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

2. 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.

3. Objectives Discuss normal endothelial Function Endothelial dysfunction
Effects of anger and stress
Effects of humor and laughter

5. 5

6. 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

7. 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!

8. 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,

9. 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

10.  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

11. 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

12.  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

13. Flow-Mediated Vasodilation (FMD)

14. 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

15. Laughter Lowers Blood Pressure
Significant reduction in BP in laughter group over control group
Systolic BP ipre / post mm/hg
Diastolic BP i pre / post mm/hg
Cortisol levels i
American Society of Hypertension Conference May 2008, New Orleans, LA

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

17. 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

18. 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 :

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

20. Would you rather do this

21. Would you rather do this or this

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

23. Adults laugh ~15 times/day23

24. Children Laugh_____?
times per day 24

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

26. Take your work seriously26

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

28. Any Singers and Dancers???

29. Any Singers and Dancers???

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

31. You just have the know where to look……

32. THANK YOU