Focus on Diabetics’ Blood Pressure
Doctors should be more aggressive in treating patients who have both diabetes and high blood pressure, the National Heart, Lung and Blood Institute said Tuesday in a new clinical guideline. An estimated 11 million Americans are victims of Type 2 diabetes, which generally begins in middle age, and 5 million of these have high blood pressure.
Because both conditions are risk factors for cardiovascular disease, the statement said, physicians should attempt to bring the blood pressure of diabetics down to 135/80. Normally, doctors try to bring pressure down to 140/90.
The authors of the advisory note that previous studies have shown dramatic effects from reducing blood pressure in diabetics. In one study, for example, reducing pressure to the newly recommended level reduced strokes by 44%, small blood vessel damage by 37%, and diabetes-related deaths by 32%. The clinical advisory can be found at https://www.nhlbi.nih.gov/hbp/health/diabetes_statement.html. More information about treatment of blood pressure is available at https://www.nhlbi.nih.gov.
Bugs Biting for Two
Pregnant women traveling to developing countries should take special precautions to ward off mosquitoes because they are twice as likely to be bitten by the sometimes-disease-carrying insects, according to British researchers.
Among factors increasing their risk of being bitten, pregnant women exhale 21% more carbon dioxide, which attracts mosquitoes, and their slightly higher body temperature (about 1 degree Fahrenheit) makes them more likely to emit skin odors, which also attract the insects.
Dr. Steve Lindsay and his colleagues at the University of Durham in northern England studied 36 pregnant and 36 non-pregnant women in rural Gambia. Each night, three women from each group slept alone under a bed net. Researchers counted the number of mosquitoes attracted to each woman. The team reported in Saturday’s Lancet (https://www.thelancet.com) that the pregnant women attracted twice as many mosquitoes.
Aspirin as Stroke Prevention
Giving aspirin to stroke victims as soon as they reach the hospital and continuing it for extended periods can sharply reduce the incidence of further attacks, according to a new analysis of two major stroke trials that included 40,000 stroke victims.
Dr. ZhengMing Chen of Oxford University reported in Friday’s issue of Stroke: Journal of the American Heart Assn. (https://stroke.ahajournals.org) that aspirin use reduces the risk of a recurrent stroke by one-third. The overall benefit after a month of use is to save the lives of nine patients out of every 1,000 stroke victims.
That may not sound like much, but there are millions of strokes each year worldwide. “Treating 1 million of those with one year of aspirin therapy will prevent about 20,000 strokes or deaths,” Chen said.
Aspirin is a blood thinner that reduces the likelihood of clotting; a blood clot in arteries leading to the brain or in the brain is the most common cause of strokes.
Aid for Crohn’s Sufferers
Human growth hormone may be useful for treating patients with Crohn’s disease, according to a small preliminary study reported in Thursday’s New England Journal of Medicine (https://www.nejm.org).
About half a million Americans suffer from Crohn’s, which is characterized by persistent diarrhea, abdominal pain, bleeding and other problems of the intestine. Current treatment requires suppressing the immune system with prednisone and other steroids, which can have many side effects.
Dr. Alfred Slonim and colleagues at North Shore University Hospital in Manhasset, N.Y., gave human growth hormone to 19 patients with moderate to severe Crohn’s and placed them on a high-protein diet. Eleven of the patients went into remission, and three others showed significant improvement, Slonim said. Eighteen patients receiving a placebo, and a high-protein diet showed no significant improvement, however. The study was sponsored by Genentech and Eli Lilly, manufacturers of human growth hormone.
Viagra and Heart Patients
Viagra does not produce any dangerous heart-related side effects in men who already have heart disease, according to researchers from the University of Pennsylvania. Their study was triggered by reports of men suffering heart attacks soon after taking the drug, which is designed to overcome impotence.
Dr. Howard C. Herrmann and his colleagues gave the drug to 14 impotent men just before they were to undergo surgery to have blocked heart arteries reopened. The team measured a variety of cardiovascular properties, including blood pressure and blood flow through key arteries, before and after the men took the drug.
The team reported in Thursday’s New England Journal of Medicine (https://www.nejm.org) that the drug produced no changes in blood pressure and that, if anything, it actually made it easier for blood to flow through the heart. The study was sponsored by Pfizer, which manufactures Viagra.
The Effect of Driving on Fertility
New evidence supports the theory that driving for long periods can reduce fertility in men, according to researchers from the Human Fertility Research Group in Toulouse, France. Previous studies had shown that professonal drivers have low sperm counts, that their sperm has unusual numbers of abnormalities and that their partners take longer to conceive.
The research team studied nine healthy volunteers who wore normal clothing and a temperature probe attached to their scrota. The team reported in Wednesday’s issue of Human Reproduction (https://humrep.oupjournals.org) that the volunteers’ scrotal temperatures rose as much as 4 degrees Fahrenheit after two hours of driving in a non-air-conditioned car. Increased temperatures reduce the viability of sperm.
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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.
