HEALTH NEWS YOU CAN USE

Manila, June 10, 2003 By Tyrone M. Reyes, M.D., (STAR) Medical progress continues to move so rapidly that it is sometimes hard to catch up with what’s new in the health field. It is also at times quite difficult to look at the large volume of medical information being made available every day and to decide which ones are useful and which ones are of no practical value.

Here are my choices of recently available new health information, culled primarily from medical journals, which I believe are important to know to keep ourselves in continued good health.

THE LOWDOWN ON HIGH BLOOD PRESSURE

There’s a new message for the millions of people whose blood pressure is just a little bit high. Your chances of having a heart attack, heart failure, or a stroke are greater than you may think.

A "normal" blood pressure reading is 129/84 or below, with the first number measuring the force of blood on the arteries when the heart is contracted, and the second number measuring the pressure with the heart at rest. A "high" reading – indicating hypertension – is 140/90 or above. Hypertension is a clear warning signal for heart disease, but recent results from the Framingham Heart Study show that men and women over age 35 whose blood pressure readings fall between normal and high are also at risk.

Government-sponsored researchers have been gathering data on residents in the Boston suburb of Framingham since 1948. They learned of the risks for those with "high-normal" pressure by following 6,859 heart-healthy people whose readings ranged from high-normal to "optimal" (which is even better than normal – less than 120/80). After 12 years, 397 of them either died of heart disease or had a heart attack, heart failure or stroke. By analyzing the blood pressure data of the victims and of those who stayed healthy, the researchers determined that the chances of a woman suffering a heart attack, heart failure or a stroke in a 10-year period rises from 2.8 percent with normal blood pressure to 4.4 percent with high-normal blood pressure. In men, it goes from 7.6 to 10.1 percent. And the risk sharply rises with age.

The Framingham findings should prompt more people to bring their blood pressure down to normal. Recommended action includes weight control, and cutting back on dietary fat, cholesterol and sodium.

NOT-SO-SWEET WARNING VS DIABETES

About half of people with undiagnosed diabetes will suffer permanent damage to nerve endings, blood vessels, or organs in seven to 10 years before the first symptoms appear. But diabetes that’s caught early can often be controlled, or even reversed with diet, exercise and other lifestyle changes – without the lifelong need for insulin or other drugs. So diabetes specialists have begun using tougher screening standards to detect the disease at the earliest stage possible.

The new guidelines, established by the American Association of Clinical Endocrinologists, apply to people who are at elevated risk for diabetes and related complications: Those with a family history of the disease, women who had gestational diabetes during pregnancy, members of some minority groups, people who are obese, or those with high blood pressure, heart disease or high triglyceride levels.

Such people at high risk for diabetes are now advised to have a fasting blood sugar test at age 30 instead of age 45, as was previously recommended. This test measures the amount of glucose per deciliter of blood. A normal reading is below 110. Anything higher suggests that diabetes may be developing.

Another key test is the A1c blood test, which gauges long-term glucose control in people who already have diabetes. According to new standards, a normal reading is less than 6.5 percent, down from seven percent previously. Lowering elevated A1c by even one percentage point reduces the risk of diabetes complications by 25 percent, says Claresa Levetan, M.D., co-chair of the committee that revised the guidelines.

COUGHING UP THE TRUTH ABOUT COUGH MEDICINES

When you’re coughing so hard that you feel as though you might break a rib, your first instinct is probably to toss back some cough syrup. But according to new research, it’s unlikely to make much of a difference. That’s the conclusion of British scientists who reviewed hundreds of scientific studies on over-the-counter cough medicines.

There are two main types of cough medicines. Antitussives, for "dry" coughs, usually contain dextromethorphan, a relative of codeine that suppresses coughs. For so-called productive coughs, there are expectorants. They contain guaifenesin, which dilutes mucus, making it easier to expel from the lungs.

Researchers at England’s University of Bristol looked at 328 studies on both types of cough medicines. They found that only 15 of the studies were randomized, controlled trials – the gold standard of scientific research – in which medicines were compared to placebos (dummy treatments) and the participants didn’t know which one they were receiving. Of these 15 studies, nine showed that cough syrup was no more effective than a placebo. The remaining six studies did show that cough medicines make a difference, but just barely: Patients who took them might have coughed one or two fewer times a night, an improvement that hardly justifies the cost – or the bad taste – of the cough medicines, says Knut Schroeder, M.D., a researcher at the university.

Not surprisingly, pharmaceutical companies vehemently dispute the validity of the study. They argue that an abundance of existing research has favorably compared cough syrups to codeine, a proven cough remedy. Because they weren’t placebo-controlled, these studies were excluded from the British review.

Cough syrup won’t do any harm, so if you feel it helps, there’s no reason not to use it. But if over-the-counter medicines aren’t effective, you might want to drink plenty of water (it moisturizes the throat, reduces irritation and helps flush cough-causing germs from the body), get plenty of rest (vigorous activity can make coughs worse), take honey and lemon (you can mix them in hot tea or stir them into a glass of water), or simply wait it out (most cough will disappear within two to three weeks). Of course, for severe cough or if it is accompanied by fever, see your doctor to make sure you don’t have a more serious medical problem.

FACING BACK PAIN

Ohio State University researchers have found a good reason why people with previous back problems so often suffer back injuries. It turns out that just about everything the typical back patient does for back protection is exactly wrong. The researchers asked people with healthy backs to do a number of lifts, and then analyzed the biomechanics of the movements involved. These observations determined that people tend to compensate for their injuries by using too many muscles – and the wrong ones to boot. For example, they may protect the injured part of their back by using muscles in the abdomen and sides as well as uninjured parts of the back, when they’d normally use a muscle from the injured area.

That sounds like a reasonable thing to do, but it’s actually self-defeating, says William Marras, Ph.D., the Ohio State University biomechanics researcher who led the study. That’s because the more muscles you use, the greater the load you’re putting on the spine. The group with injured backs use twice as much twisting force on their spines and one-and-a-half times the compressive force as the healthy group doing the same lifts. Over time, that extra spinal load can cause more back problems.

It pays to follow proven back-protection tips. Those include using your legs when you lift, not bending at the waist or leaning down and forward to lift, and strengthening your midsection muscles. But the latest research suggests some new dos and don’ts:

• Avoid repetitive lifting regardless of the weight involved. Cumulative wear and tear cause more back injuries than single heavy lifts.

• Bend sideways carefully. Rapid bending to the left and right leads to back problems.

• Twist slowly. Quick rotation at the torso stresses your spine.

• Don’t lift at all if it’s too painful. You’ll probably adjust by using the wrong muscles, inviting more back problems in the future.


Reported by: Sol Jose Vanzi

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