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High Blood Pressure In Young Adults Linked To Increased Risk Of Early Heart Disease And Stroke, Studies Suggest.

HealthDay (11/6, Gordon) reports that “two new studies suggest that when people under 40 develop high blood pressure, their risk of early heart disease and stroke go up significantly.” One “study found that in a group of about 5,000 young American adults, having high blood pressure was linked to as much as a 3.5 times higher risk of heart disease and stroke.” The other “study looked at nearly 2.5 million young adults from Korea, and also found that high blood pressure in young people increased their risk of premature heart disease and stroke by up to 85 percent.”

MedPage Today (11/6, Boyles) reports, “The results of the studies, both published in JAMA, suggest that following new and controversial hypertension guidelines may help identify young adults at increased risk for cardiovascular disease.” MedPage Today adds, “The American College of Cardiology (ACC)/American Heart Association (AHA) 2017 hypertension classification update reduced the threshold for hypertension from 140/90 mmHg to 130/80 mmHg, with stage 1 hypertension defined as a systolic BP (SBP) of 130 to 139 mmHg or a diastolic BP (DBP) of 80 to 89 mmHg.”

Late Dinner May Be Linked To Cardiometabolic Risk In American Hispanics, Latinos, Research Suggests.

MedPage Today (11/6, Lyles) reports that research suggests “eating a late dinner may contribute to cardiometabolic risk in American Hispanics and Latinos.” Researchers found that “people who consumed at least 30% of their energy after 6 pm had 23% higher odds of hypertension (OR 1.23, 95% CI 1.05-1.44) and 19% higher odds of prediabetes (OR 1.19, 95% CI 1.03-1.37) compared with those who ate less in the evening.” However, “eating in the evening was not associated with overweight, obesity, or central adiposity in the study.” The findings are scheduled to be presented at the American Heart Association’s Scientific Sessions. Get full ACC coverage of AHA 2018 at ACC.org/AHA2018.

Quitting Smoking Lowers Risk Of Cardiovascular Disease, Study Shows.

HealthDay (11/6, Reinberg) reports a study concluded that within five years of quitting smoking, a person has a 38 percent lower risk of stroke, heart attack, or other forms of cardiovascular disease. However, “it took 16 years after quitting for the risk of cardiovascular disease to return to the level of never smokers.” The researchers looked at data from 8,700 people in the Framingham Heart Study. The findings will be presented at the American Heart Association’s annual meeting. Get full ACC coverage of AHA 2018 at ACC.org/AHA2018.

  • Science has discovered that physiologic responses to weight loss trigger weight regain1-5
  • Weight loss in people with obesity causes changes in appetite hormones that increase hunger and the desire to eat for at least 1 year1
    • Multiple hormones, such as ghrelin, GLP-1, and leptin, play an important role in regulating appetite6

The brain has a central role in regulating appetite and energy balance. Metabolic adaptations to weight loss include1-5:

References:
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WARNINGS

  • Overweight and obesity are associated with increased risk of 13 types of cancer. These cancers account for about 40% of all cancers diagnosed in the United States in 2014.

13 cancers are associated with excess weight and obesity

  • aCancer in the tissue covering brain and spinal cord
    bCancer of blood cells
    cPost-menopasual women
    • Overall, the rate of new cancer cases has decreased since the 1990s but increases in overweight- and obesity-related cancers are likely slowing this progress.

Reference

2. CDC. Cancers Associated with Overweight and Obesity Make up 40 percent of Cancers Diagnosed in the United States. https://www.cdc.gov/media/releases/2017/p1003-vs-cancer-obesity.html. Accessed February 23, 2018.

  • A 5% to 10% weight loss may improve obesity-related comorbidities1-5
    • Support from health care professionals can help patients achieve clinically significant and maintained weight loss6

Physician-initiated discussions motivate patients to lose weight and change behavior6,7

  • A 5% to 10% weight loss may improve obesity-related comorbidities1-5
    • Support from health care professionals can help patients achieve clinically significant and maintained weight loss6

Physician-initiated discussions motivate patients to lose weight and change behavior6,7

  • Patients are less likely to start the dialogue for many reasons, including:
    • Potential for hearing hurtful comments about their weight8
    • Fear of being blamed for their weight problems9
    • Shame and embarrassment about their weight9
  • To achieve sustainable weight loss, long-term intervention is often required10

References:

3. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.

4. Wing RR, Lang W, Wadden TA, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481-1486.

5. Dattilo AM, Kris-Etherton PM. Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr. 1992;56(2):320-328.

6. Tuomilehto H, Seppa J, Uusitupa M, et al. The impact of weight reduction in the prevention of the progression of obstructive sleep apnea: an explanatory analysis of a 5-year observational follow-up trial. Sleep Med. 2014;15(3):329-335.

7. Foster GD, Borradaile KE, Sanders MH, et al. A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. Arch Intern Med. 2009;169(17):1619-1626

  • Patients are less likely to start the dialogue for many reasons, including:
    • Potential for hearing hurtful comments about their weight8
    • Fear of being blamed for their weight problems9
    • Shame and embarrassment about their weight9
    • To achieve sustainable weight loss, long-term intervention is often required10

References:

10. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. NEngl J Med. 2002;346(6):393-403.

11. Wing RR, Lang W, Wadden TA, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481-1486.

12. Dattilo AM, Kris-Etherton PM. Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr. 1992;56(2):320-328.

13. Tuomilehto H, Seppa J, Uusitupa M, et al. The impact of weight reduction in the prevention of the progression of obstructive sleep apnea: an explanatory analysis of a 5-year observational follow-up trial. Sleep Med. 2014;15(3):329-335.

14. Foster GD, Borradaile KE, Sanders MH, et al. A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. Arch Intern Med. 2009;169(17):1619-1626


Identifying and Managing Sleep Disorders in Primary Care

 

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JULY/AUGUST 2017 NEWSLETTER

PREP: An Interactive Tool For The Clinician

Check out the latest Zika Virus video from the New York City Department of Health and Mental Hygiene!


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Current Zika Virus Recommendations

  • Check the World Map of Areas with Risk of Zika before you travel.
  • The recommendations for travelers to areas with risk of Zika are:
  • CURRENT PREGNANCY:  Women who are pregnant (in any trimester) should not travel to areas with risk of Zika. Men who have traveled to an sexual intercourse for the duration of the pregnancy.
  • MOSQUITO AVOIDANCE:  Prevent mosquito bites while traveling to areas with Zika virus transmission, and for three weeks after returning to the U.S.
  • PLANNING PREGNANCY:  If you or your partner are trying to get pregnant, consider avoiding nonessential travel to areas with a CDC Zika travel notice. Women should wait at least eight weeks after travel before trying to get pregnant. Men should either consistently and correctly use condoms during sexual intercourse or not have sexual intercourse for at least six months after travel to an area with Zika virus transmission.
  • SYMPTOMS AFTER TRAVEL:  Zika virus testing should be offered to people with symptoms of Zika virus disease, including pregnant women and others who develop symptoms during or following travel.

Outbreaks & Security Concerns

Africa

  • Check the World Map of Areas with Risk of Zika to find out about countries in Africa with risk of Zika. Refer to the Current Zika Virus Recommendations above on how to prevent Zika virus infection when traveling to these countries.
  • Cases of polio have been reported in Nigeria.  The CDC recommends that all travelers to Nigeria be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine.
  • Cases of polio have been reported in the Democratic Republic of the Congo. The CDC recommends that all travelers to the Democratic Republic of the Congo be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine.

Asia

  • Check the World Map of Areas with Risk of Zika to find out about countries in Asia with risk of Zika. Refer to the Current Zika Virus Recommendations above on how to prevent Zika virus infection when traveling to these countries.
  • Chinese health authorities have confirmed  human cases of avian influenza A (H7N9).Travelers to China should practice hygiene and cleanliness, eat food that is fully cooked, and avoid touching birds.

Caribbean, Central and South America

  • Check the World Map of Areas with Risk of Zika to find out about countries in the Caribbean, Central and South America with risk of Zika. Refer to the Current Zika Virus Recommendations above on how to prevent Zika virus infection when traveling to these countries.
  • An ongoing outbreak of yellow fever has been reported in Brazil as of December 2016. Health authorities have expanded the list of areas in which yellow fever vaccination is recommended for travelers. Travelers should consult with a yellow fever vaccine provider to determine if they should be vaccinated. Because of a shortage of yellow fever vaccine, travelers may need to contact a yellow fever provider well in advance of travel.

Europe

  • Health officials in France have reported an outbreak of measles. CDC recommends that all international travelers protect themselves by making sure they are appropriately vaccinated against measles.

Middle East

  • The annual Hajj, or pilgrimage to Mecca, Saudi Arabia, is among the largest mass gatherings in the world. In 2017, Hajj will take place from approximately August 30 to September 4. Because of the crowds, mass gatherings such as Hajj are associated with unique health risks. Before traveling to the Hajj, travelers should visit a travel health specialist for advice, make sure they are up to date on all routine and recommended vaccines, and learn about other health and safety issues that could affect the trip.

North America

  • Local transmission of Zika virus has been reported in Brownsville, Texas. The CDC has issued guidance for people who live in or traveled to Brownsville, Texas any time after November 28th, 2016. Please refer to the Current Zika Virus Recommendations above on how to prevent Zika virus infection.
  • Miami-Dade County was previously designated as a Zika cautionary area, but that designation was removed on June 2, 2017. This means that there are no longer any travel recommendations related to Zika virus for Miami-Dade County, Florida. Although the level of risk of Zika virus transmission after a cautionary area designation is removed is not known, it is likely to be low. However, sporadic cases may still occur. For this reason, CDC recommends that people living in or traveling to Miami-Dade County continue to protect themselves from mosquito-borne illnesses.

Pacific Islands

  • Check the World Map of Areas with Risk of Zika to find out about Pacific Islands with risk of Zika. Refer to the Current Zika Virus Recommendations above on how to prevent Zika virus infection when traveling to these countries.

Traveler Health & Safety Tips

Heading Home Health Video - watch now

The CDC recommends all travelers:

  • Visit a health care provider, ideally, 4 to 6 weeks before their trip for personalized health advice, vaccines, and medications.
  • Avoid bites from mosquitoes and other bugs by using an insect repellent and wearing long-sleeved shirts, long pants, closed shoes, and hats as much as possible.
  • Stay safe around animals. Do not pet, handle, or feed unfamiliar animals, even pets.
  • Be safe on international roads. Avoid overcrowded buses and cars, always wear a seat belt, and wear a helmet when riding a bike or motorcycle.
  • Wash their hands often with soap and water and use a hand sanitizer, as needed.

Resources

This email distribution tool is supported by funding from grant U01CK000175 of the U.S. Centers for Disease Control and Prevention (CDC) to the Massachusetts General Hospital. The tool attempts to capture up-to-date notices and alerts at the time of posting; however, components of this information are constantly changing. By using this tool, you agree that the Massachusetts General Hospital and tool developers/supporters are not liable for any adverse outcomes, including those relating to travel.
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Meds Rooted in Ancient China May Help Heart: Review

But U.S. experts greet report with caution, urge further research

 

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