Health

3-in-1-blood-pressure-pill-more-effective-than-standard-care

Mon Oct 14 09:23:30 IST 2024

A new 3-in-1 blood pressure pill outperformed standard medication at lowering blood pressure in patients with uncontrolled hypertension. It is estimated that over a billion people worldwide live with hypertension which is a leading risk factor for mortality, accounting for 10.8 million deaths a year.

The GMRx2 pill contains low doses of three blood pressure drugs―telmisartan, amlodipine and indapamide―and is taken once daily. The standard treatment for hypertension involves starting off with one medication, and if it’s not effective, adding on two or more drugs as needed.

A recent study randomly assigned 300 adults, average age 52 years, with uncontrolled blood pressure to either the triple pill or standard treatment. After just one month, 81 per cent of the participants in the GMRx2 group had their blood pressure under control versus 55 per cent with standard care. This improvement continued at six months with 82 per cent achieving control, compared with 72 per cent on standard treatment.

Systolic blood pressure was 31mmHg lower in the GMRx2 group after six months, compared to 26 mmHg lower with standard care, a 5.8 mmHg difference. Every 5-mmHg reduction in systolic blood pressure is associated with a 10 per cent reduction in major cardiovascular events such as stroke, heart attack and heart failure. Both treatment plans were well tolerated.

"In low-income countries, fewer than one in four treated people achieve blood pressure control and in high-income settings it is only between 50 per cent and 70 per cent," the lead researcher said. "So, to see rates of over 80 per cent in just one month is impressive."

Results of the experimental trial were presented at the European Society of Cardiology Congress and simultaneously published in the Journal of the American Medical Association.

do-mobile-phones-cause-cancer

Fri Oct 11 10:14:56 IST 2024

A world health studies worldwide has found no link between cellphone use and brain cancer.

For the study published in the journal Environment International, 11 experts from 10 countries scanned 5,000 studies published between 1994 and 2022 to determine whether greater exposure to radio frequencies, used in mobile phones and other wireless electronics, base stations and transmitters might increase the risk of brain cancer in adults and children.

The final analysis included 63 studies and did not find an increased risk of brain cancer even with prolonged cellphone use of 10 years or more among those who spent a lot of time on their cellphones or made long phone calls.

Even though there has been a huge increase in mobile phone use in the last 20 years, there has not been a corresponding increase in the incidence of brain cancers. There was also no increased risks of leukaemia or brain cancer in children exposed to radio or TV transmitters or cellphone towers. Concerns about a potential link was first raised in 2013 by a WHO group that classified radio wave exposure as possibly carcinogenic.

best-methods-to-quit-smoking

Tue Oct 08 14:15:02 IST 2024

A scientific review of current evidence published in the journal Addiction has identified three proven strategies to quit smoking. The most effective methods to overcome nicotine dependence are varenicline, cytisine and nicotine e-cigarettes. These three methods work best when combined with counselling, or other behavioural support.

“For behavioural support, evidence is strongest for counselling and for programmes that reward people for stopping smoking,” the study said.

Bupropion and nicotine replacement therapy are also effective, especially if patches are combined with fast-acting forms like gum. Smoking is a leading cause of preventable disease and death, accounting for more than eight million deaths per year.

rwandas-marburg-fever-deaths-rise-to-11-as-its-source-is-being-investigated

Thu Oct 03 22:30:11 IST 2024

Marburg hemorrhagic fever has killed 11 people in Rwanda, health authorities said Thursday, as the East African country searches for the source of an outbreak first traced among patients in health facilities.

There are 36 confirmed cases of the disease that manifests like Ebola, with 25 of them in isolation, according to the Rwandan government's latest update.

Rwanda declared the outbreak on September 27 and reported six deaths a day later. Authorities said at the time that the first cases had been found among patients in health facilities and that an investigation was underway to determine the origin of the infection.

The source remains unclear days later, raising contagion fears in the small central African nation. Isolating patients and their contacts is key to stopping the spread of viral hemorrhagic fevers like Marburg.

The World Health Organisation has warned that cases in Kigali, the Rwandan capital, pose a risk of international spread because the city has an international airport and is connected by road to other cities in East Africa.

Testifying to growing international concern about the outbreak, two people were isolated in the northern German city of Hamburg after returning from Rwanda, where they had been in a medical facility with Marburg virus patients, the European Centre for Disease Prevention and Control said in a statement on Thursday.

Both tested negative for the virus, the ECDC statement said.

German media reports said that concern about the virus led authorities to cordon off two tracks at a railway station where the two people had arrived. One was a young medical student who had felt symptoms of the disease and contacted doctors from the train.

In Rwanda, most of the affected people are health care workers across six out of 30 districts in Rwanda. Some patients live in districts bordering Congo, Burundi, Uganda and Tanzania, according to WHO.

At least 300 people who came into contact with those confirmed to have Marburg have been identified, and an unspecified number of them are now in isolation facilities, according to Rwandan health authorities.

Rwandan Health Minister Sabin Nsanzimana said Thursday that the clinical trials for vaccination would start within days but failed to clarify which type of vaccine will be used.

He told journalists at an Africa Centers for Disease Control and Prevention briefing that Rwanda is screening everyone who presents fever, head and body ache symptoms and has so far tested 2,000 people with 5,000 more test kits expected to arrive in the country.

Rwandans have been urged to avoid physical contact to help curb the spread. Strict measures include the suspension of school and hospital visits as well as a restriction on the number of those who can attend funerals for Marburg victims. Home vigils aren't allowed in the event a death is linked to Marburg.

The US Embassy in Kigali has urged its staff to work remotely and avoid visiting offices.

Like Ebola, the Marburg virus is believed to originate in fruit bats and spreads between people through close contact with the bodily fluids of infected individuals or with surfaces, such as contaminated bed sheets. Without treatment, Marburg can be fatal in up to 88 per cent of people who fall ill with the disease.

Symptoms include fever, muscle pains, diarrhea, vomiting and, in some cases, death through extreme blood loss. There is no authorized vaccine or treatment for Marburg.

Marburg outbreaks and individual cases have in the past been recorded in Tanzania, Equatorial Guinea, Angola, Congo, Kenya, South Africa, Uganda and Ghana, according to WHO.

The virus was first identified in 1967 after it caused simultaneous outbreaks of disease in laboratories in Marburg, Germany, and Belgrade, Serbia. Seven people died after being exposed to the virus while conducting research on monkeys.

almost-half-of-dementia-cases-can-be-delayed-or-prevented

Thu Oct 03 10:21:06 IST 2024

The number of people living with dementia is expected to almost triple by 2050—from 57 million in 2019 to 153 million.

But nearly half of these cases can be delayed or prevented by tackling 14 modifiable risk factors, finds a new report published in The Lancet. The 14 modifiable risk factors which are linked with 40 per cent of all dementia cases are lower levels of education, hearing loss, vision loss, high blood pressure, diabetes, high LDL cholesterol, smoking, excessive alcohol consumption, obesity, physical inactivity, brain injury, air pollution depression and social isolation.

Hearing loss and high LDL cholesterol are responsible for most cases of preventable dementia, followed by less education in early life and social isolation in later life. Longer exposure to these risk factors has a greater impact, especially in people with high genetic risk for dementia.

“Our new report reveals that there is much more that can and should be done to reduce the risk of dementia. It is never too early or too late to take action, with opportunities to make an impact at any stage of life,” the lead author said. “Healthy lifestyles that involve regular exercise, not smoking, cognitive activity in midlife [including outside formal education] and avoiding excess alcohol can not only lower dementia risk, but may also push back its onset. So, if people do develop dementia, they are likely to live less years with it. This has huge quality of life implications for individuals as well as cost-saving benefits for societies.”

cycling-to-work-lowers-risk-of-disease-death

Mon Sep 30 15:52:53 IST 2024

Cycling or walking to and from work or school has immense mental and physical health benefits and may lower your risk of death, finds a Scottish study published in the journal BMJ Public Health. Researchers compared the health benefits of active versus inactive commuting in 82,297 people in the UK, aged 16-74 years, who listed their mode of travel in a government census.

Walking or cycling was considered active commuting, and all other types of commuting were defined as inactive. Researchers analysed hospital admissions, deaths and prescription records for nearly two decades.

Cycling provided the greatest boost to a person’s wellbeing—it was associated with a 47 per cent lower risk of death from any cause, a 51 per cent lower risk of dying from cancer and a 24 per cent lower risk of being admitted to hospital for the disease, a 10 per cent lower risk of any hospital admission, a 24 per cent lower risk of hospital admission for heart disease, a 30 per cent lower risk of being prescribed a drugs for cardiovascular diseases, and a 20 per cent lower risk of being prescribed drugs for mental health issues.

But there was a downside—cyclists were twice as likely as to be admitted to the hospital after a traffic accident. Pedestrian commuting was also associated with similar health benefits, but to a lesser extent.

new-antidote-for-cobra-bites

Mon Sep 30 09:21:14 IST 2024

A commonly prescribed blood thinner—heparin—can be repurposed as an inexpensive and effective antidote for cobra venom.

Worldwide, nearly 18 lakh people are bitten by snakes each year. Of those, about 1.38 lakh people die, mainly in poorer rural areas in low- and middle-income countries in Africa, south and southeast Asia. About four lakh more develop necrosis, the death of body tissue and cells around the snake bite, which can lead to amputation.

Current treatments are expensive and are not effective against necrosis. A team of researchers from Australia, Canada, Costa Rica and the UK used CRISPR gene-editing technology to identify ways to block cobra venom and successfully repurposed heparin to stop the necrosis. “Our discovery could drastically reduce the terrible injuries from necrosis caused by cobra bites. It might also slow the venom, which could improve survival rates,” said the study, published in Science Translational Medicine.

vegan-diet-can-slow-biological-age-in-just-8-weeks

Sat Sep 28 15:08:27 IST 2024

Eating a vegan diet, even for a short duration, may help you slow down the biological ageing process, finds a new study published in BMC Medicine. The study included 21 pairs of adult identical twins aged 40 on average and 77 per cent were women.

For eight weeks, one twin was asked to follow a healthy vegan diet that mostly included vegetables, legumes and fruit and the other twin a healthy omnivorous diet that included meat, egg and dairy each day. They ate meals that had been prepared for them for the first four weeks of the study, and prepared their own meals based on nutrition lessons for the second four weeks.

At the end of eight weeks, bloodwork results showed the vegan twins had aged less slowly at the cellular level than the omnivorous twins. They also observed decreases in the ages of the heart, hormone, liver and inflammatory and metabolic systems of participants who ate vegan.

The vegan twin also lost two kilograms more on average than their omnivorous twin. This was mainly due to differences in calorie content for the prepared meals eaten during the first four weeks of the study.

the-dangers-of-excess-belly-and-arm-fat

Sat Sep 28 09:21:26 IST 2024

A new Chinese study published in the journal Neurology suggests that people with high levels of fat in their arms or belly have an increased risk for neurodegenerative diseases like Parkinson’s and Alzheimer’s.

Researchers tracked 4,12,691 people, average age 56 years, for almost a decade. Of them, 8,224 developed neurodegenerative diseases like Alzheimer's, other forms of dementia, and Parkinson's disease during the follow up. After adjusting for risk factors such as hypertension, smoking, drinking and diabetes, researchers found that people with high levels of belly fat were 13 per cent more likely to develop these neurogenerative diseases. High levels of arm fat increased the risk by 18 per cent.

But there was one characteristic that reduced the risk—muscle strength. Those with high muscle strength were 26 per cent less likely to develop these diseases.

“This study highlights the potential to lessen people's risk of developing these diseases by improving their body composition. Targeted interventions to reduce trunk and arm fat while promoting healthy muscle development may be more effective for protection against these diseases than general weight control,” said the study.

september-29-opinion-why-are-young-people-getting-this-old-heart-condition-atrial-fibrillation-dr-anees-thajudeen

Fri Sep 27 20:08:26 IST 2024

Young people do get Atrial fibrillation. This rhythm abnormality has been considered a scourge of the aged. Atrial fibrillation is in fact the most common cardiac rhythm disorder. It has not been getting the attention it deserves for a long time. It can often be without any symptoms in its early stages and physicians have not been able to place this rhythm disorder in the context of overall heart health in the elderly.

Now we know that atrial fibrillation can impact life significantly. It can be an unrecognised source for strokes. It can cause progressive breathlessness and a situation called heart failure. Heart failure is diagnosed when the heart is not able to pump enough blood for the requirements of the body - the muscles which keep us moving, the brain which keeps us alert, the intestines which help us digest the food we eat and then the vital organs like the kidneys and liver and the heart itself. If the heart is already having any disease - from previous heart attacks or heart muscle disease of any cause, for example, atrial fibrillation can offset the balance very quickly and make life miserable.

One of the reasons why the management of atrial fibrillation took a back seat is because there has not been much clarity on how to manage this rhythm disorder. Physicians and surgeons often get around managing this rhythm disorder by treating what is easily treatable - like opening up blocked arteries in the heart or replacing damaged valves. In the elderly, the risk of stroke because of atrial fibrillation can be somewhat mitigated by taking blood thinners.

However, when atrial fibrillation happens in the young, the patient as well as the physician is deeply concerned. We would want to make this rhythm disorder go away as quickly as it came. The risk of long term atrial fibrillation cannot be understated in a patient in his forties who has decades of productive life in front of him. Patients who continue to have atrial fibrillation are at risk of stroke, heart failure and heart attacks; much more than a healthy person of the same age. In addition, there is an additional risk from various other illnesses commonly associated with this rhythm disorder. These include high blood pressure, diabetes, renal failure, obesity and sleep disordered breathing (sleep apnea) and respiratory illnesses.

Why do young people get atrial fibrillation? But, why do some old people get this problem and not all of them? AF was considered a disease affecting mostly people in their eighth decade - beyond their 70th birthday. Ageing is associated with fibrosis - progressive damage of the muscle cells lining the atria - the upper chambers of the heart. There is also dilatation of the chambers and this makes the electrical conduction in the atrium go haywire. Instead of organised electrical activation where adjacent muscle cells are sequentially activated the damaged muscles result in new channels and by-routes for electrical activity resulting in grossly disordered and chaotic electrical activity. What results is that the muscle cells get repeatedly activated - often more than 250 times per minute in a totally disordered way. The atria instead of contracting nearly once per every second will no longer have orderly contraction - but just fibrillate - quiver like a bag of worms.

In India most lifestyle diseases start much earlier - so we see patients in their late fifties and early sixties with atrial fibrillation. These patients often have various associated illnesses like obesity, disordered breathing patterns during sleep, high blood pressure or ‘insulin resistance’ which is a precursor to diabetes. All these disorders are associated with hormonal and chemical changes (including activation of dormant genes) which are ultimately damaging to the muscle cells of the atrial chambers.

When AF happens in the young we look out for all the other diseases mentioned above. We often find there is obesity disordered respiration during sleep or poorly managed hypertension. The increasing incidence of AF in the young is clearly related to the growing prevalence of lifestyle diseases, poor diet and habits and stress. Young AF can be an early manifestation of some disease which ultimately affects the heart muscle in general ( cardiomyopathy). There are many genetic abnormalities of the conduction system of the heart - which can manifest with slow or fast heart rates and sometimes increased risk of sudden death. Early onset of atrial fibrillation means the doctor should rule out such diseases and keep the patient in follow-up to see if he develops other signs of a progressive heart condition which can result in heart failure or death.

Luckily, most young patients with AF have some correctable risk factors. The unlucky ones in this regard are those rare patients who inherit genes for AF. They often have young relatives with AF. Even in these patients medications and lifestyle changes have a positive benefit. In India, we find that obesity increases the risk of AF. There is associated hypertrophy of the muscle chambers of the heart with obesity and there is also increased sleep apnea in obese patients. High-intensity sports is known to cause paroxysms of AF. Endurance athletes like marathon runners have a higher incidence of AF compared to the general population. At the other end, in our population sedentary lifestyle, and lack of physical activity are associated with ‘insulin resistance’, poor muscle mass, increased body fat and a predilection for young age atrial fibrillation.

So what does a specialist doctor do when he encounters a young patient with atrial fibrillation? The first is to rule out structural heart disease like severe valve disease or heart muscle disease. Next would be to look for a more simple rhythm disorder called supra ventricular tachycardia ( SVT ) which can be easily treated permanently and which will avoid further AF. High blood pressure and hormonal diseases like hyperthyroidism and tumours of the adrenal glands are looked for. We investigate sleep apnea and secondary causes of obesity if the patient is overweight or obese. Genetic tests are rarely advised. The management of atrial fibrillation will largely depend on the underlying cause, the frequency and severity of the illness and a nuanced judgement on the use of specific medications or interventions. Not all patients require long term medicines or invasive procedures and in some cases, getting a long lasting cure - no recurrence of atrial fibrillation - is not possible.

Most young patients with AF have various comorbidities as mentioned previously. A few patients, especially with poor control of associated conditions or poor lifestyle have progression of the disease. The AF may become a permanent feature - all ECGs show the abnormal rhythm whether one has any symptoms from it or not. Such patients especially are at risk of stroke, heart failure and other complications from atrial fibrillation.

Can you prevent atrial fibrillation? The best way to prevent AF is to identify who is at risk and to give optimal care for them. This includes avoiding or reversing weight gain or obesity, maintaining good physical activity, eating a heart healthy diet. Among other things the strongest recommendation is for weight loss - A 10% weight loss is a reasonable goal which I suggest to patients who are overweight. While losing weight a protein-rich diet and physical activity to maintain optimal muscle mass may be beneficial. Regular physical activity of moderate intensity is associated with less risk of AF. Aerobic exercise regimens and Yoga have been shown to reduce the incidence of AF episodes. The importance of very good control of blood pressure cannot be understated. It's important that physicians target BP lowering aggressively and specific anti blood pressure medications may have additional benefits. Reduced salt consumption and compliance to medications is vital in preventing long-term recurrence. Treating sleep-disordered breathing ( sleep apnea) is an important strategy because sleep apnea is a strong risk factor for atrial fibrillation. Response to medications is also improved if sleep apnea is corrected. The information on diet and activity are from observational studies and what is good for the heart is good for atrial fibrillation.

A low-calorie, fibre-rich diet high on vegetables and fruits and less on sugary food including juices and processed food. A “Mediterranean diet’ rich in locally sourced vegetables and olive oil may reduce the risk of AF.

Studies on fish-derived omega 3 fatty acids or vitamin D did not show significant benefits in large studies. Abstinence from alcohol is beneficial in persons who are used to moderate consumption, while alcohol binges have been definitely associated with an increased risk of new onset and recurrent atrial fibrillation. Alcohol is considered the most common precipitant of discrete AF episodes. Smoking is considered a risk factor and smoking cessation is strongly advised to prevent AF and other heart conditions. It is generally recommended without much evidence, that caffeine intake can increase the risk of atrial fibrillation. However, most studies have not shown a clear detrimental effect.

(Dr. Anees Thajudeen is a Senior Consultant in the Department of Cardiology and Electrophysiology at KIMSHEALTH Trivandrum)