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Obesity, which is believed to be linked with dietary fat, high, and typical Western, has been commonly associated with hypertension, especially in the African American population.



For the study, David M Pollock and colleagues at the Medical College of Georgia, Augusta, GA tested the effect of the high-fat diet in the tension of Dahl salt-sensitive rats.



The rats were monitored for their bad blood pressure (MAP) for a week before and during 4 weeks of eating a high fat diet (fat 36 per cent). The salt-resistant rats were used as controls.



In a high-fat diet for a period of 4 weeks, the salt-sensitive rats experienced a surge in the 125-MAP-line background mmHg to 150 mmHg while the controls did not experience any significant increase in MAP: 102 bottom line mmHg to 109 mmHg after against fat diet, high and 4 weeks.



The high-fat diet also did the salt-sensitive rats more susceptible to the effects of environmental stress in tension. TRACE in rats in the high-fat diet was 38.7 mmHg compared to 22.5 mmHg in those on a normal diet.



The results along with additional research support the hypothesis that "a high-fat diet contributes to hypertension and an exaggerated response of stress in rats genetically susceptible." the authors wrote in their report.



At the same conference, a new Italian study led by Dr. Rosa Maria Bruno of the University of Pisa found that vitamin C can be delivered intravenously to lower the tension by as much as 7 percent.



Another new Italian study also presented at the exhibitions of the conference that about half of people with excessive weight to the stage 1 hypertension or high blood pressure can achieve its voltage normalized by losing just 5 to the weight of 12 per cent and standardize their BMI.



The study was conducted by Roberto Fogari and colleagues at Universita 'di Pavia in Pavia, Italy.



The researchers meant to assess the role of weight loss in value of tension in people with excessive weight of stage 1 hypertension who had never received any medicine to treat his hypertensive condition.



The study involved 189 people from excessive weight (BMI 25 to 29.9 kg/m2) with stage 1 patients with hypertension (SBP tension = 140-159 mmHg or systolic and diastolic tension or DBP 90 - 99mmHg). The participants were given nutritional advice I 120 to 360 mg of Orlistat per day to achieve a 5 percent loss in weight in 6 months.



Those who successfully lost the weight concentrated in 5 percent of the treatment continued for another 6 months and the stress and weight was measured every month. At the bottom line, 6 and 12 months of treatment, ambulatory 24-hour tension was evaluated and blood samples were drawn to test leptin plasma renin and aldosterone assets.


The researchers found that 111 participants or 59 percent of the subjects of the study achieved a reduction of 5 percent in weight.



Has found that those who lost their targeted amount of weight experienced a significant drop in SBP and DBP (-6.9 and -4.2 percent respectively) and high weight loss resulted in the reduction in high tension.



Among those who managed the loss of 5 percent in weight, fifty three or 48 percent normalized their BMI and 28 of them or 53 percent normalized their tension.

FDA Considers the Risks of Mobile Medical Apps

As technology continues to advance, just about everything is becoming more readily available. Ask and you shall receive. In fact, just imagine something you may have never thought possible and there’s an app for that, or will be in the near future.
If you have an iPhone, iPad, Android, PDA or any other mobile device, you may have come across new medical apps such as iHealth’s Blood Monitoring System or AirStrip Technologies’ AirStrip Cardiology app. These are the types of products that the FDA will be reviewing in order to determine whether or not they need to be more closely monitored.
The agency plans to regulate only a small subset of mobile medical apps that present the greatest risk to patients. More specifically, any applications that market the diagnosis, cure, treatment or prevention of a disease or other condition will be more closely reviewed. The guidelines also indicate that applications that require patient-specific information are highly likely to be part of that subset.
Some of these products act as an accessory to medical devices used by doctors or transform a mobile device into a regulated medical device with the use of attachments or adapters. Others give patients medical advice based on specific data that is entered into the application. For example, WellDoc’s Diabetes Manager functions as a virtual coach for type 2 diabetes patients. Users are prompted to log their medication, carbohydrate intake, and blood glucose in order to receive reminders as well as recommendations regarding their health.
The FDA recognizes the possible risks that these types of applications may create. Devices do not always work properly. Results could get mixed up. Although many of these applications are supposed to provide the analyses that doctors would traditionally provide, those recommendations might not always be right. Therefore, the FDA has a duty to current, as well as prospective, patients to evaluate these applications and their intended functions.
Guidance documents for these regulations are still being reviewed and the agency is welcoming feedback from the public for the next 90 days.

Daily Diet: Accuracy of Menu Calorie Counts Challenged

The old adage “Let the buyer beware” is now applicable to the stated calorie count of restaurant meals. While the Health Care bill included a section which requires that chain restaurants with 20 or more locations display nutritional and calorie information, and many are coming into compliance, the accuracy of that calorie count has come into question.
As a consumer, you expect to get what you paid for, and while getting more than you asked for may seem like a bonus or a bargain, it could be packing on unwanted pounds. For example, when you order a burger at a fast food restaurant that is listed as containing 500 calories, you expect the 500 calories, no more. Such is not the case, according to new research out of Tufts University in Boston.
Research centered on 42 quick-serve and sit-down restaurants in Massachusetts, Arkansas and Indiana. The team tested 269 different menu items and revealed that almost 20 percent packed 100 or more excess calories—a finding that was most often found in lower-calorie foods. Only 7 percent of the sampled French fries, burgers and other food were within 10 calories from the stated values.
Sit-down restaurant were more often incorrect in serving portions. “There were several cases where we just got a lot more than we thought they were going to give us," said team leader Lorien Urban, a nutrition researcher at Tufts.
It’s not all bad news, however; 52 percent of tested food had 10 fewer calories or more than stated on the menu. Of course, some people might think they were getting cheated out of the food they paid for in this instance.
Nutritional labeling is a benefit for consumers, whose waistlines have continued to grow. Providing nutrition or calorie labeling on restaurant menus has proven to help consumers be more conscious and make better decisions about what they are eating. The New York Department of Health and Mental Hygiene released findings last year of an analysis on the impact of the city’s menu-labeling laws, which was mandated in 2008.
Results indicate that consumers have become more selective in choosing food with fewer calories. In fact, people purchased lower calorie meals at 9 of 13 fast-food restaurant and coffee chains that were included in the study.

Stopping Daily Aspirin Regimen Linked to Increased Risk of Heart Attack

For people diagnosed with heart disease, stopping their daily dose of aspirin puts them at greater risk of suffering a heart attack. A new study out of Spain suggests that the risk of heart attack is significantly increased by discontinuation of a daily low-dose aspirin regimen prescribed by a doctor. The study report was recently published in an online edition of the British Medical Journal.
Taking a daily aspirin in a low dosage that typically ranges between 75 and 300 milligrams is recommended for heart patients to aid in the prevention of blood clots and decrease their risk of secondary cardiovascular events. However, as many as half of patients who begin an aspirin regimen, abruptly stop taking their daily medication.
The results of the new study indicate that the increase in risk for heart attack among those who discontinue the preventative treatment is real. According to lead researcher, Dr. Luis Garcia Rodriguez, director of the Spanish Center for Pharmacoepidemiologic Research in Madrid, these heart patients “should be advised that unless there is a high risk of serious bleeding or otherwise recommended by a doctor, aspirin should never be discontinued given its overwhelming benefits.” He further cautioned, “Also, patients who need to discontinue aspirin should do so for the minimum time necessary.”
For their analysis, the researchers gathered data on 39,513 patients ranging in age from 50 to 84 years,whose medical records were part of a large database in the United Kingdom,known as the Health Improvement Network. The patients in the study had all been prescribed low-dose aspirin therapy between the years 2000 and 2007 as an aid for preventing various cardiac complications that include heart attack.
After approximately three years of follow-up, the research team discovered that a 60 percent increase in the risk of suffering a non-fatal heart attack existed among those patients who stopped taking their daily does of aspirin.
The findings remained the same no matter the duration of a patient’s aspirin regimen prior to stopping their daily meds. This accounts for a total of 4 additional heart attacks per1,000 patients who quit taking aspirin on a daily basis.
The study authors said that the results of their invegestigation supportconclusions of previous studies involving secondary care, and that the latestfindings are applicable to the general population. “Any day off aspirin is a day at risk for patientswith previous cardiovascular disease.”

Menopause and Your Changing Body

Menopause and Your Changing Body

middle-aged womanIn our culture, menopause is frequently seen as a negative milestone, a time of loss and is sometimes viewed as a disease or medical condition requiring a cure. With messages like this from the medical establishment and the media, it's no wonder many healthy women in the midst of this transition develop negative feelings towards their bodies.

What's an average woman to expect regarding her body as she travels through her perimenopausal years (typically her mid- and late- 40s)? Should she yearn for the 30-year old physique she may once have had? Is it possible to achieve that objective? What's a healthy and realistic goal for women hoping to optimize their body composition as well as their body image as they move through the last endocrinological change in their life?

Here are some facts. An average woman can expect to gain from two to five pounds during the menopausal transition, usually ending up in the lower tummy area. The main reason women experience this weight gain is the decline of estrogen. Fat cells in the hip, thigh and buttock areas have receptors for estrogen. Estrogen, in most women, drives most fat storage to the lower part of the body. As estrogen levels begin to decline, however, estrogen loses its hold on fat storage below the waist and instead, fat starts to show up in the "pinch an inch" area of the waistline. It usually extends from the belly button down to the top of your pubic hairline. It's like a small, soft pouch. I refer to this as the "menopot" and the great news is that it is not associated with life-threatening medical illnesses.

Unfortunately, many women are at risk for greater weight gain during the perimenopause and this excess fat usually is deposited deep inside the tummy, under the abdominal muscle wall. I call this Toxic Weight since this fat is unique in its ability to increase a woman's risk for diabetes, heart disease and cancer.

A woman notices that she is fighting the tendency to shape shift from a pear to an apple. Along the way, she is may be experiencing mental frustration about the weight shifts and gains.

By menopause, most women have a rich and fulfilling life history making them prouder and wiser. However, it's tough to focus on self-acceptance and emotional well being when your body feels like it has a life of its own and is gaining weight and getting harder to manage.

A growing number of women feel less attractive as they reach menopause. Recent American Society of Plastic and Reconstruction Surgeons statistics show cosmetic surgery has risen 47 percent for 51 to 64 year old women over the past five years. The media tells mature women to focus on "slowing down the ravages of time", and "reducing telltale signs of aging". These messages can affect our ideas about ourselves. The older a woman gets the harder it is to live up to the beauty standards set by an 18 year old supermodel.

So what's the answer? Stop listening and agreeing with the media hype about negativity in the menopausal years. Reject these negative messages now. Women today have many options as they undergo natural, physical changes due to menopause. You can promote peace between your mind and body during this complex life transition.

Here are some tips to help you get started.

    Physical activity has been scientifically proven to increase body confidence and sense of pleasure in life. It is also the key predictor of healthy weight maintenance.

    Check your nutritional status. One of my patients summed this up eloquently when she said, "You know, when I eat crap, I feel like crap!" No kidding. Seems simple, yet so many of us aren't eating healthful foods.

    Get a life! Find some activities you enjoy and start doing them. If you are lonely, seek out new forms of social support or reconnect with old friends. Make the time to do this.

    Be mindful and fully present each day. Each day is a gift just for you. Grasp the moment and enjoy.

    Take walks or hikes in nature. Being in nature is one of the best ways to reclaim the feelings of connectiveness to the world. Gardening can also be extremely uplifting for the spirit.

While menopause is a normal transition and a biological certainty, every woman's experience is unique. Let's take the lead from many nonwestern cultures where women look forward to the joys of aging. Drastic measures to preserve youth such as extensive cosmetic surgery are not valued in these cultures. Certainly, they should never be used as a substitute for healthy living.

Finding meaning in volunteerism and work, spending time with your family and friends, being in nature and seeing the glory in the ordinary are all roads to self and body image acceptance.

Your body is there to help you "do life" in the most meaningful way. Realizing and being thankful for this will help you appreciate, celebrate, and take care of your body.

99.5% of Hospitals Report Drug Shortages

By Katherine Hobson

Two new surveys give a snapshot of how bad the drug-shortage problem has become.

The Institute for Safe Medication Practiceshas called the recent rash of shortages“unprecedented.” Today, the American Hospital Association and American Society of Health-System Pharmacists reported what their members are saying. (The WSJ wrote about this issue earlier this year.)

The AHA says that 99.5% of the 820 community hospitals that responded to the group’s June survey reported experiencing at least one drug shortage in the past six months. A full 44% reported shortages of 21 or more different drugs.

All treatment categories were affected, hospitals said, with 80% or more respondents experiencing shortages of surgery/anesthesia, emergency care, cardiovascular, gastrointestinal/nutrition, pain or infectious disease drugs. And 66% of hospitals reportedshortages of cancer drugs. Some 47% of hospitals reported experiencing a shortage of at least one drug on a daily basis.

Shortages occur for a variety of reasons, including the unavailability of raw ingredients, FDA enforcement actions that halt production, voluntary recalls, poor inventory management, changed product formulations and even shortage rumors, which can prompt hoarding, according to the ISMP. (Indeed, 85% of the hospitals surveyed by the AHA reported that they’ve purchased “excess inventory” of certain drugs to be sure they’re not caught short-handed.)

In addition, most hospitals in the AHA survey say they’ve implemented rationing or restrictions for certain drugs and that as a result of shortages, drug costs have risen. A separate analysis released in March estimated shortages were costing hospitals at least $200 million annually.

The consequences for patients may include delayed treatment, receiving a less effective drug or not getting a recommended treatment, though most hospitals reported those things happened “rarely,” the AHA says. The ISMP reported last September on near misses and deaths resulting from drug shortages.

Meantime, the American Society of Health-System Pharmacists  surveyed directors of pharmacy and of the 353 that responded, more than 90% agreed shortages were associated with a greater burden and higher costs compared to two years ago. And 70% felt the available information on managing shortages was inadequate. It estimated an annual labor cost of $216 million a year.

The ASHP, AHA and other groups recommend that an early warning system be established that might give signs of a looming shortage, that obstacles be removed so that the FDA can streamline approval of drugs in short supply and that incentives be explored that might encourage drug makers to produce the drugs that are most needed.

Americans Have Access to Dental Care

By Katherine Hobson


We don’t typically consider oral health as part of overall health, and that’s a mistake, according to a new report from the Institute of Medicine.

Because the diseases of the mouth are inextricably linked to overall health, “the unmet oral health needs of millions of Americans cannot be neglected,” the report says.

“Almost one third of the population reports some difficulty in accessing dental care,” Caswell Evans, Jr., an author of the report and associate dean of prevention and public health sciences at the University of Illinois at Chicago College of Dentistry, tells the Health Blog.

Some people lack dental insurance even though they have private health insurance.  (The CDC reported last year that of the 172 million Americans under age 65 with private health insurance, about 27% don’t have dental coverage.)

Others who lack coverage are retired — Medicare doesn’t cover dental care, with some exceptions when it’s in connection with covered procedures, like a jaw reconstruction. Some are poor; states aren’t required to provide dental coverage to adults under Medicaid. And while kids are covered by Medicaid and the Children’s Health Insurance Program, payment rates are so low many have trouble finding a dentist who will treat them.

The report calls for a host of systemic changes intended to improve access to care, including training non-dental health pros such as pediatricians and nurses to play a bigger role in oral care, a reassessment of state practice laws to be sure they promote access to care, establishing CMS-funded state demonstration projects to include essential health benefits in adult Medicaid coverage and increasing Medicaid and CHIP reimbursement rates. (A study appearing in this week’s edition of the Journal of the American Medical Association found that higher Medicaid reimbursement rates were associated with more kids and teens getting dental care.)

In a statement, the American Dental Association praises the focus on oral health access but reaffirms its opposition to allowing non-dentists to perform functions like extractions. “Everyone deserves a dentist,” the ADA says. State laws vary greatly in what they permit non-dentists to do without supervision — seven states require a dentist to be present when a hygienist applies sealants, the report says. Specially-trained dental therapists in Alaska, meantime, can drill and fill cavities — but only in Alaska Natives.

The authors said they were cognizant of the financial pressures facing the federal and state governments. Evans says marginal increases in Medicaid reimbursement rates wouldn’t be terribly burdensome, though. And the authors said they hope that providing access to basic care might save money in the long run by preventing patients from showing up in the ER with more advanced complaints.

More than a decade ago, a U.S. Surgeon General’s report also called for a “national effort to improve oral health among all Americans.”