This week in the medical journals
Research shows Americans may be winning cholesterol war
By Peggy Peck
Editor's note: CNN.com has a business partnership with MedPageToday.com, which provides custom health content. A medical journal roundup from MedPage Today appears each Thursday.
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A bit of good news
With the billions spent every year on medical research, there ought to be a bit of good news now and then that finds its way into the major medical journals.
So it was this week with the report that Americans may be winning the cholesterol war, or at least doing better than 10 years ago. On the surface, this translates into less heart disease.
How low can we go?
That is the latest assessment from an analysis of data collected by the National Health and Nutrition Examination Surveys, or NHANES, a snapshot of the state of America's health based on data collected from a nationwide random sample.
On average, both total cholesterol and LDL cholesterol -- the so-call "bad" cholesterol linked to heart attacks and strokes -- declined significantly from 1988 to 1994 and from 1999 to 2002.
But epidemiologists from the National Center for Health Statistics, the National Heart, Lung and Blood Institute and the University of Texas Southwestern Medical Center reported in the Journal of the American Medical Association that the overall decline is driven by major declines in older men and women who are taking drugs like Lipitor (atorvastatin) and Zocor (simvastatin) to lower cholesterol.
As a result, the overall improvement can't be interpreted as a national movement to better diets and more exercise.
In this latest sample only 17 percent of Americans had total cholesterol of 240 mg/dL, which is considered high, versus 20 percent of Americans who met or exceeded the high cholesterol threshold in 1988-1994. Desirable total cholesterol is less than 200 mg/dL, while LDL cholesterol should be less than 100 mg/dL.
No pain, but maybe a gain
And speaking of exercise, it's the amount not the intensity that is important, according to a study in Chest.
A team of Duke University scientists reported that walking a brisk pace 12 miles a week benefits the heart as much as jogging 12 miles a week.
Feeling "the burn," they say, does not improve peak oxygen consumption, which is a measure of aerobic fitness. But joggers do reap one benefit over strollers: they lose weight. Walkers -- at least those who walked 12 miles a week -- did not.
Can't beat experience
Duke University researchers also reported that they have evidence that practice makes perfect -- or close to it -- in the world of implanted defibrillators. These are the tiny devices surgically implanted under the skin of the chest to detect irregular heart rhythms and send life-saving shocks to the heart to make it beat normally.
Writing in the Journal of the American College of Cardiology, the Duke team said that doctors who implant at least 11 of these devices a year have better results, as reflected by fewer device-associated infections and fewer mechanical problems.
The researchers came to that conclusion after studying medical records from 9,854 Medicare patients who had the devices, which are called implantable cardioverter-defibrillators, implanted between 1999 and 2001.
Vice President Dick Cheney is one of those who had a device implanted during that period.
Jeans don't fit? Maybe it's your genes
And a team of gene hunters at Duke reported in Cell Metabolism that obese women may have a genetic problem. A gene, called SCD1, which programs muscle tissue to store fat, may be stuck in the "on" position in these women. As a result, muscle cells are storing too much fat, which not only adds on pounds but also increases the risk of type 2 diabetes and high cholesterol.
The finding means that diet alone may not be effective in some obese women, but exercise does change muscle metabolism. So the Duke team is now investigating the effect of exercise on this stuck genetic switch.
Middle-age spread linked to prostate cancer
Before reaching for another chip while enjoying the baseball playoffs from the couch, consider this: prostate cancer survivors who have a history of putting on the pounds between ages of 25 and 40 were more than twice as likely to have their cancer recur as survivors who stayed lean during their 20s and 30s.
That is the assessment of researchers at the MD Anderson Cancer Center in Houston, Texas, who studied 526 men who had surgery for prostate cancer.
The findings were reported in Clinical Cancer Research.
Blood pressure pill bonus
The four most common types of blood-pressure medications -- diuretics, beta-blockers, ACE inhibitors, and angiotensin II receptor agonists -- also prevent headaches, according to an analysis of data from 17,641 high blood pressure patients treated with the drugs.
Only 8 percent of patients taking the blood pressure pills had headaches, while about 12 percent of high blood pressure patients taking dummy pills reported headaches.
But the researchers from Queen Mary's School of Medicine and Dentistry of the University of London, who reported the findings in Circulation, Journal of the American Heart Association, said they don't recommend using blood pressure medications to treat headaches. Fewer headaches, they say, are just a welcome side effect of the drugs.
Cool treatment promising
Infants born with a condition called hypoxic-ischemic encephalopathy have oxygen-starved brains, which increases the risk of death or disability. But a multi-center team of neonatal intensive care experts say that treating these babies with a complicated whole-body cooling therapy appears to reduce both mortality and disability.
The treatment, described in The New England Journal of Medicine, is experimental, and at this point cooling reduces but doesn't eliminate the risk of death and disability. The researchers were led by neonatologists at Wayne State University in Detroit.
There's been a lot of talk about brain food. Well, scientists at Rush University Medical Center in Chicago gave us something more to chew on this week. Eating fish at least once a week, they reported in Archives of Neurology, can help keep the brain "youthful" well into old age.
Fish eaters, they said, had significantly slower rates of age-related cognitive decline. In their study an 80-year-old with a fish-rich diet could perform on mental agility tests as well as a 77-year-old.
Endnote: Tuna salad, anyone?
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