Don’t Worry, Be Happy Relationship between Humor and the Vasculature Jeff Davis, RCIS

Disclosure I, Jeff Davis, RCIS, DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation.

Objectives Discuss normal endothelial Function Endothelial dysfunction Effects of anger and stress Effects of humor and laughter http://www.youtube.com/watch?v=UT2c9m34iQQ

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Regulatory Functions of the Endothelium Normal Dysfunction Vasodilation Vasoconstriction NO, PGI2, EDHF, BK, C-NP ROS, ET-1, TxA2, A-II, PGH2 Thrombolysis Thrombosis tPA, Protein C, TF-I, vWF PAI-1, TF-α, Tx-A2 Platelet Disaggregation NO, PGI2 Adhesion Molecules CAMs, P,E Selectins Antiproliferation NO, PGI2, TGF-, Hep Growth Factors ET-1, A-II, PDGF, ILGF, ILs Inflammation ROS, NF-B Lipolysis LPL Vogel R

Benefits of Humor and Laughter An incomplete list: Physical Lowers blood pressure Lowers blood glucose Improves heart health Boosts immune system Increases O2 intake Increases fertility!! Psychological Endorphins released Elevate mood Improve brain functioning Increases optimism, hope A stress buster!

Laughter May Help Prevent Heart Disease Reduces blood pressure, heart rate and stress hormones if practiced regularly Michael Miller, MD University of Maryland Medical Center, http://news.bbc.co.uk/1/hi/health/1024713.stm

Humour and laughter is learned, a person can develop a better sense of humour; that would affect one's own nature in a remarkable way and could be more conducive to good health. Dr Michael Miller

 American Heart Association's 73rd Scientific Sessions Michael Miller, et al. Eating with friends waiter accidentally spilled some soup on one of your friends... Not amused. Amused but wouldn't have shown it. Smiled. Laughed. Laughed heartily. If you were having a romantic evening alone with someone you really liked I would... Be quite serious. Smile occasionally, but not laugh aloud much. Smile frequently and laugh aloud from time to time. Laugh aloud quite frequently. Laughed heartily much of the time. 300 healthy, age-matched participants, surveyed re: reaction to stressful situations 150 Hx of MI or CABG 150 No Hx CAD 40% less likely to laugh 40% more likely to laugh 10

European Society of Cardiology 2011 Congress Franco Bonaguidi, et al. 228 patients with Hx cardiovascular disease followed for 10 years NOT an Angry personality profile Angry personality profile 42.6% suffered MI, 57.4% MI free (P=0.0025) 21.5% suffered MI, 78.5% MI free (P=0.0025) 11

 European Society of Cardiology 2011 Congress  Laughter Has Positive Impact On Vascular Function  Michael Miller, et al. 20 volunteers enrolled. Brachial Artery Flow assessed before and after stressful and funny movies. No differences at baseline. BAF increased in 19 of 20 an average of 22% BAF decreased in 14 of 20 an average of 35% European Society of Cardiology Congress-Paris  2011 August American College of Cardiology 12

Flow-Mediated Vasodilation (FMD)

Laugh Away that MI 24 heart attack survivors-standard Tx. Several studies Heart attack survivors experiencing 30 minutes of laughter daily less likely to experience a 2nd MI (20% vs 50%), required lower med doses, and had lower BP. (N=24) Control Laughter 50% experienced 2nd MI 20% experienced 2nd MI CAN Journal of Cardiol 1997, 13 (Suppl. B) 190B in Mind/Body Health Newsletter (Vol. 8, Number 2, 1999) Friedman, M, Ulmer, D. (1984) Treating Type A Behavior-- and Your Heart. New York: Knopf. 14

Laughter Lowers Blood Pressure Significant reduction in BP in laughter group over control group Systolic BP ipre 128.24 / post 120.78 mm/hg Diastolic BP i pre 82.37 / post 79.34 mm/hg Cortisol levels i American Society of Hypertension Conference May 2008, New Orleans, LA http://www.abstracts2view.com/ash/

Laughter Helps Immune System Dr Lee Berk, University of California, Irvine Immune system h Stress hormones i Endorphins h

lower levels of epi, norepi, TNF-α, IFN-γ, IL-6 Lee Burk, et al. 20 high-risk diabetic patients with HTN and hyperlipidemia-started on standard medications for diabetes (glipizide, TZD, metformin), hypertension (ACE inhibitor or ARB) and hyperlipidemia (statins). Researchers followed both groups for 12 months, testing their blood for stress hormones epi and norepi;  HDL cholesterol; inflammatory cytokines TNF-α IFN-γ and IL-6, and C-reactive proteins (hs-CRP). Group L viewed self-selected humor for 30 minutes in addition to the standard therapies described above. Authors conclude laughter may lower the risk of cardiovascular disease associated with diabetes mellitus and metabolic syndrome.  Further studies needed to expand and elucidate these findings. Control Laughter HDL inc 3% CRP dec 26% HDL inc 26% CRP dec 66% lower levels of epi, norepi, TNF-α, IFN-γ, IL-6 17

Laughter Improves Fertility Laughter can make you pregnant! Just over a third of women entertained by a clown conceived, compared to 19% of a group who were not, a European fertility conference heard. Israeli fertility researchers found almost doubling of conceptions from IVF treatment if ladies were entertained by clowns after treatment. Source : http://news.bbc.co.uk/2/hi/health/5099188.stm

"A merry heart doeth good like a medicine: but a broken spirit drieth the bones." Proverbs 17:22 19

Would you rather do this

Would you rather do this or this

Most major hospitals in the US now use clowns, pets, clergy, and humor intervention as a regular part of their care systems.

Adults laugh ~15 times/day 23

Children Laugh_____? 300-400 times per day 24

Laughs per Day 400 350 300 250 200 150 100 50 Grown ups Children 25

Take your work seriously 26

Take your work seriously --and yourself lightly Yeah, it’s pink... so what? 27

Any Singers and Dancers???

Any Singers and Dancers???

"From there to here, from here to there, funny things are everywhere." 30

You just have the know where to look……

THANK YOU