Common blood pressure drug tied to increased risk of skin cancer

People who take a certain water pill prescribed to control fluid retention and treat high blood pressure may be more likely to get skin cancer than other individuals, a Danish study suggests.

While the drug, hydrochlorothiazide, has long been linked to an increased risk of sunburns, the current study offers fresh evidence that this commonly prescribed medication may also make people more likely to develop two types of skin cancer: basal cell carcinoma and squamous cell carcinoma.

For the study, researchers examined national prescription registry data on hydrochlorothiazide use from 1995 to 2012 as well as cancer registry records on skin malignancies diagnosed from 2004 to 2012.

Overall, people who took hydrochlorothiazide daily for at least six years were 29 percent more likely to develop basal cell carcinoma and almost four times more likely to get squamous cell carcinoma than individuals who didn’t take this medication, the study found.

“We already knew that hydrochlorothiazide makes the skin more vulnerable to damage from UV light of sun or sunbeds,” said senior study author Anton Pottegard of the University of Southern Denmark.

“However, we did not know that hydrochlorothiazide use also appears to translate into an increased risk of non-melanoma skin cancer,” Pottegard said by email.

The study included more than 71,000 people with basal cell carcinoma, 8,600 patients with squamous cell carcinoma, and a control group of more than 313,000 people in the Danish population who didn’t have these malignancies but were otherwise similar to the cancer patients.

About 2.7 percent of patients with basal cell carcinoma and 2.1 percent of the control group were high users of hydrochlorothiazide, with a lifetime cumulative dose of at least 50,000 milligrams, or roughly six years of daily use.

Ten percent of squamous cell carcinoma cases were high users, as were 2.8 percent of people in the control group.

With the highest cumulative hydrochlorothiazide exposure — approximately 24 years of daily use — patients were 54 percent more likely to develop basal cell carcinoma and more than seven times more likely to get squamous cell carcinoma.

The study wasn’t a controlled experiment designed to prove whether or how hydrochlorothiazide might cause skin cancer.

Another limitation is that researchers lacked data on two main factors that influence the risk of skin cancer: ultraviolet light exposure and skin type, the study authors note in the Journal of the American Academy of Dermatology.

“There may be a relationship between taking hydrochlorothiazide and risk for skin cancer,” said Dr. Aaron Farberg of the Icahn School of Medicine at Mount Sinai in New York City.

“However, the relationship may not be directly causative,” Farberg, who wasn’t involved in the study, said by email.

Even so, the findings add to the evidence suggesting that patients taking hydrochlorothiazide should take extra precautions to protect their skin from damage caused by the sun, said Dr. Elizabeth Martin, president of Pure Dermatology & Aesthetics in Hoover, Alabama.

“Everyone can reduce their skin cancer risk by avoiding unprotected exposure to UV light,” Martin, who wasn’t involved in the study, said by email. “Don’t use indoor tanning devices, and protect yourself from the sun by seeking sunscreen with an SPF of 30 or higher.”

Patients taking hydrochlorothiazide shouldn’t stop without first seeing a doctor, Pottegard cautioned. While there are other safe, affordable options to manage high blood pressure, patients already taking hydrochlorothiazide won’t meaningfully alter their skin cancer risk by staying on the drug for a few months until a physician can advise them, he said.

“If you are at an increased risk of skin cancer, due to high exposure to sunlight, have already experienced skin cancer, or are otherwise predisposed to skin cancer, you should consider consulting your physician regarding a potential therapy shift,” Pottegard said.

source: interaksyon.com

Trouble falling asleep may signal high blood pressure

Trouble sleeping, especially trouble falling asleep, may be associated with high blood pressure, according to a new study from China.

This is the first study to show that certain people with insomnia are at risk for high blood pressure, said co-authors Dr. Xiangdong Tang of Sichuan University in China and Dr. Alexandros N. Vgontzas of Penn State University College of Medicine, in a statement to Reuters Health.

Insomnia with increased alertness during the day, or hyperarousal, is associated with increased chronic secretion of stress hormones like cortisol, which may lead to hypertension, they wrote.

The authors studied about 300 adults, including more than 200 chronic insomniacs who’d had trouble sleeping for at least six months. They all spent one night in the Sleep Medicine Center of West China Hospital and took a sleepiness/alertness test the following day.

At night, they were allowed to sleep as they normally would, in sound, light and temperature-controlled rooms. The next day, they were given four 20-minute nap opportunities throughout the day. Researchers measured their “sleep latency,” that is, the amount of time it took for the nappers to actually fall asleep, if they were able.

Researchers also took their blood pressure readings in the evening and in the morning.

Normal sleepers were no more likely to have high blood pressure even if they took longer to fall asleep for a nap.

For chronic insomniacs, the longer it took to fall asleep when they tried to nap during the day, the more likely they were to have high blood pressure, even after accounting for age, gender, weight and height, diabetes, and use of alcohol, tobacco and caffeine.

Compared to normal sleepers who fell asleep quickly, people with insomnia who took more than 14 minutes to fall asleep during the day were three times as likely to have high blood pressure readings or a doctor’s diagnosis of hypertension, the authors report in the journal Hypertension.

People who fell asleep in less than 14 minutes, regardless of whether or not they had insomnia, had no increased risk of high blood pressure.

About half of insomniacs and a third of the normal sleepers took more than 14 minutes to fall asleep during the day, Tang and Vgontzas wrote in the statement.

People who have trouble sleeping should ask their doctors about their blood pressure readings, they wrote.

“Insomniacs who have either short sleep at night or show signs of hyperalertness during the day are at risk for hypertension,” they wrote. “This is similar to someone who has other risk factors such as obesity, high lipids, smoking, etc.”

The United States Preventive Services Task Force recommends screening for high blood pressure for all adults over the age of 18 every year or so, regardless of sleep patterns, USPSTF chair Dr. Michael LeFevre noted in an email to Reuters Health.

Blood pressure screening causes few major harms, LeFevre said.

“However, many people who have high blood pressure in (a doctor’s) office setting do not have sustained high blood pressure outside of a medical setting,” he said. “Making the diagnosis of hypertension based only on office readings may lead to unnecessary treatment.”

Blood pressure measurements should be repeated outside the doctor’s office during the course of the day to confirm high blood pressure before diagnosing hypertension, he said.

Most people will need help from a doctor or sleep expert to start falling asleep more quickly, Tang and Vgontzas wrote.

source: interaksyon.com

Study ties higher blood sugar to dementia risk

Higher blood-sugar levels, even those well short of diabetes, seem to raise the risk of developing dementia, a major new study finds. Researchers say it suggests a novel way to try to prevent Alzheimer's disease — by keeping glucose at a healthy level.

Alzheimer's is by far the most common form of dementia and it's long been known that diabetes makes it more likely. The new study tracked blood sugar over time in all sorts of people — with and without diabetes — to see how it affects risk for the mind-robbing disease.

The results challenge current thinking by showing that it's not just the high glucose levels of diabetes that are a concern, said the study's leader, Dr. Paul Crane of the University of Washington in Seattle.

"It's a nice, clean pattern" — risk rises as blood sugar does, said Dallas Anderson, a scientist at the National Institute on Aging, the federal agency that paid for the study.

"This is part of a larger picture" and adds evidence that exercising and controlling blood pressure, blood sugar and cholesterol are a viable way to delay or prevent dementia, he said.

Because so many attempts to develop effective drugs have failed, "It looks like, at the moment, sort of our best bet," Anderson said. "We have to do something. If we just do nothing and wait around till there's some kind of cocktail of pills, we could be waiting a long time."




    About 35 million people worldwide have dementia; in the United States, about 5 million have Alzheimer's disease. What causes it isn't known. Current treatments just temporarily ease symptoms. People who have diabetes don't make enough insulin, or their bodies don't use insulin well, to turn food into energy. That causes sugar in the blood to rise, which can damage the kidneys and other organs — possibly the brain, researchers say.

The new study, published in Thursday's New England Journal of Medicine, just tracked people and did not test whether lowering someone's blood sugar would help treat or prevent dementia. That would have to be tested in a new study, and people should not seek blood-sugar tests they wouldn't normally get otherwise, Crane said.

"We don't know from a study like this whether bringing down the glucose level will prevent or somehow modify dementia," but it's always a good idea to avoid developing diabetes, he said.

Eating well, exercising and controlling weight all help to keep blood sugar in line.

The study involved 2,067 people 65 and older in the Group Health Cooperative, a Seattle-area health care system. At the start, 232 participants had diabetes; the rest did not. They each had at least five blood-sugar tests within a few years of starting the study and more after it was underway. Researchers averaged these levels over time to even out spikes and dips from testing at various times of day or before or after a meal.

Participants were given standard tests for thinking skills every two years and asked about smoking, exercise and other things that affect dementia risk.

After nearly seven years of follow-up, 524, or one quarter of them, had developed dementia — mostly Alzheimer's disease. Among participants who started out without diabetes, those with higher glucose levels over the previous five years had an 18 percent greater risk of developing dementia than those with lower glucose levels.

Among participants with diabetes at the outset, those with higher blood sugar were 40 percent more likely to develop dementia than diabetics at the lower end of the glucose spectrum.

The effect of blood sugar on dementia risk was seen even when researchers took into account whether participants had the apoE4 gene, which raises the risk for Alzheimer's.

At least for diabetics, the results suggest that good blood-sugar control is important for cognition, Crane said.

For those without diabetes, "it may be that with the brain, every additional bit of blood sugar that you have is associated with higher risk," he said. "It changes how we think about thresholds, how we think about what is normal, what is abnormal."

source: philstar.com

Mobile phone calls can cause blood pressure spikes

WASHINGTON DC - Got high blood pressure? Try hanging up your cell phone.

A study released Wednesday at the annual meeting of the American Society of Hypertension in San Francisco found that talking on a mobile phone causes systolic blood pressure - the higher number in a blood pressure reading and the number doctors pay more attention to as a risk factor for cardiovascular disease - to rise significantly.

Researchers from the Guglielmo da Saliceto Hospital in Piacenza, Italy, took 12 blood pressure readings at one-minute intervals from 94 patients with mild hypertension. The patients’ mean age was 53.

Patients were seated in a comfortable armchair in a doctor’s consulting room and left alone after the first blood pressure reading was taken using an automatic device.

Researchers phoned the patients at least three times and found that when the patient was on the phone or receiving a call, their blood pressure reading jumped from 121/77 on average to 129/82.

The American Heart Association says less than 120/80 is a healthy reading for adults age 20 and older.

Data compiled by the US Census Bureau using the World Health Organization’s (WHO) Study on Global Aging and Adult Health show hypertension to be “by far one of the most common health conditions for those age 50 and older in Russia,” with nearly half of 50- to 69-year-olds and almost two-thirds of people over 70 suffering from hypertension.

Other data, gathered by Wireless Intelligence, an Atlanta-based mobile technology research and analysis firm, show that Russia is Europe’s largest mobile phone market by connections, or the number of active mobile devices that are connected to a network.

A report by Wireless Intelligence found that, as of June last year, there were 227.1 million mobile connections in Russia, where the population is 141.9 million. That’s a mobile phone penetration of 160 percent.

In the United States, where the Centers for Disease Control and Prevention (CDC) says around 30 percent of adults have high blood pressure, the ratio of mobile phone connections (321.7 million) to population (311.6 million) is 103 percent.

During the blood pressure study, neither diastolic blood pressure - the lower number in a blood pressure reading, which is a measure of the force of blood in the arteries when the heart relaxes between beats - nor heart rate increased significantly when patients received a call.

Oddly, though, the researchers found that patients who got more than 30 calls a day seemed to have developed a form of immunity to the blood pressure spikes seen in the study. Beta-blockers also seemed to help stave off blood pressure spikes.

The researchers concluded that phone calls received when a mildly hypertensive patient is having a blood pressure reading could cause systolic pressure to spike, and advised that they turn off their phone, at least for the duration of the blood pressure test.

source: interaksyon.com

90% of Americans eat too much salt: study

WASHINGTON — About 90% of Americans eat too much salt every day, and the top food offenders include cheeseburgers, pizza, bread, deli meat and potato chips, U.S. health officials say.

The average American eats about 3,300 milligrams of sodium per day, and that does not include salt added from the shaker on the table, said the Centers for Disease Control and Prevention’s Vital Signs report.

U.S. guidelines recommend that people limit sodium to less than 2,300 milligrams per day.

High risk populations—including African-Americans, people 51 and older and those with with high blood pressure, diabetes, or chronic kidney disease—should stick to 1,500 milligrams daily.

“Too much sodium raises blood pressure, which is a major risk factor for heart disease and stroke,” said CDC director Thomas Frieden.

“These diseases kill more than 800,000 Americans each year and contribute an estimated $273 billion in health care costs.”

The report pointed to 10 types of food that add up to more than 40% of the nation’s sodium intake.

Poultry, soups, cheese, pasta dishes, meatloaf rounded out the top 10.

Some 65% of Americans’ sodium comes from food sold in stores, and 25% comes from meals in restaurants.

The CDC urged people to check labels for salt content, eat more fresh vegetables without sauce, and limit consumption of processed foods.

source: japantoday.com