TUESDAY, Aug. 14, 2018 (HealthDay News) — A low-dose three-in-one combination pill controls blood pressure more effectively than the regular medications people take, according to data from a new clinical trial.
About 70 percent of patients with mild-to-moderate high blood pressure who were given the “Triple Pill” reached their target blood pressure goal of 140/90 or less within six months, compared with 55 percent of people who were taking one or two separate blood pressure medications.
Overall, people on the Triple Pill achieved an average blood pressure of 125/76, compared with 134/81 for people receiving standard care for high blood pressure (hypertension), the Australian researchers reported.
“It’s estimated more than a billion people globally suffer from high blood pressure, with the vast majority having poorly controlled blood pressure,” said lead study author Ruth Webster, head of research programs at the George Institute for Global Health in Newtown. “Our results could help millions of people globally reduce their blood pressure and reduce their risk of heart attack or stroke.”
Target blood pressure for people in the United States is now 130/80, according to the American Heart Association and the American College of Cardiology.
The heart health associations brought the target down from 140/90 following research showing that people in the 130-139 range carry a doubled risk of heart attack, stroke, heart failure and kidney failure.
People with high blood pressure very often need to take multiple drugs to bring their pressure down to safe levels, said Dr. Vincent Bufalino, a spokesman for the American Heart Association.
“In my cardiology practice, I would say it’s the rare person who’s on a single drug — 80 percent of folks are on multiple drugs, two or three,” said Bufalino, senior vice president of the Advocate Cardiovascular Institute in Naperville, Ill.
A combination therapy with low doses of medication has great potential because it provides the most bang for the buck while reducing the risk of side effects, said Dr. Mark Huffman, an associate professor of preventive medicine and cardiology with Northwestern University’s Feinberg School of Medicine, in Chicago.
“The greatest blood pressure-lowering effect is on the initial moderate- or even low-dose medication,” Huffman said. “As you push the dose higher, the blood pressure-lowering effects start to taper off while the side effects start to increase,” he explained.
“By adding multiple drugs together at lower doses, you increase chances you’ll get a good blood pressure-lowering effect that is tolerable for the patient,” Huffman continued.
But it’s tough to get people to regularly take multiple blood pressure meds, Bufalino and Huffman said.
“It’s hard to talk somebody into taking three drugs — three sets of pills and three prescriptions and they all feel like they’re overmedicated,” Bufalino said. “Whereas a combo drug like this with a single pill, you’ve covered them treating their pressure without them having the burden of taking three sets of drugs.”
The Triple Pill contains three different types of medication commonly prescribed to people with high blood pressure — a calcium channel blocker that relaxes blood vessels, an angiotensin II receptor antagonist that keeps blood vessels from narrowing, and a diuretic that prevents the body from absorbing too much salt and retaining fluid.
Webster said that the researchers combined a half-strength dose of each of these three medications into a single pill.
About 700 patients in Sri Lanka were randomly assigned to take either the Triple Pill or receive standard blood pressure care, which generally involves starting out with one medication and then either increasing the dosage or adding other drugs until blood pressure lowers, Webster said.
“Traditionally, patients begin treatment with one drug at a very low dose, which is increased over time with additional drugs added and increased in dosage to try to reach target,” Webster noted. “Patients are brought back at frequent intervals to see if they are meeting their targets with multiple visits required to tailor their treatments and dosage. This is not only time inefficient, it’s costly.”
By six months, 83 percent of study patients in the Triple Pill group were still taking the combination pill with no change in dosage, the researchers reported.
On the other hand, two-thirds of people in the usual care group were still taking just one drug, while 29 percent had been prescribed a second drug.
The Triple Pill patients had similar numbers of adverse events compared to the patients receiving usual care, Webster said. There also was no difference in the number of people who stopped taking their medication due to side effects.
A triple-drug blood pressure pill currently is available in the United States, but it contains a higher dose of medication and is aimed at people with hard-to-treat high blood pressure, Huffman said.
The Triple Pill is aimed more at people with mild or moderate high blood pressure, Huffman added.
“As the evidence mounts, I think there will be some pressure on pharma to develop a drug” for the U.S. market similar to the Triple Pill, Bufalino said.
Such a drug might not be limited to three medications, either. Huffman is part of a clinical trial looking at a four-drug combination that uses even lower doses.
“This trial asked if three halves are greater than one,” Huffman said. “We’re now asking if four quarters are greater than one.”
The Triple Pill trial results were published in the Aug. 14 issue of the Journal of the American Medical Association.
The American Heart Association has more about high blood pressure.
MONDAY, Aug. 13, 2018 (HealthDay News) — New guidelines now recommend yearly urinary incontinence screening for all women.
But some experts say such screening needs to be introduced with caution.
Urinary incontinence (loss of bladder control) affects about 51 percent of women and can harm their physical, functional and social well-being, according to the American College of Physicians. But many women are reluctant to discuss urinary incontinence with their health care providers, and the condition is often overlooked.
The new guidelines from the Women’s Preventive Services Initiative (WPSI) call for annual screening to determine if a woman has urinary incontinence and whether it affects her daily activities and quality of life.
If treatment is warranted, the patient should be referred for further evaluation, according to the guidelines. They were published Aug. 13 in the journal Annals of Internal Medicine.
An accompanying review by Oregon Health and Science University researchers of published studies on urinary incontinence screening found that none of the studies evaluated the overall effectiveness or harms of screening.
There was limited evidence that when used by primary care doctors, screening with short questionnaires is fairly accurate in identifying symptoms of urinary incontinence, the review found.
Despite the lack of direct evidence, the WPSI said screening has the potential to identify urinary incontinence in many women who keep silent about the condition, and noted that early treatment may prevent worsening symptoms, improve quality of life, and reduce the chances of more complex and costly treatment.
In an accompanying editorial, experts at the Women’s Health Research Program at Monash University in Melbourne, Australia, wrote that implementing this type of screening is a very serious responsibility and should be introduced with caution.
They said a randomized trial to assess the benefits and harms of urinary incontinence screening is needed before it is introduced for all women.
The U.S. Office on Women’s Health has more on urinary incontinence.
MONDAY, Aug. 13, 2018 (HealthDay News) — If pressed, young adults will put their parents ahead of their close friends, a new study shows.
“Our study suggests mom still matters,” said senior author Jennifer Silvers, an assistant professor of psychology at the University of California, Los Angeles.
“Parents continue to have an enduring impact on their children as they become adults — and on their decision-making,” she said in a university news release.
In the study, researchers tested 174 participants, aged 18 to 30, and found that when forced to make a decision that benefited either a parent or a close friend, the young adults were more likely to choose the parent.
The findings were the same among men and women and across the age range, according to the study, which was published online Aug. 8 in the journal Psychological Science.
“When push came to shove, they prioritized their parents,” Silvers said. “Even though not much was at stake, the preferences were quite consistent.”
Even so, being forced to make a choice was difficult for the participants, who were tested in a series of card games that involved choosing.
“Many of them seemed conflicted,” said study author Joao Guassi Moreira, a doctoral student in Silvers’ laboratory. “Several said slight variations of, ‘Even though it was hard to not pay as much attention to my friend, I felt like I owed it to my parent, who has helped me so much.’ “
The researchers want to learn other reasons why young adults choose their parents over their close friends, and whether young teens would make the same decision.
The American Academy of Pediatrics has more on young adults.
MONDAY, Aug. 13, 2018 (HealthDay News) — Few Americans know that inactivity can increase the risk of colon, breast and other types of cancer, a new study finds.
An analysis of survey responses from 351 people revealed that while many knew a sedentary lifestyle increased their risk of heart disease (63.5 percent) and metabolic problems such as diabetes (65.8 percent), only 3.4 percent were aware it also adds to cancer risk.
The review also found low awareness that inactivity increases the risk of respiratory diseases (3.4 percent) and gastrointestinal conditions (0.9 percent).
The study was published Aug. 9 in the Journal of Health Communication.
“Many people know that not getting enough physical activity can increase your chances of having heart problems or getting diabetes. However, few people realize that inactivity can also raise their chances of getting other diseases,” lead author Erika Waters said in a journal news release.
Waters is an associate professor of surgery at Washington University in St. Louis.
Researchers blamed public health campaigns that emphasize the benefits of exercise on heart health and weight control without noting that inactivity increases the risk of cancer.
They called for greater public education about the link between exercise and cancer risk.
The U.S. National Cancer Institute has more on physical activity and cancer.
MONDAY, Aug. 13, 2018 (HealthDay News) — Researchers have found that having friends who gain weight — especially friends of the same gender — raises your chance of becoming overweight by more than 50 percent. That’s far more than if your spouse gains weight.
But they’ve also found that the same type of social influence can help you lose weight. In fact, sharing a fitness goal through your social network can help everyone in it. The team approach is most effective for people 18 to 35 years old, but has been successful for older Americans as well.
One large-scale example took place in Rhode Island. With resources from the wellness company Shape Up, now part of the Virgin Pulse group, the state encouraged thousands of people to start teams to promote weight loss and physical activity, and compete with each other.
In one year alone, nearly 1,000 small teams, some with just a few members, participated. Self-selected captains recruited team members, monitored their group’s progress, and motivated members by sending encouraging messages and updates.
New York City has its own Shape Up NYC, an initiative that offers communities throughout its five boroughs a variety of fitness options. It reported that 65 percent of participants lost weight and experienced improved health benefits, and 83 percent said they felt an increase in energy.
Successes in Rhode Island and New York validate the team approach to weight loss, the researchers say. But you don’t need to live in an area that sponsors such a program to start a team among your own circle of friends or co-workers. Set goals and initiate a friendly challenge to help everyone stay on track.
Health.gov has 7 challenges to start with co-workers for weight loss and fitness goals.
MONDAY, Aug. 13, 2018 (HealthDay News) — Women who experience rudeness and other incivilities at work are likely to be stricter with their own kids, a new study claims.
Canadian researchers conducted an online survey of 146 working mothers and their spouses. The mothers were asked about incivility at work and how effective they felt as parents, and their spouses were asked about the mothers’ parenting behaviors.
Experiencing incivility at work was strongly associated with authoritarian parenting by working mothers, but not with permissive parenting.
The researchers also found that mothers who experienced incivility at work felt less effective as parents, which could help explain why they were strict with their children, according to the researchers at Carleton University in Ottawa.
“These findings reveal some previously undocumented ways that women, in particular, suffer as a result of workplace aggression,” said study co-author Angela Dionisi. She’s an assistant professor of management at the university’s Sprott School of Business.
“In uncovering how this mistreatment in the workplace interferes with positive mother-child interactions, this research also speaks to a previously unacknowledged group of indirect incivility victims, namely children,” Dionisi said.
The study was presented on Saturday at the annual meeting of the American Psychological Association, in San Francisco.
The researchers defined authoritarian parents as those having high expectations of their children, with rules that they expect their children to follow unconditionally. The parents also tend to have many regulations and micromanage their children’s lives, valuing discipline over fun, study co-author Kathryne Dupre said.
She is an associate professor of organizational psychology at Carlton.
“This style of parenting has been associated with a variety of negative child outcomes, including associating obedience and success with love, exhibiting aggressive behavior outside the home, being fearful or overly shy around others, having difficulty in social situations due to a lack of social competence, suffering from depression and anxiety, and struggling with self-control,” Dupre said in a meeting news release.
The researchers only found an association between workplace treatment and parenting, not a cause-and-effect link.
Research presented at meetings is considered preliminary until it is published in a peer-reviewed journal.
The U.S. National Institutes of Health offers advice on positive parenting.
FRIDAY, Aug. 10, 2018 (HealthDay News) — Teen health in developing countries is vastly underfunded, researchers report.
While teens represent 26 percent of people in developing countries, teen health received just 1.6 percent of global development aid for health between 2003 and 2016, the study found.
And very little of that money was directed to serious teen problems such as anemia, depression and injuries, according to the study led by researchers from Harvard Medical School.
While the percentage of global development aid earmarked for teen problems rose from 1.3 percent to 2.2 percent between 2003 and 2016, adolescent health does not receive the attention it deserves, the researchers said.
The study defined adolescence as ages 10 to 24. More than a quarter of the population in 132 developing countries is in that age group.
“The international donor community has been ‘asleep at the wheel’ in failing to keep pace with changing demography and health needs,” study co-investigator George Patton said. He’s a researcher at the Center for Adolescent Health and Murdoch Children’s Research Institute in Victoria, Australia.
Senior study author Chunling Lu, an assistant professor of global health and social medicine at Harvard, pointed out that adolescence is a time of rapid physical, cognitive and emotional growth that shapes health for decades to come.
“Considering how important young people are for the future well-being and economic development of low- and middle-income countries, international donors need to reconsider both the levels and the patterns of investments that they are making,” Lu said in a Harvard news release.
The largest amounts of teen health funding were for HIV/AIDS, violence, tuberculosis and diarrhea. All are among the leading causes of illness and disability among teens.
But donors largely ignored other major teen health issues — such as anemia, road crash injuries and depression.
“Despite supporting the United Nations’ Global Strategy for Women’s, Children’s and Adolescents’ Health, international investment from agencies have so far failed to make serious investments in the world’s young people,” Patton said.
An infusion of funding is urgently needed, according to Lu.
“Our study shows that taking adolescent health to scale will require greater allocation of development funds for adolescent health in general and better targeting toward the major causes of disease burden among adolescents,” she said. “It’s an investment well worth making.”
The study was published Aug. 10 in the journal JAMA Network Open.
The World Health Organization has more on teen health.
FRIDAY, Aug. 10, 2018 (HealthDay News) — Sexting can lead to dissing.
That appears to be one takeaway from a small survey of North American adults in committed relationships who share explicit visuals and/or texts via mobile phones with each other.
While the survey suggests that some couples who engage in sexting do see improvements in their real-world sex life, the virtual practice was linked to a rise in ambivalence about the relationship. It was also tied to an increased penchant for viewing porn and engaging in other potentially unfaithful online behavior.
The bottom-line finding, said study author Michelle Drouin, is that while “sexting might relate to [increased] sexual satisfaction, it is also related to negative aspects of relationship functioning.”
Frequent weekly sexters and daily “hyper” sexters may end up seeing their relationship undermined by greater conflict, more insecurity and weakened commitment, she cautioned.
The practice may also ratchet up a dynamic known as “technoference,” Drouin added, in which one partner’s use of technology — at the dinner table or while simply hanging out, for example — is perceived by the other partner as bad for the relationship.
Drouin is a developmental psychologist at Purdue University in Fort Wayne, Ind.
The research initially focused on a pool of 615 adults from the United States and Canada. Three-fifths were women, and three-quarters were white. All were in a committed relationship. No one was older than 66, and the couples had been together an average of nearly 19 years.
Drouin noted that “the likelihood that adult couples are sexting decreases with age,” probably because of “age-related differences in technology usage, sexual behavior or relationship stage.”
So the researchers focused on a subgroup of 365 respondents who were under the age of 50.
The group was then divided into four different categories: those who never texted (57 percent); word-only texters, who occasionally sent non-visual sext messages (21 percent); frequent weekly texters, who sent explicit texts and images (13 percent); and hyper-texters who sent both explicit texts and images on a daily basis, sometimes several times a day (9 percent).
Those who never sexted reported just as much relationship satisfaction as those who did sext, but weekly and daily sexters reported more sexual satisfaction with their partner.
But weekly and/or daily sexting was also linked to a weakening of the ties that bind, the poll suggested, with the research team concluding that “sexting among committed relationship partners does not appear to be associated with positive relationship characteristics or outcomes.”
The researchers noted that “a greater percentage of people in same-sex relationships were frequent or hyper-sexters.”
According to Joseph Currin, an assistant professor of counseling psychology at Texas Tech University in Lubbock, “Sexting is still a somewhat complex behavior that is just now beginning to be somewhat understood.”
He noted that “sexting can range from sending sexually suggestive — sometimes perceived as ‘flirty’ — messages, all the way to sexually explicit videos. As in all behaviors, there are positive and negative aspects to it.”
But, ultimately, “sexting is a sexual activity” in which “consent is a big part, just as with any other sexual activity,” Currin explained.
“If both parties engaging in sexting want to, then it can enhance the relationship,” he suggested. “However, if someone does not, then it can harm it.”
Drouin and her colleagues, Adam Galovan of the University of Alberta in Canada and Brandon McDaniel of Illinois State University, were scheduled to present the findings Thursday in San Francisco at a meeting of the American Psychological Association. Research presented at meetings should be considered preliminary until it is published in a peer-review journal.
There’s more on how to foster a healthy relationship at the U.S. Department of Health and Human Services.
FRIDAY, Aug. 10, 2018 (HealthDay News) — More than 4 in 10 women with asthma developed chronic obstructive pulmonary disease (COPD), and heavy smoking and obesity were among the significant risk factors, a new study found.
The research involved more than 4,000 women with asthma in Canada who were followed for about 14 years after being diagnosed with the condition. During that time, 42 percent of the women developed COPD.
The researchers examined risk factors for developing asthma and COPD overlap syndrome (ACOS). They found that women who had smoked more than the equivalent of a pack of cigarettes a day for five years were much more likely to develop ACOS than those who smoked fewer cigarettes or never smoked.
However, 38 percent of the women who developed asthma and COPD overlap syndrome had never smoked.
“Previous studies have found an alarming rise in ACOS in women in recent years and that the mortality rate from ACOS was higher in women than men,” said study author Teresa To, a professor at the University of Toronto Graduate School of Public Health.
“We urgently need to identify and quantify risk factors associated with ACOS in women to improve their health and save lives,” To added in a university news release.
The study was published online Aug. 10 in the Annals of the American Thoracic Society.
COPD is a chronic lung disease caused mainly by smoking and it is irreversible. It is also the third leading cause of death in the United States, according to the American Lung Association.
In addition to smoking, the researchers found that obesity, living in a rural area, lower education levels and unemployment were significant risk factors for asthma and COPD overlap syndrome.
These factors are associated with being poor and having less access to care, under-treatment of asthma and failure to take medications, all of which can lead to more frequent asthma attacks that can cause airway changes that increase the risk of ACOS, the researchers explained.
The authors noted that people can change most of the risk factors for ACOS identified in the study.
The U.S. National Heart, Lung, and Blood Institute has more on COPD.
THURSDAY, Aug. 9, 2018 (American Heart Association) — People with obesity are known to be at increased risk for coronary heart disease, the most common type of heart disease. Now, a new study shows obesity may also increase the chance of developing peripheral artery disease.
Coronary artery disease develops when the arteries that supply blood to the heart become stiff and narrow. Peripheral artery disease affects the arteries that supply blood to the arms, legs or feet and often leads to pain or cramping in the legs or hips while walking or climbing stairs.
At least 6.8 million Americans ages 40 and older have peripheral artery disease. If left untreated, peripheral artery disease can advance to critical limb ischemia, a severe blockage in the arteries that, in some cases, can only be treated by having the affected limb amputated.
Experts say previous studies have found that smoking, diabetes and high cholesterol increase a person’s risk of developing peripheral artery disease, but the role that obesity plays in the disease has been unclear.
For the new study, published Aug. 9 in the Journal of the American Heart Association, researchers at Johns Hopkins University School of Medicine in Baltimore analyzed data on nearly 14,000 black and white men and women enrolled in the ongoing Atherosclerosis Risk in Communities Study, which began in 1987. They found that people who were obese were 1.5 times more likely to develop peripheral artery disease with critical limb ischemia than those who were normal weight.
“With increasing obesity, you have an increased risk of [both diseases], which means an increased risk of limb loss,” said Dr. Caitlin Hicks, the study’s lead author. “Everybody knows about diabetes and hypertension and their relationship to obesity, but now we’re connecting the risk of lower extremity issues to obesity.”
Hicks said their findings show why it is important for doctors to advise patients with peripheral artery disease who are obese to lose weight. But she admitted that losing weight can be particularly hard to accomplish for those with the condition.
“It’s a vicious cycle, because as people get obese [and develop peripheral artery disease], they have trouble walking … which makes it harder to lose weight, because they’re not active,” said Hicks, an assistant professor of vascular surgery and endovascular therapy at Johns Hopkins University School of Medicine.
Dr. Aruna Pradhan, a cardiologist at Harvard Medical School in Boston who was not involved in the study, noted that the study researchers couldn’t account for people whose weight may have fluctuated. She also noted that it was possible that obesity-related conditions such as diabetes might be driving the higher rates of peripheral artery disease and critical limb ischemia, rather than obesity itself.
“But that doesn’t detract from the message that reducing weight could very certainly impact the risk of peripheral artery disease, as it does with other cardiovascular diseases,” said Pradhan, who is chair of the American Heart Association’s Peripheral Vascular Disease Council.
Pradhan said she sees many patients with advanced peripheral artery disease who are awaiting surgery to have a limb amputated.
“They’re devastated by the dread of losing a limb and filled with regret over what they could have done to prevent it,” she said. “Peripheral artery disease is an epidemic among populations we’re paying less attention to: African-Americans, veterans, people without health care. We need to put it front and center. We need to pay more attention to this disease.”