Beta-blockers Don’t Prevent Complications of High Blood Pressure as Effectively as Other Medications
Beta-blockers are a class of drugs used to treat high blood pressure, or hypertension. They make the heart beat slower and with less force; as a result, blood pressure drops. For years, beta-blockers have been used as a first-line treatment for hypertension, and they are one of the most commonly used drugs for this purpose. Recently, however, two meta-analyses have found beta-blockers to be less effective than other high blood pressure medications for reducing the risk of stroke, heart attack, and death.
In a study published in the January 24, 2007 online issue of The Cochrane Library , researchers compared cardiovascular outcomes in patients taking beta-blockers versus patients taking no medications, a placebo, or other antihypertensive medications. Their findings suggest that beta-blockers should no longer be used as a first-line treatment for high blood pressure.
Wiysonge CS et al. Beta-blockers for hypertension (Cochrane Review). The Cochrane Library . 2007 Jan 24. Issue 1.
Because there is evidence that antioxidants may help prevent disease, millions of people are taking antioxidant supplements. In fact, it is estimated that 10%-20% of the adult population in North America and Europe take antioxidant supplements. But it is unclear whether these supplements are beneficial or harmful, with some studies even suggesting that they may increase the risk of death.
In the February 28, 2007 Journal of the American Medical Association , researchers looked at dozens of studies investigating the effects of antioxidant supplements. They found evidence that certain supplements were associated with an increased risk of death.
Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. JAMA . 2007;197:842-857.
Human Papillomavirus Vaccine Effective in Preventing Cervical Cancer Lesions
Genital human papillomavirus (HPV) is the most common sexually transmitted disease in the United States, and is the cause of virtually all cases of cervical cancer. Although over 100 types of HPV have been identified, two types (HPV-16 and HPV-18) are responsible for nearly 70% of all cervical cancers throughout the world.
A new HPV vaccine, which works by creating antibodies to HPV-16 and HPV-18, as well as two other HPV types, was recently approved by the US Food and Drug Administration for females aged 11-26 to prevent infection from HPV.
The results of a large clinical phase 3 trial published in the May 10, 2007 issue of the New England Journal of Medicine indicate that this HPV vaccine is highly effective in preventing high-grade cervical lesions, which include precancerous and cancerous lesions.
The FUTURE II Study Group. Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. N Engl J Med . 2007;356(19):1915-27.
For more than 60 years, studies have suggested that being in the sun may reduce the risk of dying from cancer (other than skin cancer). More recent research indicates that people with higher levels of vitamin D in their blood are less likely to develop certain cancers. Similar associations have been made between higher levels of calcium in the diet and reduced cancer risk.
A study in the June 1, 2007 issue of the American Journal of Clinical Nutrition found that women who took vitamin D and calcium supplements were 60% less likely to develop cancer than those who took a placebo.
Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduced cancer risk: results of a randomized trial. Am J Clin Nutr . 2007;85:1586-1591.
Type 2 diabetes is a serious and sometimes life-threatening disease. It is a leading cause of coronary heart disease, blindness, kidney failure, and limb amputation. Based on evidence that it can reduce blood glucose levels, the medication rosiglitazone (Avandia) was approved by the US Food and Drug Administration in 1999 for the treatment of type 2 diabetes.
A study in the June 14, 2007 issue of the New England Journal of Medicine has put the safety of rosiglitazone into question. After looking at dozens of studies investigating the effects of rosiglitazone, researchers found that the medication was associated with a 43% increase in the risk of heart attack.
Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med . Available at: http://content.nejm.org/cgi/content/full/NEJMoa072761[...]. Accessed June 6, 2007.
When you are diagnosed with a gastrointestinal (or any) cancer, your world can change in an instant. You’re suddenly forced to make decisions about treatment, to deal with your emotions and those of your loved ones, and to consider that your future may not be what you had planned. Psychotherapy may not only provide the support you need to adjust to this major life event, it may actually help you survive your cancer diagnosis.
In a study published in the July 1, 2007 Journal of Clinical Oncology , researchers compared long-term survival in patients with gastrointestinal cancer who did and did not receive psychotherapy in addition to standard care. They found that patients who received psychotherapy were significantly more likely to remain alive ten years after their cancer diagnosis than patients who did not receive psychotherapy.
Küchler T et al. Impact of psychotherapeutic support for patients with gastrointestinal cancer undergoing surgery: 10-year survival results of a randomized trial. J Clin Oncol . 2007;25:2702-2708.
Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy, is a chronic pain condition characterized by intense pain that is disproportionate to the initial injury that caused it. Other symptoms experienced by CRPS patients in the affected area include burning discomfort, changes in temperature and skin color, and extreme sensitivity to touch. CRPS may worsen over time and may spread to other parts of the body. Treatments aim to relieve painful symptoms, but no cure exists.
A previous study found that vitamin C reduced the risk of CRPS in people with wrist fractures. In a study published in the July 2007 Journal of Bone & Joint Surgery , researchers set out to confirm those findings, and to determine the most effective vitamin C dose for CRPS prevention. They found that a daily dose of 500 milligrams of vitamin C taken for 50 days significantly reduced the risk of CRPS in people with fractured wrists, compared to placebo.
Zollinger PE, Tuinebreijer WE, Breederveld RS, Kreis RW. Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose-response study. J Bone Joint Surg Am . 2007;89:1424-1431.
Hormone replacement therapy (HRT) replaces the hormones (estrogen alone or estrogen plus progesterone) that decline during menopause. Early studies suggested that long-term HRT use might reduce the risk of heart disease and osteoporosis-related fractures in postmenopausal women. But in 2002, the US Women’s Health Initiative trial showed that postmenopausal women taking HRT had an increased risk of stroke, heart attack, blood clots, and breast cancer.
In a study published in the July 11, 2007 online issue of the British Medical Journal , researchers published results from the abbreviated WISDOM trial. WISDOM found that women who started taking combined HRT several years after menopause had a significantly increased risk of cardiovascular disease and blood clots, compared to those taking placebo.
Vickers MR et al. Main morbidities recorded in the women’s international study of long duration oestrogen after menopause (WISDOM): a randomized controlled trial of hormone replacement therapy in postmenopausal women. Br Med J [serial online]. July 11, 2007.
Nicotine Replacement Therapy Helps Reduce Smoking Temporarily, but Reduction Alone May Not Improve Health
About 36 million Americans smoke cigarettes on a daily basis. While the profound health risks associated with smoking are well-known, so too is the difficulty of quitting. Annual quit rates are less than 4%. Researchers are investigating methods that may lessen cigarettes’ toxic effects among people unable or unwilling to quit, such as reducing the number of cigarettes smoked per day.
Two British researchers carefully analyzed a number of trials designed to reduce daily cigarette use among smokers with the help of nicotine replacement therapy. Their findings, in the July 18, 2007 Cochrane Database of Systematic Reviews 2007 , showed that smokers using NRT were twice as likely to cut their daily use of cigarettes by 50% and more likely to quit, than those given placebo. However, few smokers maintained the cigarette reduction over time, and blood levels of carbon monoxide did not drop significantly.
Stead LF, Lancaster T. Interventions to reduce harm from continued tobacco use. Cochrane Database of Systematic Reviews 2007 , Issue 3.
Bell’s palsy is a weakness of facial muscle from inflammation of the facial nerve. Sometimes this is caused by an infection, but many times the cause is unknown. The paralysis is usually temporary. Treating this illness with steroids has been debated for many years because there has been no good evidence. A study published in the New England Journal of Medicine offers new hope for quick recovery from Bell’s palsy with the steroid medication called prednisolone.
Patients taking prednisolone (with or without acyclovir) had better recovery than those taking the placebo. At three months, 83% of the prednisolone group were symptom-free compared to only 63% of the placebo group. At nine months, 94% of the prednisolone group had no symptoms compared to 81% of the placebo group. While at the end of nine months many in the placebo group did experience full recovery, the treatment group recovered sooner. There were very few bad reactions to the medication.
Sullivan FM, Swan IR, Donnan PT, Morrison JM, Smith BH, McKinstry B, et al. Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med . 2007 Oct 18;357(16):1598-607.
- Reviewer: Larissa Lucas, MD
- Review Date: 01/2008 -