EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 8, 2004
To contact corresponding author Stephen L. Archer, M.D., call Phoebe Dey at 780/492-0437.

DRUG FOR ERECTILE DYSFUNCTION APPEARS SAFE FOR SOME MEN WITH CONGESTIVE HEART FAILURE

CHICAGO—Carefully selected men with congestive heart failure appear to be able to safely take sildenafil, a drug used to treat erectile dysfunction (ED), if they are not taking nitrates to treat their heart condition, and have no evidence of myocardial ischemia, according to an article in the March 8 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

Erectile dysfunction affects an estimated 52 percent of men aged 40 to 70, is common in patients with congestive heart failure (CHF), and is associated with symptoms of depression, according to the article. Reports of deaths associated with sildenafil caused some physicians not to prescribe the drug to patients with heart disease. Sildenafil can decrease blood pressure in patients who take nitrates, and should not be taken by this group, the article states.

Linda J. Webster, M.Sc.N., of the University of Alberta, Edmonton, Canada, and colleagues studied the effectiveness and safety of sildenafil among 35 carefully selected men with CHF who did not use nitrates. The men were randomly assigned to one of two groups: one group took sildenafil for six weeks, then switched to a placebo for another six weeks. The other group started with placebo for six weeks, then switched to sildenafil for the remainder of the 12-week study. Follow-up visits took place at 2, 4, 6, 8, 10, and 12 weeks.

The researchers found even though sildenafil caused a slight reduction in blood pressure, no patient in the study experienced a dangerous drop in blood pressure while taking sildenafil. In addition, sildenafil improved erectile dysfunction and also appeared to reduce depression.

"The major finding of this study is that sildenafil is safe and effective in treating ED in men with moderate… heart failure who undergo appropriate screening," write the authors.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 8, 2004
To contact Chenchen Wang, M.D., M.Sc., call Melissa McPherson at 617/636-0200.

TAI CHI HAS PHYSICAL, PSYCHOLOGICAL BENEFITS

CHICAGO—A review of previously published studies suggests that among patients with chronic health conditions, Tai Chi appears to have beneficial effects on balance, flexibility, and cardiovascular health, according to a review article in the March 8 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

According to the article, Tai Chi is a traditional Chinese martial art that has been practiced in China for centuries. Tai Chi combines deep breathing with relaxation and postures that flow from one to another through slow movements. Tai Chi is practiced to promote good health, memory, concentration, digestion, balance, and flexibility and is thought to improve anxiety and depression, the article states.

Chenchen Wang, M.D., M.Sc., of Tufts-New England Medical Center, Boston, and colleagues analyzed 47 studies identified by a search of English and Chinese databases of medical literature that reported on the effects of Tai Chi in patients with various chronic health conditions.

"Overall, these studies reported that long-term Tai Chi practice had favorable effects on the promotion of balance control, flexibility, and cardiovascular fitness and reduced the risk of falls in elders," the authors write.

"Benefits were reported by the authors of these studies in cardiovascular and respiratory function in healthy subjects and in patients who had undergone coronary artery bypass surgery as well as in patients with heart failure, hypertension, acute myocardial infarction, arthritis, and multiple sclerosis," report the researchers. "Benefit was also found for balance, strength, and flexibility in older subjects; falls in frail elderly subjects; and pain, stress, and anxiety in healthy subjects."

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 8, 2004
To contact corresponding author Carlos A. Camargo, Jr., M.D., Dr.P.H., call Julie Bergen at 617/726-0274.

ALCOHOL-RELATED EMERGENCY DEPARTMENT VISITS HIGHER THAN PREVIOUSLY THOUGHT

CHICAGO—Emergency department visits for alcohol-related illnesses or injuries are approximately three times higher than previous estimates, according to an article in the March 8 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

According to the article, alcohol-related diseases and injuries pose a significant burden on hospital emergency departments (EDs). Because patients often fail to disclose their drinking habits to physicians, and ED physicians sometimes fail to identify signs of alcohol abuse, the number of alcohol-related ED visits may have been underestimated, according to information in the article.

Alden J. McDonald III, B.A., of Massachusetts General Hospital, Boston, and colleagues examined alcohol-related ED visits at a national level using data from the National Hospital Ambulatory Medical Care Survey for 1992 through 2000.

The researchers used 37 diagnoses that could be alcohol-related to estimate the total number of alcohol-related ED visits from 1992 through 2000.

The researchers found that there were an estimated 68.6 million ED visits attributable to alcohol from 1992 through 2000, averaging 7.6 million alcohol-related ED visits per year. Alcohol-related visits accounted for 7.9 percent of the total 866.5 million ED visits in that time period.

Patients aged 30 to 49 had twice the rate of ED visits with diagnoses that were considered to be completely attributable to alcohol than patients aged 15 through 29, or 50 and older. The visit rate for males with diagnoses 100 percent attributable to alcohol was three times higher than for females, and the visit rate for blacks with such diagnoses was approximately two times that for whites.

"Although U.S. public health officials recognize that EDs throughout the United States face an enormous burden from alcohol-related diseases and injuries, this study shows that the current literature significantly underestimates the magnitude of this burden," write the authors. "Our nine-year study also reveals a rising trend in the number and rate of alcohol-related ED visits and a widening gap between sexes and a shrinking gap between races among those seen in the ED with certain alcohol-related diagnoses."

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 8, 2004
To contact Scot E. Moss, M.A., call Jane Miller at 608/265-1604.

STUDY DOCUMENTS INCIDENCE OF AND RISK FACTORS FOR DRY EYE IN OLDER PERSONS

CHICAGO—Although there are few risk factors for dry eye, the condition develops fairly commonly in the older population, according to an article in the March issue of the Archives of Ophthalmology, one of the JAMA/Archives journals.

According to the article, dry eye syndrome is a common source of discomfort among the elderly population, has been associated with rheumatoid arthritis and other autoimmune diseases, and can affect quality of life.

Scot E. Moss, M.A., of the University of Wisconsin - Madison, and colleagues examined the incidence of dry eye in participants of the Beaver Dam Eye Study, which included 5,924 people aged 43 to 84 in 1988-1990 living in Beaver Dam, Wisconsin.

The researchers studied 2,414 participants who did not report any symptoms of dry eye in examinations that took place between 1993 and 1995. Dry eye risk factor information was collected during these visits, as well as information on cardiovascular disease risk factors, medications, medical history and lifestyle. Participants were re-examined between 1998 and 2000.

The researchers found that during the five-year interval between the two examination periods, dry eye developed in 322 of the 2,414 subjects, with an incidence (rate of new disease) of 13.3 percent. The incidence was significantly associated with age. After adjusting data to take into account age, incidence was greater in participants with a history of allergy or diabetes who used antihistamines or diuretics, and with poorer self-rated health. Incidence was lower in participants taking angiotensin-converting enzyme inhibitors (ACE inhibitors, used to treat high blood pressure) or who drank alcohol.

The researchers also found several factors that were not associated with dry eye including sex, blood pressure, hypertension, cholesterol levels, body mass index (BMI), arthritis, gout, osteoporosis, cardiovascular disease, thyroid disease, smoking or use of caffeine, vitamins, anti-anxiety medications, antidepressants, calcium channel blockers or anticholesterolemics (drugs to help lower cholesterol).