All work and no play makes Jack an unhealthy boy. Scientists revisited a 40-year-old study and learned that individuals who took short vacations were at a higher risk of premature death than those who took longer time off, even though they had the advantage of receiving medical counseling. The authors believe that a lack of stress relief put many of the participants into an early grave.

The original Helsinki Businessmen Study performed in 1974 and 1975 included 1,222 middle-aged male executives born from 1919 to 1934. At the time, the participants were randomized and split into two groups: a control group (610 men) and an intervention group (612 men).

Men in the intervention group received medical counseling every four months and were advised to do aerobic physical activity, eat a healthier diet, lose weight, and stop smoking. When this advice was found to render no improvement, the men in the intervention group were also given drugs that lower blood pressure (beta-blockers and diuretics). Meanwhile, the executives in the control group received no special medical attention and carried on with their usual healthcare.

As reported at the time, the risk of cardiovascular disease in the intervention group was reduced by 46% by the end of the trial. What was surprising, however, is that 15 years later, in 1989, more people in the intervention group died than in the control group.

Now, researchers at the University of Helsinki have completed a 40-year follow-up by using national death registers and examining previously unreported baseline data on amounts of work, sleep, and vacation.

Until 2004, the research team found that participants in the intervention group had a higher death rate than those in the control group. Death rates leveled out between 2004 and 2014.

Why would people who were given special medical attention die earlier? One thing that seems to have influenced mortality is vacationing. In the intervention group, men who took three weeks or less annual vacation had a 37% greater chance of dying from 1974 to 2004 than those who took more than three weeks. Vacation time had no impact on risk of death in the control group.

The participants who took shorter vacations worked more and slept less than those who took longer vacations. So all of this stressful lifestyle may have overridden any health benefits from the medical intervention. In fact, the Finnish researchers think that the intervention itself also contributed to the stress.

“Don’t think having an otherwise healthy lifestyle will compensate for working too hard and not taking holidays,” said Professor Timo Strandberg, of the University of Helsinki, Finland. “Vacations can be a good way to relieve stress.”

Stress management wasn’t part of preventive medicine in the 1970s. Nowadays, it is recommended for individuals that have or are at risk for cardiovascular disease.  

“Our results do not indicate that health education is harmful. Rather, they suggest that stress reduction is an essential part of programmes aimed at reducing the risk of cardiovascular disease. Lifestyle advice should be wisely combined with modern drug treatment to prevent cardiovascular events in high-risk individuals,” Strandberg said.

The findings appeared in the Journal of Nutrition, Health & Aging and were presented at ESC Congress today.

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