Study Suggests Flu Vaccine Provides Moderate Protection Against Flu
As flu season approaches, a new analysis finds that the flu vaccine provides only moderate protection against the flu, noting that such protection is greatly reduced or absent during some flu seasons.
The analysis is published in The Lancet.
"While the vaccine does work, and we still recommend that it be used, it does not demonstrate the kind of efficacy that has often been reported," says study researcher Michael T. Osterholm, MD, of the University of Minnesota Center for Infectious Disease Research and Policy.
Information Gap on Vaccine Effectiveness
The researchers also say there is a lack of evidence for the effectiveness of flu vaccines in the most vulnerable groups, such as the elderly.
"For those over age 65 there are real gaps in the information we have about effectiveness compared to young, healthy adults," he says. "It is clear that we need to develop new and better vaccines to fill these gaps."
Osterholm says the analysis represents the most exhaustive review ever conducted of the effectiveness of the flu vaccines used in the U.S.
The researchers screened 5,700 articles and studies, identifying just 31 that used highly specific diagnostic testing to confirm influenza.
Their review of these studies showed that the trivalent inactivated vaccine (TIV) -- which accounts for about 90% of flu vaccines given in the U.S. -- had 59% effectiveness in healthy adults between the ages of 18 and 65.
The vaccine's effectiveness in children, teens, and the elderly could not be determined because no trials involving these groups met the researchers' inclusion standards.
Nasal Spray Vaccine for Children
Ten studies examined the nasal spray flu vaccine in children between the ages of 6 months and 7 years, finding it was effective for of 83% of that group.
The nasal vaccine is approved for use in healthy people ages 2 to 49.
Osterholm tells WebMD that the impressive protection should convince vaccine policy makers to recommend the nasal spray flu vaccine over the injected TIV vaccine in children.
"The [nasal spray flu vaccine] works very well in children, but it has never been preferentially recommended," he says. "We could potentially have a much greater impact in preventing influenza if we were to encourage the use of [the nasal spray flu vaccine] in that group."
Andrew Pavia, MD, who chairs the Pandemic Influenza Task Force of the Infectious Diseases Society of America, says the new analysis confirms what has been known about the current flu vaccine.
"Everyone agrees that we need better vaccines and we are making progress in that direction," he tells WebMD. "We have known for years that the vaccine we have does not provide a first-rate level of protection in the elderly and the very young, but it does provide protection. It would be terrible if the message to the public was that getting vaccinated isn't important."
In fact, he says, the less effective a vaccine is, the more important it is that as many eligible people as possible get vaccinated to protect those who are most vulnerable.
"With a vaccine that is less than perfect, which is most of our vaccines, much of the protection comes from having widespread coverage within a community," he says.
Better Vaccines May Be on the Way
Osterholm and colleagues conclude that new vaccines are needed that work in different ways from current ones.
But infectious disease expert William Schaffner, MD, says research focused on making the current vaccines better is already paying off.
"The last five years has seen more research aimed at developing better flu vaccines than the previous 50," he says.
Two new vaccines have been licensed within the last two years: a high-dose vaccine that is expected to provide better protection for people over 65 and an intradermal vaccine delivered with a needle that is much smaller than traditional needles.
Schaffner says there is also optimism that a universal vaccine covering all strains of the influenza virus may be on the horizon. Because it would deliver a much higher level of protection than current vaccines, it could be given every five or 10 years instead of every year, he says.
Pavia agrees that the universal vaccine, which he calls the Holy Grail of flu vaccine research, may soon be a reality thanks to recent scientific breakthroughs.
"We have a clear path forward that could get us there within the decade," he says.
Source: http://www.webmd.com/cold-and-flu/news/20111025/how-effective-are-seasonal-flu-vaccines
Tai Chi May Help Control Asthma
Study Shows Chinese Exercise System May Help Breathing of Asthma Patients
Asthma sufferers may be able to better control their breathing and improve their exercise performance with some training in tai chi, new research indicates.
Tai chi is a method of traditional Chinese exercise involving coordinated breathing and body movements.
Scientists in Thailand enrolled 17 adult patients (average age 57) with persistent asthma in a six-week tai chi training program.
After the training period patients showed significant improvements in peak flow variability, asthma control, and quality-of-life measures, the researchers say.
Patients were more comfortable on a six-minute walk and increased their maximum work rate and maximum oxygen consumption after taking part in the exercises, the researchers say in a news release.
The researchers conclude that tai chi can help people control asthma and prove to be an effective, non-pharmacologic adjunctive therapy for people with persistent asthma.
The authors are on staff in the department of medicine at Ramathibodi Hospital in Thailand.
The 17 patients attended supervised exercise once per week, followed by daily home-based exercise assignments using an audio-visual guide. This routine lasted six weeks.
The researchers measured such things as oxygen consumption and exercise endurance, concluding that tai chi improved both maximum and functional exercise capacities and improved exercise performance.
The research was presented at CHEST 2008, the annual meeting of the American College of Chest Physicians, in Philadelphia.
Source: http://www.webmd.com/asthma/news/20081028/tai-chi-may-help-control-asthma
Asthma sufferers may be able to better control their breathing and improve their exercise performance with some training in tai chi, new research indicates.
Tai chi is a method of traditional Chinese exercise involving coordinated breathing and body movements.
Scientists in Thailand enrolled 17 adult patients (average age 57) with persistent asthma in a six-week tai chi training program.
After the training period patients showed significant improvements in peak flow variability, asthma control, and quality-of-life measures, the researchers say.
Patients were more comfortable on a six-minute walk and increased their maximum work rate and maximum oxygen consumption after taking part in the exercises, the researchers say in a news release.
The researchers conclude that tai chi can help people control asthma and prove to be an effective, non-pharmacologic adjunctive therapy for people with persistent asthma.
The authors are on staff in the department of medicine at Ramathibodi Hospital in Thailand.
The 17 patients attended supervised exercise once per week, followed by daily home-based exercise assignments using an audio-visual guide. This routine lasted six weeks.
The researchers measured such things as oxygen consumption and exercise endurance, concluding that tai chi improved both maximum and functional exercise capacities and improved exercise performance.
The research was presented at CHEST 2008, the annual meeting of the American College of Chest Physicians, in Philadelphia.
Source: http://www.webmd.com/asthma/news/20081028/tai-chi-may-help-control-asthma
Wheezing With Colds Raises Risk of Asthma
Rhinovirus-Related Wheeze Big Risk Factor in Kids
Infants and toddlers who wheeze when they are sick with colds have a big risk of developing asthma later in childhood, a new study shows.
Wheezing with rhinovirus infection during the first three years of life was associated with a tenfold increase in asthma risk by age 6, researchers from the University of Wisconsin report.
Nearly 90% of the children in the study who wheezed with rhinovirus infection during their third year of life had a diagnosis of asthma three years later.
There are more than 100 identified rhinoviruses that are known to cause colds, but until now, these viruses have not been strongly associated with asthma risk, the study's principal investigator tells WebMD.
Instead, much attention has been focused on another common infectious agent, known as respiratory syncytial virus (RSV). Young children who are hospitalized with RSV infections have a high risk of developing asthma later in childhood.
"When we started this study we fully expected to find that RSV was the big culprit, but that is not what we found," says Robert F. Lemanske Jr., MD.
Colds, Wheezing, and Asthma
Wheezing occurs as a result of airway narrowing, and it is characterized by a whistling sound in the lungs during breathing.
As many as half of children will wheeze with respiratory illness at some point during their first three years of life, but many of them will not go on to develop asthma.
Early respiratory illness is a well-recognized risk factor for childhood asthma, but the impact of specific respiratory viruses on the airway disorder is not well understood.
In an effort to better understand the relationship between virus illness and childhood asthma, Lemanske and colleagues closely followed 259 children from birth through their sixth birthdays.
The children were considered at high risk for developing asthma because one or both parents had asthma or respiratory allergy.
By age 6, 28% of the children had been diagnosed with asthma.
Children who wheezed while sick with colds during the first year of life were three times more likely than children who did not wheeze while sick to develop the respiratory disease.
Wheezing with rhinovirus infection during the second year of life was associated with a sixfold increase in asthma risk, and wheezing with infection during the third year of life increased asthma risk about 30-fold.
By comparison, wheezing with RSV infection during the first three years of life was associated with a threefold increase in asthma risk, and RSV-associated wheezing during the third year increased asthma risk tenfold.
Wheezing with rhinovirus infection was identified as the most significant predictor of asthma in these high-risk children.
Wheezing With Colds Should Raise Suspicion
The next step, Lemanske says, is to examine specific rhinoviruses to see if some are more closely linked to asthma risk than others.
"Not everybody who gets a cold develops asthma," he says. "Are there certain strains that are more pathologic? We don't know."
He adds that the message to parents and pediatricians is that any wheezing associated with respiratory illness should raise suspicions about asthma.
"We would argue that kids who wheeze with rhinovirus need to be followed closely," Lemanske says.
American Thoracic Society past president John Heffner, MD, agrees.
"We have known that respiratory infections that lead to hospitalization are associated with increased asthma risk in children," he tells WebMD. "But now we know that the risk extends to common infections that don't often lead to hospitalization."
Source: http://www.webmd.com/asthma/news/20080930/wheezing-colds-raises-risk-asthma
Infants and toddlers who wheeze when they are sick with colds have a big risk of developing asthma later in childhood, a new study shows.
Wheezing with rhinovirus infection during the first three years of life was associated with a tenfold increase in asthma risk by age 6, researchers from the University of Wisconsin report.
Nearly 90% of the children in the study who wheezed with rhinovirus infection during their third year of life had a diagnosis of asthma three years later.
There are more than 100 identified rhinoviruses that are known to cause colds, but until now, these viruses have not been strongly associated with asthma risk, the study's principal investigator tells WebMD.
Instead, much attention has been focused on another common infectious agent, known as respiratory syncytial virus (RSV). Young children who are hospitalized with RSV infections have a high risk of developing asthma later in childhood.
"When we started this study we fully expected to find that RSV was the big culprit, but that is not what we found," says Robert F. Lemanske Jr., MD.
Colds, Wheezing, and Asthma
Wheezing occurs as a result of airway narrowing, and it is characterized by a whistling sound in the lungs during breathing.
As many as half of children will wheeze with respiratory illness at some point during their first three years of life, but many of them will not go on to develop asthma.
Early respiratory illness is a well-recognized risk factor for childhood asthma, but the impact of specific respiratory viruses on the airway disorder is not well understood.
In an effort to better understand the relationship between virus illness and childhood asthma, Lemanske and colleagues closely followed 259 children from birth through their sixth birthdays.
The children were considered at high risk for developing asthma because one or both parents had asthma or respiratory allergy.
By age 6, 28% of the children had been diagnosed with asthma.
Children who wheezed while sick with colds during the first year of life were three times more likely than children who did not wheeze while sick to develop the respiratory disease.
Wheezing with rhinovirus infection during the second year of life was associated with a sixfold increase in asthma risk, and wheezing with infection during the third year of life increased asthma risk about 30-fold.
By comparison, wheezing with RSV infection during the first three years of life was associated with a threefold increase in asthma risk, and RSV-associated wheezing during the third year increased asthma risk tenfold.
Wheezing with rhinovirus infection was identified as the most significant predictor of asthma in these high-risk children.
Wheezing With Colds Should Raise Suspicion
The next step, Lemanske says, is to examine specific rhinoviruses to see if some are more closely linked to asthma risk than others.
"Not everybody who gets a cold develops asthma," he says. "Are there certain strains that are more pathologic? We don't know."
He adds that the message to parents and pediatricians is that any wheezing associated with respiratory illness should raise suspicions about asthma.
"We would argue that kids who wheeze with rhinovirus need to be followed closely," Lemanske says.
American Thoracic Society past president John Heffner, MD, agrees.
"We have known that respiratory infections that lead to hospitalization are associated with increased asthma risk in children," he tells WebMD. "But now we know that the risk extends to common infections that don't often lead to hospitalization."
Source: http://www.webmd.com/asthma/news/20080930/wheezing-colds-raises-risk-asthma
Implanted Lenses May Treat Milder Nearsightedness
Study: Phakic Intraocular Lenses Are as Safe and Effective as Standard Laser Eye Surgery
An eye operation typically reserved for patients with severe nearsightedness may be a safer alternative to standard laser eye surgery for patients with less severe forms of nearsightedness, according to a new report published in the recent issue of The Cochrane Library.
Researchers at Moorfields Eye Hospital NHS Foundation Trust in London reviewed three clinical trials that randomly assigned patients to different types of surgery used to correct nearsightedness (myopia).
Myopia is the leading cause of vision impairment around the globe, according to the World Health Organization.In the U.S., 32 million people aged 40 and older are myopic.
The more common surgical procedure, excimer laser refractive surgery, treats myopia by removing parts of the cornea. The second procedure, which is relatively new and not used as widely, implants a thin lens called a phakic intraocular lens (IOL) permanently into the eye to eliminate the need for eyeglasses or contact lenses. Both procedures change the path of light entering the eye and bring images into sharper focus. Phakic IOLs were approved by the FDA in 2004.
Phakic IOLs: Risk of Cataracts
The study showed that one year after undergoing the procedure, 20/20 vision without eyeglasses was the same for patients who received either laser surgery or phakic IOLs. One year after the surgical procedure, the phakic IOL patients had clearer spectacle-corrected vision, better contrast sensitivity (the ability to perceive differences between an object and its background), and higher satisfaction scores than laser eye surgery patients. However, there was a slight increased risk of developing cataracts among the phakic IOL group.
The researchers' conclusions were based on three clinical trials that included a total of 228 eyes in 132 men and women ranging in age from 21 to 60. The patients had moderate to severe myopia.
The advantages of phakic IOLs are that "it does not involve removing any corneal tissue, and it is reversible. ... In the unlikely event of any problems the synthetic lens can be removed at a later date,” study author Allon Barsam tells WebMD in an email interview.
“Our findings suggest phakic IOLs are safer than excimer laser surgery" for correcting moderate to high levels of nearsightedness, Barsam says. “Although it’s not currently standard clinical practice, it could be worth considering phakic IOL treatment over the more common laser surgery" for patients with moderate nearsightedness.
Regarding the risk of cataracts, Barsam says more long-term studies are needed to assess any risks that might not arise during a one-year follow up and that might be unique to phakic IOL patients.
Second Opinion
James Salz, MD, clinical professor of ophthalmology at the University of Southern California at Los Angeles and a spokesman for the American Academy of Ophthalmology, says the data reviewed in this report are too limited to draw any immediate conclusions that would change current practices.
“It’s a bit misleading with a small review like that because it’s just a few hundred cases,” Salz tells WebMD. “Most of us would not agree it’s safer to do an intraocular lens procedure because it’s a more invasive procedure. Laser surgery doesn’t cause cataracts in anybody, but phakic IOLs cause cataracts in a percentage of people. I don’t think that study would change the opinion of most surgeons who would do this surgery on a daily basis.”
Salz says phakic IOLs might be an option for moderate myopia in patients with abnormal-shaped corneas, but he says “those cases are rare.”
D. Rex Hamilton, MD, director of the Laser Refractive Center at the Jules Stein Eye Institute at the University of California at Los Angeles, says the findings in this review reflect his own clinical experiences.
“The findings of this study are consistent with my clinical experience that LASIK is extremely safe and effective up to moderate levels of myopia (-7 to -8 D),” Hamilton tells WebMD in an email interview. “Above this range, LASIK patients tend to lose some contrast sensitivity (the ability to see shades of grey) particularly in dim light settings. Phakic IOLs have an advantage with regard to contrast sensitivity in the highly myopic population. Although there is a slightly increased risk of cataract formation with phakic IOL implantation (particularly in higher corrections, above -15 D and in patients over the age of 40 at the time of implantation), phakic IOL implantation remains the procedure of choice for highly myopic patients who qualify.”
Source: http://www.webmd.com/eye-health/news/20100512/implanted-lenses-may-treat-milder-nearsightedness
An eye operation typically reserved for patients with severe nearsightedness may be a safer alternative to standard laser eye surgery for patients with less severe forms of nearsightedness, according to a new report published in the recent issue of The Cochrane Library.
Researchers at Moorfields Eye Hospital NHS Foundation Trust in London reviewed three clinical trials that randomly assigned patients to different types of surgery used to correct nearsightedness (myopia).
Myopia is the leading cause of vision impairment around the globe, according to the World Health Organization.In the U.S., 32 million people aged 40 and older are myopic.
The more common surgical procedure, excimer laser refractive surgery, treats myopia by removing parts of the cornea. The second procedure, which is relatively new and not used as widely, implants a thin lens called a phakic intraocular lens (IOL) permanently into the eye to eliminate the need for eyeglasses or contact lenses. Both procedures change the path of light entering the eye and bring images into sharper focus. Phakic IOLs were approved by the FDA in 2004.
Phakic IOLs: Risk of Cataracts
The study showed that one year after undergoing the procedure, 20/20 vision without eyeglasses was the same for patients who received either laser surgery or phakic IOLs. One year after the surgical procedure, the phakic IOL patients had clearer spectacle-corrected vision, better contrast sensitivity (the ability to perceive differences between an object and its background), and higher satisfaction scores than laser eye surgery patients. However, there was a slight increased risk of developing cataracts among the phakic IOL group.
The researchers' conclusions were based on three clinical trials that included a total of 228 eyes in 132 men and women ranging in age from 21 to 60. The patients had moderate to severe myopia.
The advantages of phakic IOLs are that "it does not involve removing any corneal tissue, and it is reversible. ... In the unlikely event of any problems the synthetic lens can be removed at a later date,” study author Allon Barsam tells WebMD in an email interview.
“Our findings suggest phakic IOLs are safer than excimer laser surgery" for correcting moderate to high levels of nearsightedness, Barsam says. “Although it’s not currently standard clinical practice, it could be worth considering phakic IOL treatment over the more common laser surgery" for patients with moderate nearsightedness.
Regarding the risk of cataracts, Barsam says more long-term studies are needed to assess any risks that might not arise during a one-year follow up and that might be unique to phakic IOL patients.
Second Opinion
James Salz, MD, clinical professor of ophthalmology at the University of Southern California at Los Angeles and a spokesman for the American Academy of Ophthalmology, says the data reviewed in this report are too limited to draw any immediate conclusions that would change current practices.
“It’s a bit misleading with a small review like that because it’s just a few hundred cases,” Salz tells WebMD. “Most of us would not agree it’s safer to do an intraocular lens procedure because it’s a more invasive procedure. Laser surgery doesn’t cause cataracts in anybody, but phakic IOLs cause cataracts in a percentage of people. I don’t think that study would change the opinion of most surgeons who would do this surgery on a daily basis.”
Salz says phakic IOLs might be an option for moderate myopia in patients with abnormal-shaped corneas, but he says “those cases are rare.”
D. Rex Hamilton, MD, director of the Laser Refractive Center at the Jules Stein Eye Institute at the University of California at Los Angeles, says the findings in this review reflect his own clinical experiences.
“The findings of this study are consistent with my clinical experience that LASIK is extremely safe and effective up to moderate levels of myopia (-7 to -8 D),” Hamilton tells WebMD in an email interview. “Above this range, LASIK patients tend to lose some contrast sensitivity (the ability to see shades of grey) particularly in dim light settings. Phakic IOLs have an advantage with regard to contrast sensitivity in the highly myopic population. Although there is a slightly increased risk of cataract formation with phakic IOL implantation (particularly in higher corrections, above -15 D and in patients over the age of 40 at the time of implantation), phakic IOL implantation remains the procedure of choice for highly myopic patients who qualify.”
Source: http://www.webmd.com/eye-health/news/20100512/implanted-lenses-may-treat-milder-nearsightedness
High Blood Pressure in Kids Can Linger
Children With Hypertension More Likely to Have Higher Blood Pressure as Adults
Problems with high blood pressure that start in childhood may last a lifetime.
A new review of research confirms that children with elevated blood pressure levels are more likely to have high blood pressure, or hypertension, as adults.
"The blood pressure tracking data indicate that children with elevated blood pressure levels often grew up to become adults with elevated blood pressure," researcher Youfa Wang, MD, PhD, of the Johns Hopkins Bloomberg School of Public Health, says in a news release.
"It is important to monitor blood pressure in children -- since early detection and intervention could prevent hypertension and related disease risks later in life," Wang says. "For example, studies show that even slightly elevated blood pressure as adults will increase future risks for cardiovascular disease considerably."
High Blood Pressure Starts Early
In the study, published in Circulation: Journal of the American Heart Association, researchers reviewed 50 studies published since 1970 from various countries that tracked high blood pressure from childhood into adulthood.
Researchers analyzed blood pressure levels at various ages during childhood and compared them with follow-up measurements taken in the same individuals up to 47 years later.
The results showed a consistent relationship between the children's blood pressure levels and blood pressure levels as adults. In particular, blood pressure levels among older children appeared to have a stronger link to blood pressure levels in later adulthood.
Researchers say an estimated 73 million adults have high blood pressure, which is a major contributor to heart disease, heart failure, stroke, kidney failure, and other health problems.
They say targeting children with high blood pressure with lifestyle modification techniques such as a healthy diet and regular exercise may help reduce their risk of high blood pressure and its related health consequences as adults.
Source: http://www.webmd.com/hypertension-high-blood-pressure/news/20080617/high-blood-pressure-in-kids-can-linger
Problems with high blood pressure that start in childhood may last a lifetime.
A new review of research confirms that children with elevated blood pressure levels are more likely to have high blood pressure, or hypertension, as adults.
"The blood pressure tracking data indicate that children with elevated blood pressure levels often grew up to become adults with elevated blood pressure," researcher Youfa Wang, MD, PhD, of the Johns Hopkins Bloomberg School of Public Health, says in a news release.
"It is important to monitor blood pressure in children -- since early detection and intervention could prevent hypertension and related disease risks later in life," Wang says. "For example, studies show that even slightly elevated blood pressure as adults will increase future risks for cardiovascular disease considerably."
High Blood Pressure Starts Early
In the study, published in Circulation: Journal of the American Heart Association, researchers reviewed 50 studies published since 1970 from various countries that tracked high blood pressure from childhood into adulthood.
Researchers analyzed blood pressure levels at various ages during childhood and compared them with follow-up measurements taken in the same individuals up to 47 years later.
The results showed a consistent relationship between the children's blood pressure levels and blood pressure levels as adults. In particular, blood pressure levels among older children appeared to have a stronger link to blood pressure levels in later adulthood.
Researchers say an estimated 73 million adults have high blood pressure, which is a major contributor to heart disease, heart failure, stroke, kidney failure, and other health problems.
They say targeting children with high blood pressure with lifestyle modification techniques such as a healthy diet and regular exercise may help reduce their risk of high blood pressure and its related health consequences as adults.
Source: http://www.webmd.com/hypertension-high-blood-pressure/news/20080617/high-blood-pressure-in-kids-can-linger
Statins Lower Blood Pressure
Taking Statin Drugs Leads to “Modest, but Significant” Drop in Blood Pressure, Study Shows
Chalk up another potential benefit to taking statins. A newly released study shows that the cholesterol-lowering drugs also help to lower blood pressure. Study authors say it's the first time research has shown that statins work this way in the body.
Researchers looked at 973 men and women in southern California. The participants had no known heart disease or diabetes. Participants were given either Zocor, Pravachol, or a placebo every day for six months.
Statins and Blood Pressure
People who took either one of the two statin drugs had a "modest, but significant" reduction of blood pressure when compared with the group who took a placebo pill.
"We found that statins lower both systolic and diastolic blood pressure, and that the effect extends to patients with pre-hypertension, with normal blood pressure, and persons not on blood-pressure lowering medications," according to a news release from study researcher Beatrice Golomb, MD, PhD.
Golomb is with the University of California, San Diego School of Medicine.
Statins are one of the best-selling prescribed drugs in the world, used mainly to treat high cholesterol. But physicians have long observed that the health benefits obtained from statin use seem to be more rapid than could be explained from the effects of these medications on plaque accumulation. The blood pressure reduction effect could prove to be part of the answer.
Lower blood pressure is linked to lower stroke risk. Study authors suspect that one of the ways the use of statins is helpful in reducing stroke is through the blood pressure effect.
Golomb and her team recommend more research, looking into how different types of statins might work, plus how different dosages and a longer treatment time may affect blood pressure.
The study is published in the April 14 edition of the journal Archives of Internal Medicine.
Source: http://www.webmd.com/hypertension-high-blood-pressure/news/20080411/statins-lower-blood-pressure
Chalk up another potential benefit to taking statins. A newly released study shows that the cholesterol-lowering drugs also help to lower blood pressure. Study authors say it's the first time research has shown that statins work this way in the body.
Researchers looked at 973 men and women in southern California. The participants had no known heart disease or diabetes. Participants were given either Zocor, Pravachol, or a placebo every day for six months.
Statins and Blood Pressure
People who took either one of the two statin drugs had a "modest, but significant" reduction of blood pressure when compared with the group who took a placebo pill.
"We found that statins lower both systolic and diastolic blood pressure, and that the effect extends to patients with pre-hypertension, with normal blood pressure, and persons not on blood-pressure lowering medications," according to a news release from study researcher Beatrice Golomb, MD, PhD.
Golomb is with the University of California, San Diego School of Medicine.
Statins are one of the best-selling prescribed drugs in the world, used mainly to treat high cholesterol. But physicians have long observed that the health benefits obtained from statin use seem to be more rapid than could be explained from the effects of these medications on plaque accumulation. The blood pressure reduction effect could prove to be part of the answer.
Lower blood pressure is linked to lower stroke risk. Study authors suspect that one of the ways the use of statins is helpful in reducing stroke is through the blood pressure effect.
Golomb and her team recommend more research, looking into how different types of statins might work, plus how different dosages and a longer treatment time may affect blood pressure.
The study is published in the April 14 edition of the journal Archives of Internal Medicine.
Source: http://www.webmd.com/hypertension-high-blood-pressure/news/20080411/statins-lower-blood-pressure
Diet, Weight Drug May Curb Hypertension
Healthy Diet, Weight Loss Drug Xenical Linked to Better Blood Pressure in Hypertension Patients
Losing weight with a healthy diet or with the weight loss drug Xenical may ease high blood pressure, according to a new research review.
Reaching and maintaining a healthy weight helps treat or prevent high blood pressure (hypertension). And a healthy diet and active lifestyle are important for blood pressure, too.
The new research review doesn't change any of that. The reviewers aren't suggesting taking weight loss pills instead of making lifestyle changes.
The reviewers, who included Karl Horvath, MD, of Austria's Medical University of Graz, analyzed data from 15 weight loss studies of adult hypertension patients. Here's a quick look at their findings.
Diet and High Blood Pressure
Seven of the reviewed studies focused on diet, not drugs.
Together, the studies included 1,632 patients. Some patients were assigned to go on weight loss diets. For comparison, others didn't change their eating habits.
The studies lasted for at least six months. During that time, the dieters shed 9 pounds more than those who kept their diets.
The dieters also trimmed 6 extra points off their systolic blood pressure (the first number in a blood pressure reading) and about 3 extra points off their diastolic blood pressure (the second number in a blood pressure reading), compared with those who didn't diet.
Weight Loss Drugs and High Blood Pressure
The review also included eight studies of the weight loss drugs orlistat, sold under the brand name Xenical, and sibutramine or Meridia.
Orlistat is also the active ingredient in the over-the-counter weight loss drug Alli. But the reviewed studies used Xenical's prescription dose, not Alli's dose.
The studies, which lasted for at least six months, together included 3,132 patients who took Xenical or a placebo and 610 patients who took Meridia or a placebo.
In most of those studies, the patients also got advice about diet and physical activity.
Patients taking Xenical or Meridia lost 8.2 more pounds, on average, than those taking the placebos.
Compared with placebo, Xenical was linked to an average systolic blood pressure improvement of 2.5 points and an average diastolic blood pressure improvement of 2 points.
But Meridia users had an average increase of about 3 points in their systolic blood pressure, compared with placebo. "Although [Meridia] treatment reduced body weight, it did not lower or might even elevate blood pressure," write Horvath and colleagues.
Meridia is already known to "substantially increase blood pressure or heart rate in some patients and should not be given to patients with uncontrolled or poorly controlled hypertension," states Meridia's web site.
Xenical is made by Roche Laboratories; Meridia is made by Abbott Laboratories.
Writing in today's edition of the Archives of Internal Medicine, the reviewers note that several of the studies weren't of top-notch quality.
Source: http://www.webmd.com/hypertension-high-blood-pressure/news/20080324/diet-weight-drug-may-curb-hypertension
Losing weight with a healthy diet or with the weight loss drug Xenical may ease high blood pressure, according to a new research review.
Reaching and maintaining a healthy weight helps treat or prevent high blood pressure (hypertension). And a healthy diet and active lifestyle are important for blood pressure, too.
The new research review doesn't change any of that. The reviewers aren't suggesting taking weight loss pills instead of making lifestyle changes.
The reviewers, who included Karl Horvath, MD, of Austria's Medical University of Graz, analyzed data from 15 weight loss studies of adult hypertension patients. Here's a quick look at their findings.
Diet and High Blood Pressure
Seven of the reviewed studies focused on diet, not drugs.
Together, the studies included 1,632 patients. Some patients were assigned to go on weight loss diets. For comparison, others didn't change their eating habits.
The studies lasted for at least six months. During that time, the dieters shed 9 pounds more than those who kept their diets.
The dieters also trimmed 6 extra points off their systolic blood pressure (the first number in a blood pressure reading) and about 3 extra points off their diastolic blood pressure (the second number in a blood pressure reading), compared with those who didn't diet.
Weight Loss Drugs and High Blood Pressure
The review also included eight studies of the weight loss drugs orlistat, sold under the brand name Xenical, and sibutramine or Meridia.
Orlistat is also the active ingredient in the over-the-counter weight loss drug Alli. But the reviewed studies used Xenical's prescription dose, not Alli's dose.
The studies, which lasted for at least six months, together included 3,132 patients who took Xenical or a placebo and 610 patients who took Meridia or a placebo.
In most of those studies, the patients also got advice about diet and physical activity.
Patients taking Xenical or Meridia lost 8.2 more pounds, on average, than those taking the placebos.
Compared with placebo, Xenical was linked to an average systolic blood pressure improvement of 2.5 points and an average diastolic blood pressure improvement of 2 points.
But Meridia users had an average increase of about 3 points in their systolic blood pressure, compared with placebo. "Although [Meridia] treatment reduced body weight, it did not lower or might even elevate blood pressure," write Horvath and colleagues.
Meridia is already known to "substantially increase blood pressure or heart rate in some patients and should not be given to patients with uncontrolled or poorly controlled hypertension," states Meridia's web site.
Xenical is made by Roche Laboratories; Meridia is made by Abbott Laboratories.
Writing in today's edition of the Archives of Internal Medicine, the reviewers note that several of the studies weren't of top-notch quality.
Source: http://www.webmd.com/hypertension-high-blood-pressure/news/20080324/diet-weight-drug-may-curb-hypertension
Collaborative Care for Depression Has Heart Benefit
Collaborative Care for Depression Has Heart Benefit
Collaborative care for depression -- started in the hospital -- improves the symptoms of heart disease as well as depression, a study shows.
In collaborative care, a non-physician care manager coordinates a patient’s care with both a primary doctor and a psychiatrist. The care manager also educates the patient about depression, treatment options, and depression’s effects on heart disease. He or she also follows up with the patient to assess how well the patient is doing and whether the patient is sticking to the prescribed treatment.
In this six-month study, published in Circulation: Cardiovascular Quality and Outcomes, researchers followed 175 heart disease patients who had also been diagnosed with depression. The treatment the participants received began while they were still in the hospital, where they had been admitted for an abnormal heart rhythm, unstable angina, heart attack, or heart failure. According to the researchers, this is a critical time to intervene.
“That patients were easily identified and effective treatment begun before discharge is a crucial aspect of our study -- with a minimal amount of effort, those patients most in need for treatment received effective therapy before discharge, when the likelihood for missed opportunity to apply effective treatment rises,” the researchers write.
Source: http://www.webmd.com/heart-disease/news/20110308/collaborative-care-for-depression-has-heart-benefit
Collaborative care for depression -- started in the hospital -- improves the symptoms of heart disease as well as depression, a study shows.
In collaborative care, a non-physician care manager coordinates a patient’s care with both a primary doctor and a psychiatrist. The care manager also educates the patient about depression, treatment options, and depression’s effects on heart disease. He or she also follows up with the patient to assess how well the patient is doing and whether the patient is sticking to the prescribed treatment.
In this six-month study, published in Circulation: Cardiovascular Quality and Outcomes, researchers followed 175 heart disease patients who had also been diagnosed with depression. The treatment the participants received began while they were still in the hospital, where they had been admitted for an abnormal heart rhythm, unstable angina, heart attack, or heart failure. According to the researchers, this is a critical time to intervene.
“That patients were easily identified and effective treatment begun before discharge is a crucial aspect of our study -- with a minimal amount of effort, those patients most in need for treatment received effective therapy before discharge, when the likelihood for missed opportunity to apply effective treatment rises,” the researchers write.
Source: http://www.webmd.com/heart-disease/news/20110308/collaborative-care-for-depression-has-heart-benefit
Brain Tumors: New Gene Clues
New Studies Point to Key Genes in Brain Tumors Called Gliomas
Scientists have identified a network of up to 31 genes linked to brain tumors called gliomas, including one that may be a target for new treatments.
Those discoveries are featured in two new studies published in The Journal of the American Medical Association.
In the first study, scientists identify up to 31 genes that, when containing certain mutations, set the stage for the development of gliomas.
Those genes aren't necessarily the only genes involved in gliomas, but they appear to be ringleaders, researcher Markus Bredel, MD, PhD, says in a news release.
"These 31 genes are the kingpins in what you could call an organized crime network of genes that enable the tumor to grow with breathtaking speed," says Bredel, who works at the Northwestern Brain Tumor Institute at Northwestern University.
People with widespread mutations in those genes had worse survival than people with a lesser extent of mutations.
The second study shows that one particular gene, the ANXA7 gene, may make a good target for future treatments for glioblastomas, which are the most common type of glioma.
Glioblastoma survival appears to be worse in patients who only have one copy of the ANXA7 gene, instead of the usual two copies, according to the study.
The ANXA7 gene acts as a tumor-suppressing gene, and when only one copy of it is present, it may be easier for glioblastomas to grow, note the researchers, who included Ajay Yadav, PhD, of the Northwestern Brain Tumor Institute, along with Bredel and scientists from other institutions.
The ANXA7 gene findings could have "significant" meaning for future glioblastoma treatments; as more genetic discoveries about cancer are made the findings could "usher in a new era in cancer research," states an editorial published with the studies.
Source: http://www.webmd.com/cancer/brain-cancer/news/20090715/brain-tumors-new-gene-clues
Scientists have identified a network of up to 31 genes linked to brain tumors called gliomas, including one that may be a target for new treatments.
Those discoveries are featured in two new studies published in The Journal of the American Medical Association.
In the first study, scientists identify up to 31 genes that, when containing certain mutations, set the stage for the development of gliomas.
Those genes aren't necessarily the only genes involved in gliomas, but they appear to be ringleaders, researcher Markus Bredel, MD, PhD, says in a news release.
"These 31 genes are the kingpins in what you could call an organized crime network of genes that enable the tumor to grow with breathtaking speed," says Bredel, who works at the Northwestern Brain Tumor Institute at Northwestern University.
People with widespread mutations in those genes had worse survival than people with a lesser extent of mutations.
The second study shows that one particular gene, the ANXA7 gene, may make a good target for future treatments for glioblastomas, which are the most common type of glioma.
Glioblastoma survival appears to be worse in patients who only have one copy of the ANXA7 gene, instead of the usual two copies, according to the study.
The ANXA7 gene acts as a tumor-suppressing gene, and when only one copy of it is present, it may be easier for glioblastomas to grow, note the researchers, who included Ajay Yadav, PhD, of the Northwestern Brain Tumor Institute, along with Bredel and scientists from other institutions.
The ANXA7 gene findings could have "significant" meaning for future glioblastoma treatments; as more genetic discoveries about cancer are made the findings could "usher in a new era in cancer research," states an editorial published with the studies.
Source: http://www.webmd.com/cancer/brain-cancer/news/20090715/brain-tumors-new-gene-clues
Brain Cancer Vaccine Shows Promise
An experimental new cancer vaccine may one day help prevent brain tumors in those at risk. A new study shows the vaccine completely prevented brain cancers from forming in laboratory rats.
"The results of our study are very encouraging. The 100% protection is pretty dramatic," says study author Linda Liau, MD, assistant professor of neurosurgery at UCLA, in a news release. "However, we don't yet have ways to determine who is at high risk of developing brain tumors. So our next step is to begin preliminary testing of this vaccine as a possible treatment strategy for brain tumors."
Although the results are promising, researchers say human tests are still several years away. The findings appear in the April 15 issue of the journal Cancer Research.
Researchers say there is critical need for new brain cancer treatments. The disease affects more than 17,000 Americans each year and it is almost always fatal within two years.
The vaccine is designed to boost the immune system's ability to fight off specific proteins that are produced by tumors. But the problem is that every brain tumor produces different kinds of proteins, so it's impossible to know beforehand which ones should be included in the vaccine for each individual patient.
But Liau says the vaccine may work, in part, by teaching the immune system how to recognize the brain cancer cells as abnormal and attack them. The researchers did this by using the bacteria Listeria to transport the tumor proteins. This helped the immune system recognize the proteins as abnormal cells.
Using this approach, "the immune system can become a better detective and will start to recognize and attack brain tumor cells with other kinds of [proteins]," Liau says.
UCLA researchers are now planning to refine the vaccine and develop a form of it that can be safely used in humans. The hope is that the vaccine may eventually be used to provide a targeted treatment against existing brain tumors as well as to prevent tumors in persons at risk.
Source: http://www.webmd.com/cancer/brain-cancer/news/20020419/brain-cancer-vaccine-shows-promise
"The results of our study are very encouraging. The 100% protection is pretty dramatic," says study author Linda Liau, MD, assistant professor of neurosurgery at UCLA, in a news release. "However, we don't yet have ways to determine who is at high risk of developing brain tumors. So our next step is to begin preliminary testing of this vaccine as a possible treatment strategy for brain tumors."
Although the results are promising, researchers say human tests are still several years away. The findings appear in the April 15 issue of the journal Cancer Research.
Researchers say there is critical need for new brain cancer treatments. The disease affects more than 17,000 Americans each year and it is almost always fatal within two years.
The vaccine is designed to boost the immune system's ability to fight off specific proteins that are produced by tumors. But the problem is that every brain tumor produces different kinds of proteins, so it's impossible to know beforehand which ones should be included in the vaccine for each individual patient.
But Liau says the vaccine may work, in part, by teaching the immune system how to recognize the brain cancer cells as abnormal and attack them. The researchers did this by using the bacteria Listeria to transport the tumor proteins. This helped the immune system recognize the proteins as abnormal cells.
Using this approach, "the immune system can become a better detective and will start to recognize and attack brain tumor cells with other kinds of [proteins]," Liau says.
UCLA researchers are now planning to refine the vaccine and develop a form of it that can be safely used in humans. The hope is that the vaccine may eventually be used to provide a targeted treatment against existing brain tumors as well as to prevent tumors in persons at risk.
Source: http://www.webmd.com/cancer/brain-cancer/news/20020419/brain-cancer-vaccine-shows-promise
Blood Pressure Drug Appears to Prevent Migraines
Researcher Harald Schrader, MD, says serendipity played a large role in his decision to study a popular blood pressure drug as a preventive therapy for migraines. The Norwegian University of Science and Technology professor says he had suffered from crippling headaches for several years when he also was found to have high blood pressure.
"I was placed on [the blood pressure medication] lisinopril, and my headaches got better almost immediately," Schrader tells WebMD. "Soon after that, we gave the drug to a woman we were treating for disabling migraines who also had borderline high blood pressure. A few weeks later, we got a hand-written, four-page letter from her telling us that the treatment had given her a new life."
Schrader and colleagues now have more scientific evidence that lisinopril, which goes under various trade names such as Prinivil or Zestril and is among the class of high blood pressure medicines known as ACE inhibitors, really does prevent migraines. In the Jan. 6 issue of the British Medical Journal, they report that the therapy appears to work as well as other preventive agents with fewer side effects.
For a frequent migraine sufferer, reducing the number of agonizing headaches that occur each month could mean the difference between living a relatively normal life and living in constant pain or fear of pain. Several drugs or drug classes, including beta-blockers, which are used for heart problems and high blood pressure, and certain antiseizure drugs, have been shown to reduce migraine frequency in many patients, but side effects such as weight gain and sluggishness make them less than ideal for long-term use.
"At present, the preventive treatments for migraines are still rather unsatisfactory," former International Headache Society president Ninan T. Mathew, MD, tells WebMD. "We are still on the lookout for something that can be taken long term with reasonable results. From this point of view, this ACE inhibitor seems to be a reasonable choice." Mathew, who is director of the Houston Headache Clinic in Houston, Texas, reviewed the study for WebMD.
In this study, funded by one lisinopril manufacturer, AstraZeneca, Schrader and colleagues treated almost 50 patients with either lisinopril or a placebo for a 12-week period. They then switched the medications so that those formerly on the placebo received the active drug for a 12-week period and those formerly given lisinopril received the placebo. Participants were asked to record their total hours with headache, days with headache, and days with migraine in a diary. They also recorded which medicine they used to treat headaches and days they missed from work due to headaches.
In nearly a third of the patients, symptoms were reduced by half while on lisinopril. These patients also had fewer overall days with migraine.
Schrader says, that although it is difficult to compare this study with other studies, because it is so different, "[It] appears to us that the effectiveness of this agent is in the same range as beta-blockers and [the anti-seizure drug] sodium valproate."
Mathew says larger studies are needed to determine whether ACE inhibitors like lisinopril are a better choice for the prevention of migraines than medications that are now commonly prescribed. He says that migraine patients now have more choices than ever for both the prevention and treatment of their headaches.
"The field of migraine treatment has changed completely in the last 15 or 20 years," he says. "The majority of patients with migraines can be managed very well. The main problem today is that many physicians haven't kept up and don't know how to treat migraines. The most common mistake is to treat a migraine like any other pain."
Mathew says the most important thing a patient can do is find a doctor who is knowledgeable about the treatment of migraines.
"Patients are often given pain medications and combinations of medicines that are not appropriate for the treatment of migraines," he says. "If you fracture your arm, you are given morphine or codeine for the pain, but the same approach should not be applied to migraines. There are very good [medications that are best for migraines] out there, and there is no excuse for a doctor not to know about them."
Source: http://www.webmd.com/migraines-headaches/news/20000105/blood-pressure-drug-appears-to-prevent-migraines
"I was placed on [the blood pressure medication] lisinopril, and my headaches got better almost immediately," Schrader tells WebMD. "Soon after that, we gave the drug to a woman we were treating for disabling migraines who also had borderline high blood pressure. A few weeks later, we got a hand-written, four-page letter from her telling us that the treatment had given her a new life."
Schrader and colleagues now have more scientific evidence that lisinopril, which goes under various trade names such as Prinivil or Zestril and is among the class of high blood pressure medicines known as ACE inhibitors, really does prevent migraines. In the Jan. 6 issue of the British Medical Journal, they report that the therapy appears to work as well as other preventive agents with fewer side effects.
For a frequent migraine sufferer, reducing the number of agonizing headaches that occur each month could mean the difference between living a relatively normal life and living in constant pain or fear of pain. Several drugs or drug classes, including beta-blockers, which are used for heart problems and high blood pressure, and certain antiseizure drugs, have been shown to reduce migraine frequency in many patients, but side effects such as weight gain and sluggishness make them less than ideal for long-term use.
"At present, the preventive treatments for migraines are still rather unsatisfactory," former International Headache Society president Ninan T. Mathew, MD, tells WebMD. "We are still on the lookout for something that can be taken long term with reasonable results. From this point of view, this ACE inhibitor seems to be a reasonable choice." Mathew, who is director of the Houston Headache Clinic in Houston, Texas, reviewed the study for WebMD.
In this study, funded by one lisinopril manufacturer, AstraZeneca, Schrader and colleagues treated almost 50 patients with either lisinopril or a placebo for a 12-week period. They then switched the medications so that those formerly on the placebo received the active drug for a 12-week period and those formerly given lisinopril received the placebo. Participants were asked to record their total hours with headache, days with headache, and days with migraine in a diary. They also recorded which medicine they used to treat headaches and days they missed from work due to headaches.
In nearly a third of the patients, symptoms were reduced by half while on lisinopril. These patients also had fewer overall days with migraine.
Schrader says, that although it is difficult to compare this study with other studies, because it is so different, "[It] appears to us that the effectiveness of this agent is in the same range as beta-blockers and [the anti-seizure drug] sodium valproate."
Mathew says larger studies are needed to determine whether ACE inhibitors like lisinopril are a better choice for the prevention of migraines than medications that are now commonly prescribed. He says that migraine patients now have more choices than ever for both the prevention and treatment of their headaches.
"The field of migraine treatment has changed completely in the last 15 or 20 years," he says. "The majority of patients with migraines can be managed very well. The main problem today is that many physicians haven't kept up and don't know how to treat migraines. The most common mistake is to treat a migraine like any other pain."
Mathew says the most important thing a patient can do is find a doctor who is knowledgeable about the treatment of migraines.
"Patients are often given pain medications and combinations of medicines that are not appropriate for the treatment of migraines," he says. "If you fracture your arm, you are given morphine or codeine for the pain, but the same approach should not be applied to migraines. There are very good [medications that are best for migraines] out there, and there is no excuse for a doctor not to know about them."
Source: http://www.webmd.com/migraines-headaches/news/20000105/blood-pressure-drug-appears-to-prevent-migraines
Sleep Deprivation Linked to Prediabetes
Study Shows Increased Risk for People Who Get Less Than 6 Hours of Sleep a Night
Here's one more reason to get a good night's sleep.
People who sleep less than six hours per night are more likely to develop impaired fasting glucose, or prediabetes, a study shows.
The research was presented this week at the American Heart Association's Annual Conference on Cardiovascular Disease Epidemiology and Prevention.
The study examined the health records of nearly 1,500 participants in the Western New York Health Study. Researchers identified 91 participants who had fasting blood glucose levels of less than 100 milligrams per deciliter (mg/dL) during baseline exams between 1996 and 2001; the participants had higher blood fasting glucose levels -- between 100 mg/dL and 125 mg/dL -- at follow-up exams in 2003-2004.
Those 91 participants were compared with 273 people who had blood glucose levels of less than 100 mg/dL both at baseline and follow-up. Researchers matched the groups according to gender, race/ethnicity, and year of study enrollment.
A normal fasting blood glucose level is less than 100 mg/dL. A fasting blood glucose result of 100mg/dL to 125 mg/dL is considered impaired fasting glucose. Having impaired fasting glucose is commonly referred to as prediabetes because many people with prediabetes go on to develop type 2 diabetes.
Participants reported how much they slept during the work week. Participants fell into three categories: short sleepers (less than six hours), mid-sleepers (six to eight hours), and long sleepers (more than eight hours).
During the six-year study period, participants who slept on average less than six hours a night during the work week were 4.56 times more likely than those getting six to eight hours of sleep to convert from normal blood sugar levels to impaired fasting glucose, researchers said. These findings took into account other factors such as age, obesity, and family history of diabetes.
No association was found in people who slept more than eight hours compared to those who slept six to eight hours.
"This study supports growing evidence of the association of inadequate sleep with adverse health issues," study researcher Lisa Rafalson, PhD, a National Research Service Award fellow and research assistant professor at the University at Buffalo in New York, says in a news release.
Here's one more reason to get a good night's sleep.
People who sleep less than six hours per night are more likely to develop impaired fasting glucose, or prediabetes, a study shows.
The research was presented this week at the American Heart Association's Annual Conference on Cardiovascular Disease Epidemiology and Prevention.
The study examined the health records of nearly 1,500 participants in the Western New York Health Study. Researchers identified 91 participants who had fasting blood glucose levels of less than 100 milligrams per deciliter (mg/dL) during baseline exams between 1996 and 2001; the participants had higher blood fasting glucose levels -- between 100 mg/dL and 125 mg/dL -- at follow-up exams in 2003-2004.
Those 91 participants were compared with 273 people who had blood glucose levels of less than 100 mg/dL both at baseline and follow-up. Researchers matched the groups according to gender, race/ethnicity, and year of study enrollment.
A normal fasting blood glucose level is less than 100 mg/dL. A fasting blood glucose result of 100mg/dL to 125 mg/dL is considered impaired fasting glucose. Having impaired fasting glucose is commonly referred to as prediabetes because many people with prediabetes go on to develop type 2 diabetes.
Participants reported how much they slept during the work week. Participants fell into three categories: short sleepers (less than six hours), mid-sleepers (six to eight hours), and long sleepers (more than eight hours).
During the six-year study period, participants who slept on average less than six hours a night during the work week were 4.56 times more likely than those getting six to eight hours of sleep to convert from normal blood sugar levels to impaired fasting glucose, researchers said. These findings took into account other factors such as age, obesity, and family history of diabetes.
No association was found in people who slept more than eight hours compared to those who slept six to eight hours.
"This study supports growing evidence of the association of inadequate sleep with adverse health issues," study researcher Lisa Rafalson, PhD, a National Research Service Award fellow and research assistant professor at the University at Buffalo in New York, says in a news release.
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