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“Statins Aren’t the Only Way to Lower Cholesterol” plus 9 more Health – TIME


“Statins Aren’t the Only Way to Lower Cholesterol” plus 9 more Health – TIME

Statins Aren’t the Only Way to Lower Cholesterol

Posted: 27 Sep 2016 08:44 AM PDT

Statins are the perfect example of a blockbuster drug; they’re extremely good at lowering cholesterol levels and reducing risk of heart events, they’re relatively safe to take, and they’re widely prescribed, since heart disease continues to be the leading killer of Americans.

But statins aren’t the only way to lower cholesterol. Others include changing diet, having surgery to shorten part of the intestines or taking different drugs. How do statins compare to these?

In a new report published in JAMA, Dr. Marc Sabatine, a cardiologist at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, and his colleagues scanned 49 trials involving nine different ways to lower cholesterol in more than 300,000 people to find out. The cholesterol-lowering strategies fell into four main groups: statins, which work by reducing the amount of cholesterol made in the liver and increasing the liver’s ability to pull LDL cholesterol out of the blood; other strategies that work similarly to statins but aren’t statins, such as diet and the drug ezetimibe; fibrates and niacin, which increase HDL levels and in turn lower LDL levels in the circulation; and the newest class of cholesterol-lowering drugs, PCSK9 inhibitors, which, like statins, increase the liver’s ability to clear LDL from the blood through a different gene.

Sabatine found that the statins and the drugs that work like statins, but aren’t, both reduced the risk of heart events by about the same amount: for every 40mg/dL drop in LDL, there was about a 23-25% reduction in the risk of a heart attack, stroke, need for interventions like a stent or death from heart disease. The fibrates and niacin—which haven’t been as popular in recent years because some studies haven’t shown they can reduce heart events appreciably—also showed some benefit, but not as much as the statins and the strategies that work like statins. (In fact, the Food and Drug Administration recently withdrew approval for these agents in combination with statins to lower cholesterol.) The newest drugs, the PCSK9 inhibitors, also showed benefit, but since they were only recently introduced on to the market, there haven’t been enough long-term studies to solidify their benefit in comparison to statins.

The results are enlightening, given that in 2013, the American Heart Association and the American College of Cardiology—the country’s leading heart health organizations—revised their recommendations for treating cholesterol and shifted attention away from a target LDL, instead focusing on lowering cholesterol by any amount, from whatever baseline, to reduce risk of heart disease. In doing that, they put a greater emphasis on statins as a first-line therapy to reduce cholesterol. As a result, statins have become the go-to drugs for cholesterol and the only ones many doctors, especially primary care physicians, rely on to help their patients keep their LDL in check.

“If you look at older versions of the guidelines, there was a focus on getting LDL cholesterol down through a series of different options,” says Sabatine. “Then there was a pivot away from that and an intense focus on statins, which are great drugs and highly effective. But these data remind us that we need to focus on treating the risk factor, which is high cholesterol, and think about what the right tools are for doing that.”

The findings should provide hope for people who can’t tolerate statins or are worried about the rare side effect of muscle weakness linked to the drugs. Sabatine also says that as data continue to show that lower is better when it comes to LDL, the results may also inform doctors about how to add other non-statin therapies to statins in order to help people achieve much lower levels than are currently recommended. That may finally start to lower rates of heart disease and drop deaths from heart attacks as well.

“In our country the average LDL is 120 to 130 mg/dL, but that doesn’t mean it’s normal,” he says. “In studies of hunter-gatherer populations where there is virtually no coronary disease, LDL is around 25 to 50mg/dL. So there is a need to sort out the relationship for what LDL levels should be, but all of the data so far support the benefit of lowering to levels far lower than we current consider normal.” At least these results show that we may have several options for achieving that.

Why U.S. Women Still Die During Childbirth

Posted: 27 Sep 2016 08:14 AM PDT

More U.S. women are dying from pregnancy or childbirth complications today than in recent history, causing alarm stateside as maternal mortality drops worldwide.

The United Nations set a goal to reduce the global maternal mortality rate by 75% between 1990 and 2015, and while most nations succeeded in lowering that number, the U.S. has experienced an uptick in recent years. A report published in the September issue of the journal Obstetrics & Gynecology found that from 2000 to 2014, the maternal mortality rate for 48 states and Washington, D.C. increased 27% from close to 19 deaths per 100,000 live births to close to 24 deaths per 100,000 live births. In Texas, the rate doubled between 2010 to 2012.

Another recent report from the Institute for Health Metrics and Evaluation reported a rise in the U.S. maternal mortality rate since 2000 (with a slight drop in the past two years), and a 2015 report from the World Health Organization (WHO) pointed out that the U.S. has a higher maternal mortality rate than Iran, Libya and Turkey. The WHO determined that half of the U.S. deaths were preventable.

“This is a really important issue,” says Marian MacDorman, author of the Obstetrics & Gynecology study and a research professor at the University of Maryland. “These are deaths of young women with families and often young children who need care.”

Here’s what may be at play:

Record keeping problems: National data on maternal mortality is inconsistent, and some health authorities argue that the uptick in maternal deaths is at least partially due to improved detection of pregnancy-related deaths. However, MacDorman says the 27% increase observed in her study is a true rise in maternal deaths, rather than a reporting issue.

More American women are obese: America’s growing obesity problem is a factor. There’s also a growing number of pregnant women in the U.S. with chronic health problems like high blood pressure, heart disease, and diabetes—all of which put women at a greater risk for complications during pregnancy. According to the CDC, heart-related problems make up a substantial portion of pregnancy-related deaths.

Access is inconsistent: Between 2000 to 2015, Texas saw a spike in maternal mortality while the state also underwent changes to reproductive health services, including the closure of several clinics offering abortions and other services. In 2011, the state’s family planning budget was cut by two-thirds. Experts say the lack of access is probably not solely responsible for the state’s dramatic spike in deaths, but as The Texas Tribune reports, it may have exacerbated the issue. “I’ve done my best to try to investigate this as a data error and I can’t find any changes to account for it,” says MacDorman. “It’s very concerning what’s happening in Texas.”

Racial disparities persist: Black women in the United States are up to three times more likely to die in pregnancy and childbirth compared to white women. While they are not significantly more likely to develop conditions like hemorrhage and preeclampsia—which threaten a women’s health during childbirth—they are more likely to die from them.

Rise in cesarean births: The rates of c-section deliveries among American women rose 53% from 1996 to 2007, now accounting for 32% of births. “Cesarean has its place, and it has saved the lives of mothers and babies,” says Dr. Michael Lu, an associate administrator with the Maternal and Child Health Bureau at the Health Resources and Services Administration. “But cesarean has its complications and these can increase the risk of maternal death.” C-sections require intensive surgery, and are associated with higher health and safety risks for mothers and infants.

Women are having children later: Lu says older women are at a greater risk for maternal mortality, with a couple caveats. “It’s not clear whether it’s age, or that older women have more chronic conditions when they enter pregnancy,” he says. “The demographic of childbearing is changing. Women are getting older and they are entering pregnancy with more conditions like obesity, diabetes, and heart disease.” To combat the problem, Lu says his department is focusing on improving the health of women before they get pregnant, and improving the quality and safety of maternal health care nationwide.

World’s First Baby Born With DNA From Three Parents

Posted: 27 Sep 2016 08:06 AM PDT

In a world first, a baby has been born with DNA from three biological parents.

Five-month-old Abrahim Hassan’s Jordanian parents, Ibtisam Shaban and Mahmoud Hassan, were treated by a U.S. team based in Mexico using a controversial technique that allows parents with rare genetic mutations to have healthy babies, the New Scientist reports.

Shaban carries genes for Leigh syndrome, a rare genetic disorder characterized by the degeneration of the central nervous system; the brain, spinal cord, and optic nerve. Although she is healthy, Shaban’s first two children died because of Leigh syndrome, so she sought out the help of the New Hope Fertility Center in New York.

Doctors at the center carried out a ‘spindle nuclear transfer’, where they removed the nucleus from one of Shaban’s eggs and inserted it into a donor egg which had had its nucleus removed. The resulting egg was then fertilized with Hassan’s sperm. An embryo was then implanted in Shaban – and, nine months later, Abrahim was born.

When Abrahim was tested for Leigh syndrome, they found less than 1% of his mitochondria (tiny structures found in cells) carried the mutation. He will continue to be monitored by doctors to make sure the levels remain as low. “Generally it is thought to take around 18% of mitochondria to be affected before problems start,” says the New Scientist.

Kids Who Grew Up on Farms Have Fewer Allergies: Study

Posted: 27 Sep 2016 07:38 AM PDT

People who grow up on a farm tend to have lower allergy risk than their rural and urban counterparts, according to new research.

Researchers behind the study, published in the journal Thorax, evaluated data from more than 10,000 people living in 14 countries. Adults who grew up on farms were less likely to respond to allergens and have nasal symptoms of allergies, according to the study. These adults were also 54% less likely to have asthma or hayfever.

Researchers remain unsure what drives the correlation between spending childhood on a farm and the development of allergies, though they speculated that exposure to certain microbes, air pollution and physical activity could all play a role.

The study also suggests a correlation between lung strength and growing up a farm. Women who lived on a farm before age 5 consistently had stronger lungs as adults. The correlation was not significant in men.

Cancer Death Rates Vary Among Asian Ethnic Groups, Study Finds

Posted: 27 Sep 2016 05:45 AM PDT

A study of cancer mortality rates and trends among Asian Americans has revealed that specific ethnic groups face higher rates of some cancer types.

Researchers obtained data on 85,616 cancer-related deaths from 2003 to 2011 from the National Center for Health Statistics for the study, which was published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research. They examined the mortality statistics by cancer type, sex, and ethnicity (divided into Asian Indian, Chinese, Filipino, Japanese, Korean and Vietnamese).

As well as determining that there is generally a lower cancer death rate among Asian Americans than non-Hispanic white people, specific cancer rates were shown to differ between the various ethnic groups. Stomach cancer, for example, accounted for 10-15% of Korean cancer deaths and 5-10% of Chinese, Japanese, and Vietnamese cancer deaths.

Breast cancer death rates were significantly lower among most Asian American women than non-Hispanic white women, however they were higher among those of Filipino and Asian Indian descent.

Lung cancer was identified as the leading cause of all cancer-related deaths among Asian American men, with a modest increase in lung cancer deaths found among Chinese, Filipina, and Japanese women specifically.

Caroline A. Thompson, an assistant professor of epidemiology at San Diego State University and the study’s lead author, believes these results show that Asian Americans in the U.S. would benefit from ethnic-specific cancer prevention efforts.

“For patients, it’s important to understand your risk profile and to consider cultural, lifestyle, or modifiable health behaviors that might increase your risk of cancer,” she said.

In recent years, Asian Americans have surpassed Hispanics as the most rapidly growing racial or ethnic group in the U.S. There are currently 17.3 million living in the U.S., representing 5.6% of the population. By the year 2050, the U.S. Census Bureau estimates the Asian American population will exceed 40 million.

Concussion Diagnoses in Teens Hit a Record High

Posted: 27 Sep 2016 04:01 AM PDT

Diagnoses of concussions rose to a record high between 2010 and 2015, particularly among teens, according to a new report published by Blue Cross Blue Shield Association.

The insurance company reports that more than 936,000 claims were filed for diagnosed concussions among its members, and that rates for adolescents between age 10 and 19 surged 71% during that time, while rates for adults increased by 26%. Most of the teen spike is due to sports, especially football, since rates increased sharply during the sport’s fall season, according to the claims data. Much of the increased diagnosis can be tied to heightened awareness of concussions and the health effects of brain injury, after states enforced laws requiring athletes who experienced brain injuries to obtain medical clearance before resuming practice or play in a game, the study authors say. Teens were five times more likely to be diagnosed with a concussion than all other age groups combined.

While adolescent males are more likely to be diagnosed than females, rates of concussions among adolescent females is also climbing, increasing by 118% during the last six years compared to a 48% rise among males.

The data also revealed that the number of people experiencing post-concussion syndrome, which include headaches and dizziness that can last for weeks after a concussion, doubled during the study’s time period.

The data suggest that new laws are raising awareness of the dangers of concussion, and that more younger people are getting evaluated for concussion and post-concussion symptoms after a head injury. Such awareness, say doctors, is critical to continuing to provide proper care for concussions and limiting their potential long-term health effects, which can include serious neurological damage.

Unsafe Air-Pollution Levels Affect 9 in 10 People Globally, Report Says

Posted: 26 Sep 2016 09:05 PM PDT

More than 90% of the world’s population lives in areas with unsafe pollution levels, according to a new report.

The research, conducted by the World Health Organization (WHO), underscores the growing risk that air pollution poses to virtually every demographic group across the globe. More than 6 million people died in 2012 from ailments related to air pollution, according to the WHO.

“Air pollution continues take a toll on the health of the most vulnerable populations — women, children and the older adults,” said Flavia Bustreo, WHO assistant director general, in a statement. “For people to be healthy, they must breathe clean air from their first breath to their last.”

Read More: Global Air Pollution Is on the Rise Despite Decades of Efforts to Stop It

The study incorporates data on levels of particulate matter, a mixture of tiny particulates that make up pollution, in 3,000 cities and towns across the globe. Unsafe air-pollution levels hit every region tracked, but some areas are worse off than others. Residents of Africa, Asia and the Middle East tend to face the worst pollution, according to the report. High-income countries also tend to be far better off than their low- and middle-income counterparts, where 90% of global deaths occur.

Still, not everyone in the developed world lives with clean air. Around 15% of cities in high-income cities in the Americas, including places like Los Angeles and Manhattan, fall short of WHO standards, according to the report. In Europe, more than 60% of high-income cities fall short including Paris and London.

Read More: How Air Pollution Contributes to Millions of Early Deaths

The trend lines on air pollution depend on where researchers look and what kind of pollutant they evaluate. Particulate-matter pollution has declined in recent decades in most developed countries, though it remains present at unsafe levels. Nitrogen oxide, another toxic pollutant, has become more prevalent in the developed world particularly Europe thanks to the rise of diesel vehicles. In developing countries, levels of particulate matter continue to increase in line with economic and industrial growth, and the rise in car ownership

The body of research on the health effects — and subsequent economic effects — of air pollution has grown in recent years as scientists have uncovered the way even small amounts of air pollution influence everything from pregnancy to brain functioning.

Honey May Be a Natural Way to Beat Bacteria

Posted: 26 Sep 2016 03:30 PM PDT

A type of honey from New Zealand may be able to beat back bacteria, a new study found. If proven effective, the honey could potentially be used to lower the risk for infections among people using medical devices like catheters.

Manuka honey has been used for centuries as a natural remedy, and has been shown in the past to have antibacterial and anti-inflammation effects. In the new study, published Monday in the Journal of Clinical Pathology, researchers looked at whether the honey could prevent bacteria from building up on surfaces, too.

Medical devices that go inside a person, like a catheter, can develop biofilms—a layer of bacteria that can attach to surfaces. The problem is that these biofilms can become infection reservoirs, causing health complications. Around 100 million catheters are sold globally every year, and they are associated with health risks like urinary tract infections. To assess Manuka honey’s potential to lower this risk, the researchers tested its effect on two types of bacteria commonly known to cause UTIs from catheter use: Escherichia coli (E.coli) and Proteus mirabilis. The study authors say E.coli is the cause of 80%–85% of urinary tract infections.

The researchers diluted the honey to different levels and tested its ability to combat bacterial buildup on plastic plates in a laboratory. They found that the honey inhibited the bacteria’s ability to develop into a biofilm, even at the lowest concentration levels. More research will be needed before it’s determined whether honey could work to prevent bacteria buildup on catheters in people.

The researchers write that while there’s substantial evidence that Manuka honey could have therapeutic benefits, but that its potential role in medicine has not been proven in research. However, the study authors argue that the honey doesn’t react worse than other compounds that might be used instead. “In fact, no drug or dressing receives ringing endorsement, suggesting that the field is under-investigated or difficult to address,” the authors write.

Another bonus for honey, according to the researchers, is that so far, studies suggest bacteria develop a resistance to honey. Antibiotic resistance is a major problem worldwide. Bacteria can naturally become resistant to drugs used to treat it, and widespread use of antibiotics through the years in medicine and agriculture have contributed to the problem.

How Exercise Helps You Age Better

Posted: 26 Sep 2016 02:00 PM PDT

There’s even more reason to exercise, especially as you get older. While study after study confirms the benefits of physical activity for the heart, mind and body, many older adults do not follow a regular exercise regimen. The findings of a new study may compel them to change, though.

In a study published in the Annals of Internal Medicine, researchers led by Dr. Thomas Gill, a professor medicine at Yale University School of Medicine, followed more than 1,600 elderly adults who were mostly sedentary at the start of the study. Gill had half of them start a walking and strength and balance training regimen, and by the end of the study, the results were clear: people who exercised spent 25% less time disabled or injured than those who did not.

“The benefit wasn’t just limited to preventing initial onset of disability but was also effective in promoting recovery after a disability,” says Gill. “Then, once the recovery occurred, the intervention was effective in preventing subsequent episodes of disability.”

That’s important for seniors, he says, since most previous studies looking at exercise’s benefits only focused on whether physical activity could prevent disability. But since most elderly spend time cycling in and out of periods of immobility, the latest results show that exercise can also help them reduce the time spent with limited activity and independence.

“This demonstrates that a physical activity program really has continued, sustained benefit over an extended period of time,” says Gill. The exercise could be working to build up a reserve capacity that makes them fitter and stronger and therefore better able to bounce back after injuries like falls or illness. That means they might be able to recover more quickly if they do experience a blow to their health.

The results were especially encouraging since even though all of the participants had some limitations in their activity, including impairments in balance, their gait or muscle strength. Many also had chronic illnesses that required multiple medications and therefore represented about 50% of Americans in their age group.

“People can change their lifestyle to build in physical activity into their weekly schedule,” says Gill. “And then they can accrue those benefits. And even in the event of serious illness or injury that leaves them disabled, they still have a high likelihood of recovery. We hope that will provide additional incentives for older persons and their families, as well as physicians, to more aggressively recommend the benefits of physical activity in this population. It’s probably the single best mechanism for them to maintain their independence.”

CDC Investigates E. Coli Outbreak Linked to Ground Beef

Posted: 26 Sep 2016 01:08 PM PDT

The Centers for Disease Control and Prevention opened an investigation into a multi-state E. coli outbreak linked to ground beef from the Massachusetts-based Adams Farm Slaughterhouse.

The slaughterhouse recalled beef, veal and bison after 7 people across four states reported E. coli infections that were traced back to the facility, the CDC announced on Saturday. Three people were infected in Massachusetts, while 2 cases were reported in Connecticut. Pennsylvania and West Virginia each had 1 case of the infection.

Five people have been hospitalized so far, the CDC said. Interviews with infected people revealed they had eaten ground beef from Adams Farms Slaughterhouse in the week before they became sick.

The recalled products were shipped to farmers’ markets, retail locations and restaurants in Massachusetts, Connecticut and eastern New York, and some products may have been shipped to neighboring states, the CDC said in a statement.

Those who bought packages of meat with the affected case codes should safely throw the meat out or return it to the seller, the CDC advised.

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