several VA medical centers.
According to Dr. Lopez-Jimenez, there are two possible explanations of how a heavy meal could bring on a heart attack. One is that fatty meals may affect the function of the endothelium, the inner layer of the arteries. (The study did not record details on what was eaten.) The other is that eating increases the blood level of norepinephrine, a hormone that acutely raises blood pressure and pulse rate.
Collaborating with VA's Dr. Lopez-Jimenez on the study were Murray A. Mittleman, M.D.; Malcom Maclure, Sc.D.; Geoffrey H. Tofler, M.D.; Jane B. Sherwood, R.N.; and James E. Muller, M.D., all of Beth Israel Deaconess Medical Center in Boston.
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