JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives of Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF INTERNAL MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, February 26, 2007)
USE OF COMMON PAIN RELIEVERS ASSOCIATED WITH INCREASED RISK OF ELEVATED BLOOD PRESSURE IN MEN
SMOKING MAY BE A RISK FACTOR FOR TUBERCULOSIS
GARLIC DOES NOT APPEAR TO LOWER CHOLESTEROL LEVELS
STRENUOUS PHYSICAL ACTIVITY ASSOCIATED WITH LOWER BREAST CANCER RISK
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 26, 2007
Media Advisory: To contact John P. Forman, M.Sc., M.D., call Lori J. Shanks at 617-534-1604.
USE OF COMMON PAIN RELIEVERS ASSOCIATED WITH INCREASED RISK OF ELEVATED BLOOD PRESSURE IN MEN
CHICAGO—Men who regularly take commonly available and widely used pain relievers may have an increased risk of high blood pressure compared with those who do not use these medications, according to a report in the February 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Acetaminophen, ibuprofen and aspirin are among the most commonly used drugs in the United States, according to background information in the article. Two large studies have recently suggested that pain-relieving medications (analgesics) may be associated with an increased risk of hypertension (high blood pressure) in women. However, the association has not been extensively studied in men.
John P. Forman, M.Sc., M.D., of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues followed a total of 16,031 male health professionals (average age 64.6 years) who did not have a history of high blood pressure. The men were asked in 2000 and again in 2002 about whether and how often they used three types of pain relievers: acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs, which include ibuprofen and naproxen) and aspirin. They were also asked to report if their physician had diagnosed them with hypertension.
Over four years of follow-up, 1,968 men developed hypertension. Compared with men who did not take analgesics, those who took acetaminophen six or seven days a week had a 34 percent higher risk of hypertension. Those who took NSAIDs six or seven days a week had a 38 percent higher risk and those who took aspirin six or seven days a week had a 26 percent higher risk. The researchers also looked at the total number of pain-relieving pills men took each week, regardless of type. Compared with men who took no pills, those who took 15 or more pills each week had a 48 percent higher risk of hypertension.
All three types of analgesics may inhibit the effects of chemicals that relax the blood vessels, decreasing blood pressure, the authors suggest. Acetaminophen also may impair cell functioning through high levels of oxygen (oxidative stress) or reduce the proper functioning of blood vessel lining.
“These data add further support to the hypothesis that non-narcotic analgesics independently elevate the risk of hypertension,” the authors write. “Given their common consumption and the high prevalence of hypertension, our results may have substantial public health implications and suggest that these agents be used with greater caution. The contribution of non-narcotic analgesics to the hypertension disease burden merits further study.”
(Arch Intern Med. 2007;167:394-399. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by a scientist development grant from the American Heart Association and by grants from the National Institutes of Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 26, 2007
Media Advisory: To contact corresponding author Kirk R. Smith, Ph.D., call Sarah Yang at 510-643-7741.
SMOKING MAY BE A RISK FACTOR FOR TUBERCULOSIS
CHICAGO—Smoking appears to increase the risk of becoming infected with tuberculosis and the risk for the development of active disease upon infection, according to an analysis of previously published research in the February 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
About one-third of the world’s population is infected with the bacteria that cause tuberculosis (TB), but the organism is usually rendered inactive by the immune system, according to background information in the article. Active tuberculosis developed in approximately 8.8 million individuals in 2003 and is responsible for about 1.7 million deaths worldwide each year. “It has long been suggested that tobacco smoking may affect rates of TB morbidity and mortality,” the authors write. “This could be a result of increasing the risk of infection with TB mycobacteria, increasing the rate of active TB disease, or increasing the TB mortality rate; plausible mechanisms exist.”
Michael N. Bates, Ph.D., and colleagues at the School of Public Health, University of California, Berkeley, performed a meta-analysis of 24 previously published studies that examined the association between smoking and TB. Six of the publications dealt with the risk for TB infection, 13 with active TB disease and five with death from TB.
Across the studies, individuals who smoked had a 73 percent increased risk of becoming infected with tuberculosis and were more than twice as likely to develop active tuberculosis than those who did not smoke. This suggests that smokers are 40 to 60 percent more likely than non-smokers to develop tuberculosis disease after being infected with TB bacteria. The excess risk of death from TB associated with smoking was less than the excess risk of TB disease, suggesting that smoking does not increase the risk of death among those who already have active TB.
There are several potential explanations for the association, although more research is needed to determine the mechanisms involved, the authors note. Smoking could decrease immune response or damage the function of cilia in the airways, increasing the risk for TB. “Tuberculosis control policies should in the future incorporate tobacco control as a preventive intervention,” the authors write.
“Potentially, smoking is one of the most modifiable of exposures,” they conclude. “In developing countries, where life expectancy is short, highlighting smoking as a risk factor for TB may have greater resonance than advertising its risks for cancer and cardiovascular disease.”
(Arch Intern Med. 2007;167:335-342. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by a Fogarty International Training and Research Program award, a grant from Fogarty International Center Global Tobacco Control Research and Training Program, and by the Center for Occupational and Environmental Health, University of California (Berkeley, Davis, and San Francisco). Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 26, 2007
Media Advisory: To contact Christopher D. Gardner, Ph.D., call Susan Ipaktchian at 650-725-5375. To contact corresponding editorialist Mary Charlson, M.D., call Jonathan Weil at 212-821-0560.
GARLIC DOES NOT APPEAR TO LOWER CHOLESTEROL LEVELS
CHICAGO—Three forms of garlic—including raw garlic and two types of commercial garlic supplements—did not significantly reduce low-density lipoprotein (LDL or “bad”) cholesterol during a six-month trial, according to results published in the February 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
“Garlic supplements, many of which seek to package the benefits of raw garlic in more palatable forms, are promoted as cholesterol-lowering agents and are among the top-selling herbal supplements,” the authors write as background information in the article. Crushing garlic triggers the formation of a compound known as allicin, which has been shown to prevent the formation of cholesterol in the laboratory. However, clinical trials on garlic as a cholesterol-lowering agent in humans have been inconsistent.
Christopher D. Gardner, Ph.D., Stanford University Medical School, Calif., and colleagues enrolled 192 adults age 30 to 65 who had moderately high LDL levels (130 to 190 milligrams per deciliter) beginning in November 2002. Forty-nine participants were randomly assigned to receive raw garlic, 47 to take a powdered garlic supplement, 48 to take an aged garlic supplement and 48 to take placebo. The amount of garlic consumed in the three garlic groups was the equivalent of an average-sized garlic clove each day, six days per week. Fasting blood cholesterol levels were assessed monthly, and the chemical composition of the supplements was checked regularly.
A total of 169 adults completed the study, which continued through June 2005. “Retention was 87 percent to 90 percent in all four treatment arms, and the chemical stability of study materials was high throughout the trial,” the authors write. “There were no statistically significant effects of the three forms of garlic on LDL cholesterol concentrations.” Levels of other types of cholesterol—including high-density lipoprotein (HDL or “good” cholesterol), triglycerides and total cholesterol–high density lipoprotein cholesterol ratio—also remained the same. No serious adverse events occurred, although bad body and breath odor were reported to occur often or almost always by 28 participants (57 percent) in the raw garlic group.
“The results of this trial should not be generalized to other populations or health effects. Garlic might lower LDL in specific subpopulations, such as those with higher LDL concentrations, or may have other beneficial health effects,” the authors write. “Based on our results and those of other recent trials, physicians can advice patients with moderately elevated LDL cholesterol concentrations that garlic supplements or dietary garlic in reasonable doses are unlikely to produce lipid benefits.”
(Arch Intern Med. 2007;167:346-353. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported grants from the National Institutes of Health, the Human Health Service, General Clinical Research Centers, National Center for Research Resources and from the National Science Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: GARLIC MAY STILL POSSESS CARDIOVASCULAR BENEFITS
Garlic has been used since ancient times to treat cardiovascular and infectious diseases, write Mary Charlson, M.D., and Marcus McFerren, Ph.D., M.D., of Weill Cornell Medical College, New York, in an accompanying editorial.
“While garlic has been evaluated for its anti-infective, antioxidant and anticancer properties, a large number of recent basic and clinical studies have focused on its potential effect in preventing cardiovascular disease,” they write. Although the study authors “convincingly demonstrate that raw garlic and two popularly used supplements do not reduce LDL cholesterol more than 10 milligrams per deciliter when used for six months vs. placebo for six months, the results do not demonstrate that garlic has no usefulness in the prevention of cardiovascular disease.”
“Garlic is one of the top-selling dietary supplements in the United States, in part because familiarity with garlic as a food gives consumers confidence that garlic supplements are safe. In general, they probably are,” Drs. Charlson and McFerren write. “Do they prevent cardiovascular disease? The jury is still out.”
(Arch Intern Med. 2007;167:325-326. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 26, 2007
Media Advisory: To contact corresponding author Leslie Bernstein, Ph.D., call Jon Weiner at 323-442-2830.
STRENUOUS PHYSICAL ACTIVITY ASSOCIATED WITH LOWER BREAST CANCER RISK
CHICAGO—Women who regularly engage in strenuous physical activity may have a lower risk of developing both invasive breast cancer and in situ (early-stage) breast cancer than women who do not, according to a report in the February 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
“Few established risk factors for breast cancer are easily modifiable,” the authors write as background information in the article. Physical activity has been associated with breast cancer risk and may be one of the few risk factors that women can control. “Questions remain regarding the amount and intensity of physical activity and the periods when activity provides the greatest breast cancer risk reduction.”
Cher M. Dallal, M.S., University of Southern California, Los Angeles, and colleagues studied 110,599 women age 20 to 79 who were part of the California Teachers Study, established in 1995 and 1996. At the beginning of the study, the women were asked about their average participation in moderate (such as brisk walking, golf or volleyball) and strenuous (including swimming laps, aerobics and running) physical activity from high school to their current age and also in the past three years. The women also provided information about other breast cancer risk factors, including race, family history and use of hormone therapy.
Through 2002, 2,649 women were diagnosed with invasive breast cancer and 593 with in situ breast cancer. Women who reported participating in strenuous activity for more than five hours per week over the long term had a 20 percent lower risk of invasive breast cancer and 31 percent lower risk of in situ breast cancer than women who participated in less than 30 minutes of strenuous activity per week. “Long-term moderate physical activity and strenuous and moderate activity in the past three years were not associated with invasive breast cancer,” the authors write. Similarly, moderate activity did not appear to influence the risk of in situ breast cancer.
The researchers also examined the association between strenuous physical activity and the risk of breast cancer by hormone receptor type, or which hormones can bind to proteins on the surface of the tumor. Strenuous activity appeared to be associated with a lower risk of estrogen-receptor–negative but not estrogen-receptor–positive breast cancers.
“In summary, these results provide additional evidence supporting a protective role for long-term strenuous recreational physical activity on risk of invasive and in situ breast cancer, whereas the beneficial effects of moderate activity are less clear. For invasive breast cancer, strenuous and moderate physical activity affect risk of estrogen-receptor–negative tumors, but neither affects risk of estrogen-receptor–positive tumors.”
(Arch Intern Med. 2007;167:408-415. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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