EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 22, 2004
To contact corresponding author J. Michael Gaziano, M.D., M.P.H., call Mary Buckley at 617/232-9500, ext. 4201.

DRINKING ALCOHOL IN MODERATION MAY REDUCE RISK OF DEATH FROM CARDIOVASCULAR DISEASE AMONG MEN WITH HIGH BLOOD PRESSURE

CHICAGO—Light to moderate alcohol consumption may reduce the risk of death from cardiovascular disease (CVD) in men with high blood pressure, according to an article in the March 22 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

According to background information in the article, previous studies have shown an inverse association between moderate alcohol consumption and CVD mortality, but it is unknown whether this association is true in men with hypertension (high blood pressure).

Maciej K. Malinski, M.D., from the University of Massachusetts Medical School, Worcester, and colleagues studied data from 14,125 male physicians who were enrolled in the Physicians' Health Study by February 1984 who reported past or current treatment for hypertension but had no history of myocardial infarction (heart attack), stroke, cancer or liver disease. The researchers investigated the relationship between alcohol consumption and all-cause mortality (death due to any cause), and deaths due to CVD among the participants. Men in the study answered questions about alcohol consumption, CVD risk factors, cholesterol and lifestyle.

During an average follow up of 5.4 years, there were 1,018 deaths, including 579 from CVD (56.9 percent). At the beginning of the study, 17 percent of the men reported drinking alcohol rarely or never, 11 percent reported monthly alcohol use (one to three drinks per month), 40 percent reported weekly alcohol use (one to six drinks per week), and the remaining 32 percent reported daily alcohol use (one or more drinks per day).

The researchers found that "Compared with nondrinkers, weekly and daily drinkers had a significantly lower risk of death of 28 percent and 27 percent. Similarly there was a reduced risk of CVD mortality [death] with increased levels of alcohol intake," write the authors. They also found that compared to participants who rarely or never drank, weekly drinkers had a 39 percent lower risk of dying from CVD, and daily drinkers had a 44 percent lower risk of CVD mortality.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 22, 2004
To contact Peter M. Houck, M.D., call the Centers for Medicare & Medicaid Services Office of Public Affairs at 202/690-6145

GIVING ANTIBIOTICS WITHIN FOUR HOURS OF ARRIVAL AT A HOSPITAL IMPROVES OUTCOMES FOR OLDER PATIENTS WITH PNEUMONIA

CHICAGO—Giving older patients antibiotics within four hours of their arrival at a hospital for treatment of pneumonia reduces the length of hospital stay, and may reduce the chances of dying, according to an article in the March 22 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

According to the article, pneumonia is the second leading reason for hospitalization among Medicare beneficiaries, accounting for more than 600,000 Medicare hospitalizations yearly, and is the fifth leading cause of death among Americans older than 65 years. Timely administration of antibiotics to hospitalized patients with pneumonia has been associated with improved survival, the article states. Guidelines recommend antibiotic treatment within eight hours of arrival at a hospital.

Peter M. Houck, M.D., from the Centers for Medicare & Medicaid Services, Seattle, and colleagues investigated whether administration of antibiotics within less than eight hours of arrival at the hospital was associated with significant improvements in hospitalized patients with pneumonia who had not been treated prior to arriving at the hospital.

The researchers examined medical records from a national random sample of 18,209 Medicare patients older than 65 years who were hospitalized with pneumonia from July 1998 through March 1999.

Among the 13,771 (75.6 percent) of patients who did not receive any treatment prior to their arrival at a hospital, antibiotic administration within four hours of arrival was associated with reduced death in the hospital (6.8 percent vs. 7.4 percent), reduced likelihood of dying within 30 days of admission to the hospital (11.6 percent vs. 12.7 percent) and reduced likelihood that the length of stay (LOS) at the hospital exceeded 5 days (42.1 percent vs. 45.1 percent). The average length of stay was an average of about half a day shorter for patients who received antibiotics within four hours of arriving at the hospital. The researchers also found that 60.9 percent of all patients received antibiotics within four hours of arriving at a hospital.