News in brief - Sept. 15, 2003

Health disparities in managing blood pressure, cholesterol - Pneumonia in the military - CDC releases vaccine storage guidelines for power outages - ED admissions for drug use increase

Health disparities in managing blood pressure, cholesterol

Black women are more likely to die from heart attacks or strokes than are white women, but are less likely to receive adequate treatment, said a new study published in the Aug. 26 rapid access issue of Circulation: Journal of the American Heart Assn.

Researchers found that black women had nearly twice the rate of heart attack and death as their white counterparts. However, despite this greater risk of coronary events, the blood pressure and cholesterol of black women were less well managed than those of white women, they said.

The findings indicate that physicians need to change the way they view and treat heart disease in black women, said Ashish K. Jha, MD, lead author and now a research fellow at Boston's Brigham and Women's Hospital and Harvard School of Public Health.

Researchers used data from the Heart and Estrogen/progestin Replacement Study (HERS), a large clinical trial that initially evaluated the role of hormone therapy in women with heart disease. HERS enrolled 2,699 women younger than 80 from 20 medical centers nationwide. Eight percent of the women, or 218, were black.

About 25% of the black women in the study had adequate blood pressure control versus 63% of the white women. Black women had acceptable cholesterol levels 30% of the time versus 38% of the time for white women. Despite their higher risk of heart disease, black women were 10% less likely to receive aspirin and 27% less likely to receive statins to lower cholesterol.

Pneumonia in the military

The Dept. of Defense has been investigating a series of unusual pneumonia cases that have affected about 100 members of the military deployed in the Mideast, said William Winkenwerder, MD, assistant secretary of defense for health affairs.

Nineteen developed severe pneumonia and two service members have died, he said. Of the serious cases, no two individuals (18 men and one woman) were from the same unit. Thirteen of the service members became ill in Iraq, and the others were in Kuwait, Qatar, Uzbekistan and Djibouti.

The defense department has determined that the cases do not represent an epidemic and are not being spread through person-to-person contact. "We are making significant progress in eliminating a number of possible causes, such as SARS and vaccines," said Dr. Winkenwerder.

CDC releases vaccine storage guidelines for power outages

The Centers for Disease Control and Prevention announced instructions for maintaining vaccine potency when the power goes out. The directive was in response to last month's blackout, which left much of the Northeast and Midwest in the dark for as long as 24 hours.

The agency suggests not opening refrigerators and freezers until the power is restored and, if it is possible to do so without opening the door, monitoring vaccine temperatures.

When the power comes back, the vaccine temperature should be recorded and then monitored until it returns to normal. The duration for which the vaccine was exposed to higher than ideal temperatures should also be noted. Questionable vaccines should be kept separate from any new product.

No vaccine should be administered if there is any doubt about its viability, but it should also not be discarded unless the manufacturers or the public health departments confirm that it is no good.

ED admissions for drug use increase

Emergency department admissions for abuse of narcotic pain medications increased 20% nationally last year and admissions related to marijuana use increased by 24%, according to data released in August by the Substance Abuse and Mental Health Administration's Drug Abuse Warning Network last month.

Admissions related to all forms of drug abuse remained stable at just more than 670,000 when compared with 2001 but the kinds of drugs used varied widely. Some drugs were more widely used in some regions than others.

Chicago had the highest rate of drug-related visits with 551 per 100,000 population, although Buffalo's rates appeared to be growing the fastest and jumped 15% for all visits and 37% for emergency department admissions linked to alcohol combined with another drug. Denver had an 11% increase in ED visits related to heroin. Narcotic painkillers were the most common drugs seen in New Orleans' emergency departments.

"We must continue to strengthen our prevention programs and build substance abuse treatment capacity so that people don't abuse drugs and tax the medical and economic resources of our emergency departments," said Health and Human Services Secretary Tommy G. Thompson.