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, April 14, 2008)
STATINS MAY HELP REDUCE BLOOD PRESSURE
BLOOD PRESSURE–LOWERING DIET ALSO MAY BE ASSOCIATED WITH LOWER RISK FOR HEART DISEASE, STROKE
DIURETICS ASSOCIATED WITH BONE LOSS IN OLDER MEN
COLON CANCER RISK PERCEPTION ASSOCIATED WITH SCREENING BEHAVIOR
ARCHIVES OF OPHTHALMOLOGY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, April 14, 2008)
HORMONE USE RELATED TO LOWER RISK OF MACULAR DEGENERATION IN POSTMENOPAUSAL WOMEN
EARLY VISION SCREENING ASSOCIATED WITH BETTER EYESIGHT IN CHILDREN WITH AMBLYOPIA
ARCHIVES OF NEUROLOGY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, April 14, 2008)
BLOOD URATE LEVELS ASSOCIATED WITH THE PROGRESSION OF PARKINSON’S DISEASE
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, April 14, 2008
Media Advisory: To contact Beatrice A. Golomb, M.D., Ph.D., call Debra Kain at 619-543-6163.
STATINS MAY HELP REDUCE BLOOD PRESSURE
CHICAGO—The medications known as statins, typically prescribed to lower blood cholesterol levels, may also modestly reduce blood pressure, according to a report in the April 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Several previous studies have suggested that statins may have an effect on blood pressure, particularly in patients with hypertension (high blood pressure), according to background information in the article. Statins may activate compounds that widen blood vessels and improve their function.
Beatrice A. Golomb, M.D., Ph.D., and colleagues at the University of California, San Diego, La Jolla, conducted a randomized, double-blind trial comparing statins to placebo in 973 individuals who did not have diabetes or cardiovascular disease. For six months between 2000 and 2004, 322 participants were assigned to take 20 milligrams of simvastatin, 323 to take 40 milligrams of pravastatin (doses frequently prescribed for cholesterol-lowering purposes) and 328 to take placebo. Participants’ blood pressure was measured at the beginning of the study, at one and six months during treatment, and again two months after ending treatment (eight months after the beginning of the study).
Among individuals assigned to take statins, systolic [top number] blood pressure decreased by an average of 2.2 millimeters of mercury and diastolic [bottom number] blood pressure decreased by an average of 2.4 millimeters of mercury. “Blood pressure reductions ranged from 2.4 to 2.8 millimeters of mercury for both systolic blood pressure and diastolic blood pressure with both simvastatin and pravastatin, in those subjects with full follow-up and without potential for influence by blood pressure medications (i.e., neither receiving nor meriting blood pressure medications),” the authors write.
The effect of statins on blood pressure was not evident at one month of treatment, was significant at six months of treatment and dissipated two months after treatment ended.
“This study adds to our understanding of the effects of statins, currently the best-selling prescription drugs in the world,” the authors write. “The reduction in blood pressure seen with statins may contribute—among other identified factors—to some of the ‘rapid’ cardiovascular benefits of statins, arising too swiftly to be explained by effects of statins on plaque accumulation.”
(Arch Intern Med. 2008;168[7]:721-727. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was funded by the National Heart, Lung, and Blood Institute, National Institutes of Health. The UCSD General Clinical Research Center also helped to support this effort. 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, April 14, 2008
Media Advisory: To contact Teresa T. Fung, Sc.D., call Diane Millikan at 857-492-6438.
BLOOD PRESSURE—LOWERING DIET ALSO MAY BE ASSOCIATED WITH LOWER RISK FOR HEART DISEASE, STROKE
CHICAGO—Women who eat diets similar to the Dietary Approaches to Stop Hypertension (DASH) diet—which is low in animal protein, moderate in low-fat dairy products and high in plant proteins, fruits and vegetables—appear to have a lower risk of coronary heart disease and stroke, according to a report in the April 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
The DASH diet has been shown to reduce both systolic (top number) and diastolic (bottom number) blood pressure in individuals with high or normal blood pressure, according to background information in the article. The diet has also been shown to reduce low-density lipoprotein (“bad”) cholesterol and is recommended in national dietary guidelines as an example of a healthy eating pattern.
Teresa T. Fung, Sc.D., of Simmons College, Boston, and colleagues studied 88,517 female nurses age 34 to 59 in the Nurses’ Health Study who did not have cardiovascular disease or diabetes in 1980. Seven times from 1980 through 2004, the women reported the types of foods they ate regularly over the previous year. Researchers then calculated a DASH score for each woman based on eight food and nutrient components. Their scores increased when they ate more fruits, vegetables, whole grains, nuts and legumes and stayed close to the recommended amounts of low-fat dairy. Scores decreased with increased consumption of red and processed meats, sweetened beverages and sodium.
Through 24 years of follow up, 2,129 women had a non-fatal heart attack, 976 died of coronary heart disease and 2,317 had strokes. Higher DASH scores were associated with a lower risk for heart disease and stroke. When separated into groups based on their DASH scores, the one-fifth of women who had diets that were most similar to the DASH diet were 24 percent less likely to develop fatal or non-fatal coronary heart disease and 18 percent less likely to have a stroke than the one-fifth of women with the lowest DASH scores.
In a subgroup of women who provided blood samples, higher DASH scores were also associated with lower levels of C-reactive protein and interleukin 6. These compounds are markers of inflammation, which has been associated with heart disease risk.
Similar studies should be conducted to determine if associations between the DASH-style diet and risk for heart disease and stroke remain similar in other populations, the authors note. In addition, the diet should be compared to others shown to predict the risk of heart disease, including the Mediterranean diet.
(Arch Intern Med. 2008;168[7]:713-720. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was funded 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, April 14, 2008
Media Advisory: To contact Lionel S. Lim, M.D., M.P.H., call Ken Roberts at 203-732-7432.
DIURETICS ASSOCIATED WITH BONE LOSS IN OLDER MEN
CHICAGO—Older men who take loop diuretics, commonly prescribed drugs for heart failure and hypertension, appear to have increased rates of hip bone loss than men who are not taking this medication, according to a report in the April 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
“Loop diuretics are one of the most commonly prescribed medications among older adults,” the authors write as background information in the article. These medications increase the amount of calcium excreted in urine, potentially damaging bones over the long term. In observational studies, use of loop diuretics has been associated with an increased risk of hip and other fractures. “However, there is uncertainty as to whether this increased fracture risk is attributable to negative effects on bone mineral density, fall-related mechanisms (e.g., dizziness and orthostasis [low blood pressure when standing up]), or associated comorbidities [co-occurring illnesses].”
Lionel S. Lim, M.D., M.P.H., of Griffin Hospital, Derby, Conn., and colleagues studied 3,269 men age 65 and older (average age 72.7). At an initial examination between 2000 and 2002 and at a follow-up visit an average of 4.6 years later, the men answered questions about medication use and brought in containers for all medication taken during the past 30 days. Bone mineral density of the total hip and two subregions was measured.
A total of 84 men continuously used loop diuretics between the two time periods, 181 used them intermittently and 3,004 did not use them. After adjusting for other related factors, the average annual rate of decline in total hip bone mineral density was -0.33 percent in non-users, -0.58 percent in intermittent users and -0.78 percent among continuous users.
“Compared with rates of hip bone loss among non-users of diuretics, adjusted rates of loss were about two-fold greater among intermittent loop diuretic users and about 2.5-fold greater among continuous loop diuretic users,” the authors write. Findings were similar at the subregions of the hip.
“We conclude that loop diuretic use in older men in associated with increased rates of hip bone loss,” the authors write. Future research should address the underlying mechanisms, they note. “Our findings suggest that health care providers should take into account loop diuretic use when evaluating older men for risk factors for bone loss and fracture risk.”
(Arch Intern Med. 2008;168[7]:735-740. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. 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, April 14, 2008
Media Advisory: To contact corresponding author Eliseo J. Perez-Stable, M.D., call Vanessa DeGier at 415-514-1592.
COLON CANCER RISK PERCEPTION ASSOCIATED WITH SCREENING BEHAVIOR
CHICAGO—Women’s perception of their cancer risk appears to vary by race and may affect how likely they are to undergo screenings, particularly for colon cancer, according to a report in the April 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Risk of developing and dying from cancer varies by race and ethnicity among women, according to background information in the article. For example, African Americans have the highest risk of developing colon cancer and dying from breast or cervical cancer, while Latinas have higher rates of illness and death from cervical cancer but a lower risk of breast and colon cancer. “Communication of cancer risk to ethnically diverse populations of women has the potential to affect screening behavior,” the authors write. “With increasing epidemiological information that quantifies the risks and benefits of early detection and prevention strategies, women’s perceived risk for cancer may become a more important factor in the decision to undergo screening.”
Sue E. Kim, Ph.D., M.P.H., of the University of California, San Francisco, and colleagues conducted in-person and telephone interviews regarding breast, cervical and colon cancer with 1,160 women age 50 to 80 (average age 61). “Perceived personal risk for each cancer was measured on a word scale (no risk to very high risk) and compared with self-reported screening behavior by ethnicity,” the authors write.
Of the women, 338 (29 percent) were white, 167 (14 percent) were African American, 239 (21 percent) were Latina and 416 (36 percent) were Asian. Perceived risk for each cancer varied by ethnicity; “we found that Asian women had the lowest perceived risk for breast, cervical and colon cancers and that Latinas had the highest perceived risk,” the authors write. “This perceived risk was associated with obtaining self-reported cancer screening tests after other factors were accounted for.”
Almost half of the participants (572) reported either a personal or family history of cancer. This type of history was associated with a higher risk perception for breast and colon cancer. Women with a family history of cancer were almost twice as likely to have undergone colonoscopy as women without a family history.
“Evaluation of perceived risk of cancer may be useful to clinicians who are recommending screening tests and incorporating an intervention to help diverse populations understand risk and interpret medical data,” the authors conclude.
(Arch Intern Med. 2008;168[7]:728-734. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by the Agency for Healthcare Research and Quality for an Excellence Center to Eliminate Ethnic/Racial Disparities and by a grant under the Resource Centers for Minority Aging Research program by the National Institute on Aging, the National Institute of Nursing Research and the National Center on Minority Health and Health Disparities, 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, April 14, 2008
Media Advisory: To contact Diane Feskanich, Sc.D., call Lori J. Shanks at 617-534-1604.
HORMONE USE RELATED TO LOWER RISK OF MACULAR DEGENERATION IN POSTMENOPAUSAL WOMEN
CHICAGO—Women who take postmenopausal hormones appear to have a lower risk of developing advanced stages of the eye disease age-related macular degeneration, especially if they had also taken oral contraceptives in the past, according to a report in the April issue of Archives of Ophthalmology, one of the JAMA/Archives journals.
Age-related macular degeneration (AMD) is the leading cause of vision loss and blindness among older adults, affecting 1.75 million Americans, according to background information in the article. “Although genetics plays a key role in susceptibility to AMD, environmental factors, such as smoking, are also important,” the authors write. “Evidence of higher rates of AMD in women than in men and links between AMD and cardiovascular disease suggested a role for estrogen in the etiology” or development of the condition.
Diane Feskanich, Sc.D., of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues assessed estrogen-related factors such as postmenopausal hormone use, past use of oral contraceptives, ages at first period and menopause and childbirth history in 74,996 post-menopausal women in the Nurses’ Health Study. Between 1980 and 2002, 554 of the women developed early (beginning-stage) AMD and 334 women developed neovascular (more advanced, involving the formation of new blood vessels) AMD.
“Current postmenopausal hormone users had a notable 48 percent lower risk of neovascular AMD compared with those who had never used postmenopausal hormones, although risk did not decline linearly with longer durations of use,” the authors write. “Risk was lowest for postmenopausal hormone users who had used oral contraceptives in the past.”
In contrast, risk of early AMD was 34 percent higher among current postmenopausal hormone users and oral contraceptive use was not associated with early AMD risk. “The higher risk of early AMD among postmenopausal hormone users was unexpected and in apparent conflict with the observed inverse association for neovascular AMD,” the authors write. Women who had given birth had a 26 percent lower risk of early AMD.
“Taken together, these findings suggest a role for estrogen in the pathogenesis of AMD that requires further research in specific early and late signs of disease,” they conclude.
(Arch Ophthalmol. 2008;126[4]:519-524. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This research was supported 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, April 14, 2008
Media Advisory: To contact corresponding author Robert W. Arnold, M.D., call 907-276-1617.
EARLY VISION SCREENING ASSOCIATED WITH BETTER EYESIGHT IN CHILDREN WITH AMBLYOPIA
CHICAGO—Children who screen positive for amblyopia, reduced vision in one eye, before age 2 appear to have better visual outcomes than those whose vision problems are detected during screenings between ages 2 and 4, according to a report in the April issue of Archives of Ophthalmology, one of the JAMA/Archives journals.
Screening for amblyopia typically consists of visual acuity screening—where patients are asked to read letters on a chart—along with an examination to detect cataract, problems with eye alignment and other risk factors for the condition, according to background information in the article. Conventional visual acuity testing requires that children are old enough to cover one eye and read visual charts, whereas objective screening for risk factors and newer techniques involving taking photographs of the eye (photoscreening) can be performed in younger children.
Between 1996 and 2006, Alaska Blind Child Discovery—a cooperative, charitable research effort to offer vision screening to Alaskan children—used photoscreening to detect visual problems in 21,367 rural and urban Alaskan children through grade 2. Valerie G. Kirk and colleagues at Ophthalmic Associates, Anchorage, assessed the 94 children who screened positive before age 4 and were treated and followed for at least two years.
After amblyopia treatment, the 36 children who were screened before age 2 had better vision than the 58 who were screened between ages 2 and 4. “Despite similar levels of amblyogenic risk factors, the proportion of children failing to reach a visual acuity of 20/40 was significantly less among those screened before age 2 years (5 percent) than in those screened from ages older than 2 years and younger than 4 years (17 percent),” the authors write.
“Very early photoscreening yields better visual outcomes in amblyopia treatment compared with later photoscreening in preschool-aged children,” they conclude.
(Arch Ophthalmol. 2008;126[4]:489-492. 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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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, April 14, 2008
Media Advisory: To contact corresponding author Alberto Ascherio, M.D., call Todd Datz at 617-432-3952.
BLOOD URATE LEVELS ASSOCIATED WITH THE PROGRESSION OF PARKINSON’S DISEASE
CHICAGO—Higher blood levels of the compound urate, a salt derived from uric acid that is associated with gout, may be associated with a slower progression of Parkinson’s disease, according to an article posted online today that will appear in the June 2008 print issue of Archives of Neurology, one of the JAMA/Archives journals.
Urate is a powerful antioxidant that circulates at high levels in the human bloodstream, according to background information in the article. It may serve as one of the body’s major defenses against oxidative stress, or damage to cells caused by nitrogen and oxygen. Oxidative stress may contribute to the loss of brain cells that produce dopamine, leading to Parkinson’s disease and other neurodegenerative disorders.
Michael A. Schwarzschild, M.D., Ph.D., of Massachusetts General Hospital, Boston, and colleagues studied 804 individuals with early Parkinson’s disease who were enrolled in a drug trial conducted between April 2002 and August 2005. Participants’ blood urate levels were measured at the beginning of the study. They were then seen one month later and again every three months until 24 months had passed. At each visit, they were clinically assessed to determine if their disease had progressed enough to require dopaminergic therapy.
Overall, 493 participants (61 percent) became disabled enough by their Parkinson’s disease to require dopaminergic therapy by the end of the study. Patients with high blood urate levels were less likely to progress to this point. When participants were separated into five groups based on their blood levels of urate, those in the group with the highest levels (6.7 millimeters per deciliter or higher) were half as likely to require dopaminergic therapy as those with the lowest levels (less than 4.3 milligrams per deciliter).
The apparent association between urate levels and Parkinson’s disease progression could indicate that urate itself protects dopamine-producing neurons that are typically destroyed as the condition worsens, the authors note. Alternatively, other compounds that the body eventually turns into urate could be neuroprotective.
“Measurement of urate on its own in patients with newly diagnosed Parkinson’s disease as an indicator of an individual patient’s future rate of progression is likely to be of modest clinical utility,” the authors write. However, targeting urate or its precursors could be a promising pathway for the development of therapies to treat Parkinson’s disease.
(Arch Neurol. 2008;65[6]:(doi:10.1001/archneur.2008.65.6.nct70003).
Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This work was supported by National Institutes of Health grants and the Beeson Scholars Program of the American Federation for Aging Research. The PRECEPT study was supported by Cephalon, Inc. and H. Lundbeck A/S. The analyses of the fully accessible PRECEPT database were carried out independently by the Parkinson Study Group Biostatistics Center in Rochester, N.Y. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
PLEASE NOTE: The April 2008 issue of Archives of Neurology is part 2 of a theme issue on genetics and genomics. Studies featured in the issue address:
- Genetic risk factors for Parkinson’s disease
- Gene-targeted therapies for neurological diseases
- Neural stem cell therapy
- Complications of Huntington’s disease
(Arch Neurol. 2008;65[4]:467-474, 447-451, 452-456, 476-480.
Available to the media pre-embargo at www.jamamedia.org).
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