HEADLINES / TRENDS l STATS l RESEARCH l MEDIA l PEOPLE

February 2013

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Blood Pressure Rising in Children

In a trend that mirrors the significant increase in childhood obesity seen in recent years, the number
of children suffering from high blood pressure has risen sharply—a danger of which parents aren’t
always aware.

“Pediatric hypertension is under the radar,” says Ernesto Schiffrin, MD, PhD, American Heart Association spokesperson and physician-in-chief and chair of the Sir Mortimer B. Davis Jewish General Hospital Department of Medicine and vice chair of medicine at McGill University, both in Montreal.

A study published last year in the journal Hypertension looked at inpatient treatment for pediatric hypertension. Researchers from the University of Michigan examined hospital discharge records for children over a 10-year period. The team found that hospitalizations related to high blood pressure nearly doubled from 12,661 in 1997 to 24,602 in 2006. Inpatient charges went up an estimated $3.1 billion over that time span, an increase of 50%.

Obesity was found to be one of the most common secondary diagnoses. Schiffrin says hypertension mostly affects children age 9 and older, “which correlates with the increased prevalence of obesity.”

Schiffrin thinks continuing research is helping to dispel the “myth that pediatric hypertension is different from adult hypertension.” He explains that doctors have long thought children only suffered secondary hypertension, blood pressure that increases in response to an underlying disorder such as adrenal or kidney problems. “As our knowledge has increased, we understand that an increasing number of kids have primary hypertension that will track into adulthood,” he says. “This paper is quite significant in that sense.”

Unlike adults, for whom there is a specific pressure-reading cutoff indicating the presence of high blood pressure, determining hypertension in children requires taking the child’s age, gender and height into account. It also “takes some care to get an accurate blood pressure in a child. They need the right-sized cuff, so you have to have the right equipment,” says Sarah de Ferranti, MD, MPH, director of the Preventive Cardiology Clinic at Boston Children’s Hospital. “Once you get a number you feel is reliable you need to see what is normal for that child.”

The concern about an early blood pressure rise is how it affects a child’s health over the long term. “The concern is that we’re going to see increasing rates of stroke, heart attack, kidney failure, arrhythmias. It’s hard to know exactly what consequences are going to occur; that would require
a long study with lots of kids,” says de Ferranti.

What’s a parent to do? First, “look at the amount of salt they’re serving their kids, not just at the table but the hidden salt in packaged foods,” de Ferranti notes. What’s more, “Parents should promote physical activity within the family. It doesn’t have to be varsity-level sports—just get everyone out and active.” Schiffrin says the AHA has a number of programs to improve eating habits in children, including changes in school lunches—more fish, fresh produce and low-fat dairy—but that parents “have to be a good role model—that’s critical.”

“Pediatric hypertension has huge human and economic impact,” says Schiffrin. “It is a major, although unrecognized, public health issue.”

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CoQ10 Helps Heart Failure Patients

People with heart failure suffer from poor circulation caused by a heart that doesn’t function properly. But a recent study indicates that coenzyme Q10 (CoQ10) can help boost the heart’s pumping power.

Scientists at the Tulane University School of Medicine analyzed data from clinical trials in which participants received CoQ10 for up to 24 weeks. Dosages ranged from 60 to 300 milligrams per day.

Supplementation was found to be associated with a 3.7% improvement in left ventricular ejection fraction, a measure of how well the heart can pump blood throughout the body.

“Congestive heart failure is a leading cause of morbidity and mortality in the United States and worldwide. The findings of this meta-analysis suggest that supplementation with CoQ10 may be of benefit in patients,” the research team wrote in the American Journal of Clinical Nutrition. “To our knowledge...our meta-analysis was the most comprehensive, with 13 studies.” The team noted that the greatest benefit was found in people with less severe disease progression.

According to the American Heart Association, 5.7 million people in the US have heart failure, and the rate is rising as the population ages. The circulation problems associated with this condition can lead to fatigue, dizziness and weakness. Edema, or fluid accumulation in the body’s tissues, can develop if blood backs up in the veins.

High blood pressure is present in 70% of all heart failure patients. Other underlying conditions include heart attack and coronary artery disease, or blockages in arteries feeding the heart.

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B Vitamins May Drop

Colorectal Cancer Risk

Increased intakes of two members of the B-vitamin complex—riboflavin (B2) and pyridoxine (B6)—have been linked with risk reductions for colorectal cancer, the third leading cause of cancer-related deaths in the US.

A multinational research team led by the Fred Hutchinson Cancer Research Center in Seattle looked at data taken from 88,045 postmenopausal women participating in the Women's Health Initiative Observational Study. More than 1,000 cases of colorectal cancer developed over the course of the study.

“Vitamin B-6 and riboflavin intakes from diet and supplements were associated with a decreased risk of CRC,” wrote the team in the American Journal of Clinical Nutrition. The associations “were particularly strong for regional disease [cancer that had spread to adjacent tissues] and among women drinkers who consumed alcohol infrequently.”

The highest average intakes of riboflavin and pyridoxine were linked to a 20% reduction in risk compared with the lowest intakes.

The team also noted that less-than-adequate amounts of either vitamin “leads to the accumulation of
homocysteine, a metabolite strongly linked with colorectal cancer.” High levels of homocysteine, which is produced as a result of amino acid metabolism, has also been linked to cardiovascular problems and an increase in bone fracture risk.

The American Cancer Society estimates that 143,460 new cases of colorectal cancer occur in the
US each year. In addition to increasing age, risk factors include family history, a personal history
of either colorectal cancer or inflammatory bowel disease, obesity, inactivity, smoking and heavy alcohol use.

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RESOURCE

Mended Hearts

Its Mission:

Providing patient-to-patient support for people with heart disease who

face “lifestyle changes, depression, recovery and treatment”


Contact: www.mendedhearts.org

888-432-7899

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Scent-sing True Love

Looking for that special someone come Valentine’s Day? You may want to sleep on it, as long as you have a T-shirt handy.

Forget speed dating or singles websites—the latest path to lasting romance among hip lonelyhearts is the pheromone party. Pheromones are chemicals that indicate sexual availability. First discovered in insects, these substances also exist in other animals, including people. But while the link between pheromones and mating behaviors is direct among moths—males flutter with joy when they get a whiff—scientists say things get more complicated as you move into higher mammal territory.

That hasn’t stopped people from trying to make the connection, which explains the pheromone party
phenomenon. For three nights, partygoers sleep in clean T-shirts that are then frozen in sealed bags to set the scent. At the party each bag is given a number and a gender indication; participants inhale from the bags to sniff out their best match, which is revealed at the end of the evening.

“This type of event really allows us to use another part of our sensory stimuli to aid in the attraction process,” says Shannon Chavez, PsyD, of SHE: Sexual Health Experts (www.SHEmd.com). “The pheromone can evoke an emotional response.”

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W O R D

Arrhythmia

An abnormal heartbeat—too fast, too slow or irregular—caused by
problems with the heart’s electrical system.
Most arrhythmias pose no danger but some can have serious,
even life-threatening, consequences if not treated.

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U P D A T E

Back Pain: Fewer Scans,

More Acupuncture

In “Back Pain Relief” (September Malady Makeover), we learned that not all practitioners favor automatic imaging studies after back injuries and that acupuncture can bring relief.

Recent research supports both points. The journal Spine published a study of data from 1,226 workers who hurt their lower backs. The one in five who underwent MRI scans within six weeks after injury were twice as likely to be on disability at one year as those who didn’t get scans. The study team blamed overtreatment, calling it a “cascade of care.” And an Archives of Internal Medicine study found that acupuncture outperformed placebo treatments in nearly 18,000 patients. Many had chronic back woes; others suffered from arthritis, migraines or shoulder pain.

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