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" HSI - Jenny Thompson " <HSIResearch

HSI e-Alert - Reality Double Check

Wed, 24 Aug 2005 07:00:00 -0400

 

 

 

 

HSI e-Alert - Reality Double Check

 

Health Sciences Institute e-Alert

****************************************************

August 24, 2005

 

 

 

Dear Reader,

 

My husband came running into the living room to see what was the

matter. Apparently I had let out a yelp loud enough to give him the

impression that the couch had burst into flames or something.

 

I was in distress all right. But there was no need for fire

extinguishers or a 911 call.

 

I'd been watching ABC's World News Tonight when anchor Charles Gibson

began a segment that he characterized as " a reality check. " (Insert

yelp here.)

 

Sorry, Charlie. Time for a double check on that " reality. "

 

-----------

Nurses in pain

-----------

 

ABC's " reality check " concerned a study just published in the American

Heart Association (AHA) journal Hypertension. We'll take a quick look

at the study and then get back to ABC in a moment.

 

A team from Brigham and Women's Hospital (BWH) at Harvard University

analyzed data from the first and second Nurses' Health Studies. Using

information from questionnaires, the researchers gathered data on

hypertension and painkiller use in more than 5,000 women, ages 51-77

in the first study and ages 34-53 in the second study. None of the

women had hypertension at the outset of either study.

 

Results showed that aspirin intake had no association with the

development of hypertension. But other painkillers didn't fare as well:

 

* Women in the older age group who used an average of 400 mg of

ibuprofen per day had an 80 percent increased risk of hypertension

compared to women who didn't use ibuprofen.

* Women in the younger group who used 400 mg of ibuprofen per day

had a 60 percent increased risk of hypertension

* Women in either group who took an average of 500 mg or more of

acetaminophen daily were twice as likely to develop hypertension

compared to women who didn't use the drug

 

In the published study, the authors write: " Because acetaminophen and

nonsteroidal anti-inflammatory drugs are commonly used, they may

contribute to the high prevalence of hypertension in the United States. "

 

-----------

Follow the money

-----------

 

In many e-Alerts I've taken studies to task when their designs were

obviously flawed or the conclusions clearly biased. And basically

that's all ABC did with the BWH study. Or that's how it appears on the

surface.

 

What made me yelp was this: I've never seen ABC take apart a study and

criticize the design. In just the past month we've seen vitamin E and

echinacea treated unfairly by flawed research that was widely

reported. But in both those cases ABC just got in line with the rest

of the mainstream press and reported only the negative results, not

the glaring flaws.

 

So why did ABC pick this study for a grilling? Well, there could be

all sorts of reasons. But, hmmm, let's see, the possibility that comes

to mind most readily is the fact that the network receives millions of

dollars in advertising revenues from the makers of acetaminophen and

ibuprofen products.

 

Just a thought.

 

-----------

Reality...checked

-----------

 

Here's how the ABC piece went. Reporter John McKenzie stated that,

" Many doctors today were unusually critical of this latest research,

and they worried about the fear it could trigger. " Well heaven FORBID

there should be any fear of these painkillers which have been PROVEN

to cause gastrointestinal problems along with kidney and liver damage

when taken in excess. But fears about vitamin E, which is safe and has

been shown to promote heart health? Hey, no problem there.

 

But who were these " many doctors " ? And in what context were they

voicing their concerns? Did the doctors call a press conference? Or

did an industry advocacy group issue a statement? Did the doctors

contact ABC? Or did ABC contact the doctors? Mr. McKenzie doesn't say.

He just refers to " many doctors. " And then quotes two.

 

Here are the flaws in the BWH study, according to the doctor duo:

 

* Researchers didn't measure the subjects' blood pressure, they

relied on subjects to report on any diagnosis of hypertension

* Researchers didn't count the pills subjects were taking - again

they relied on the subjects to report painkiller intake

* There was no follow up to see if the amount or type of

painkillers taken at the beginning of the study changed by the end of

the study

* The study didn't rule out other potential causes of hypertension

 

These are valid points, although a couple of them are fairly weak. For

instance, if a nurse says she's been diagnosed with high blood

pressure, well c'mon, she's a NURSE! She would know.

 

What Mr. McKenzie doesn't note is that the researchers are well aware

that their findings are not the last word on the question of a

painkiller/hypertension link.

 

In an AHA press release about the study, lead author, John Phillip

Forman, M.D., states that more research is needed to confirm the

findings, and adds, " It is important to emphasize that our study is

not proof that these drugs will raise blood pressure in all women.

Rather, women and their doctors should use caution when using these

drugs. "

 

That seems like a reasonable conclusion: Be cautious. Talk to your doctor.

 

The ABC report, on the other hand, ends on this note: " The doctors

told ABC News there's no reason for people to change how they're using

these pain pills, at least not based on this study. "

 

So if you're a middle-aged woman who's taking acetaminophen or

ibuprofen daily, should you ignore this study and make no change in

your painkiller use? Or should you be cautious and talk to your doctor?

 

One of those suggestions is clearly flawed.

 

****************************************************

 

....and another thing

 

" A cigar has a fire at one end and a fool at the other. "

 

That's how journalist and newspaper editor Horace Greeley expressed

his distaste for cigar smoking. In the rough and tumble newsrooms of

the 19th Century, he was probably exposed to quite a bit of second

hand smoke from nickel cigars and hand-rolled cigarettes. He may have

never imagined that he was probably doing as much " smoking " as his

stogie-loving and cigarette-smoking peers.

 

Studies have revealed this general timeline of how second hand smoke

affects the heart:

 

* 5 minutes: The aorta begins to stiffen

* 30 minutes: The blood begins to become " sticky " with activated

blood platelets; damage to the artery linings begins; blood vessel

dilation is reduced

* 2 hours: Heart rhythm may become disturbed

 

By some estimates, an eight-hour shift spent working in a smoky

environment has the same effect on the cardiovascular system as

smoking an entire pack of cigarettes. So in effect, a nonsmoker who

spends day after day in such an environment is essentially a smoker.

It's called " passive " smoking, but it's smoking nonetheless, and

carries an equal risk of cancer, asthma, and heart attack that

endangers everyday smokers.

 

Fortunately, nonsmokers exposed to second hand smoke may get some

cardiovascular protection with an adequate intake of vitamin C.

 

Previous research suggests that lung cancer and cardiovascular

problems triggered by passive smoking are associated with an increase

in oxidative stress. A 2003 study from the University of California,

Berkeley (UC), examined the effects of vitamin C and other nutrients

on oxidative stress in 67 middle-aged nonsmokers who were regularly

exposed to second hand smoke.

 

Split into three groups, the subjects were given either 500 mg of

vitamin C daily; a mix of vitamin C, E, and alpha-lipoic acid; or a

placebo. After two months, researchers found that, compared to the

placebo group, the vitamin C group showed a decrease in oxidative

stress of more than 11 percent, and the nutrient mix group of almost

13 percent.

 

Can an 11, 12, or 13 percent reduction in oxidative stress protect you

from a heart attack triggered by passive smoking? The answer to that

would depend on many variables. But any margin of safety is welcome

when the heart is exposed to the dangers of second-hand smoke.

 

To Your Good Health,

 

Jenny Thompson

 

 

 

****************************************************

 

Sources:

 

" Non-Narcotic Analgesic Dose and Risk of Incident Hypertension in US

Women " Hypertension, Published online before print, 8/15/05,

hyper.ahajournals.org

" Doctors Question Hypertension-Painkillers Link " John McKenzie, ABC

News, 8/16/05, abcnews.go.com

" Most Popular Painkillers Linked to High Blood Pressure in Women "

American Heart Association press release, 8/17/05, medicalnewstoday.com

" Vitamin C Supplementation Decreases Oxidative Stress biomarker

f2-Isoprostanes in Plasma of Nonsmokers Exposed to Environmental

Tobacco Smoke " Nutrition and Cancer, 2003; 45(2), 176-84, ncbi.nlm.nih.gov

" Vitamin C to Counter Passive Smoking Damage " NutraIngredients.com,

8/6/03, nutraingredients.com

 

************************

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