News in brief - Nov. 17, 2003

Hypertension study targets younger black men - Ipecac is out for poisons - Diet, exercise can reduce cancer risk - FDR may not have had polio

Hypertension study targets younger black men

A health care team successfully treated the high blood pressure of a group of black men, ages 21 to 54, living in an inner-city neighborhood in Baltimore, according to a study conducted by the Johns Hopkins University School of Nursing. Younger black men are not typical targets of hypertension efforts.

The team, supervised by a physician, provided half of a group of about 300 men with blood pressure management techniques, social services, job training and housing assistance. At the study's start, 17% of this group had their blood pressure well controlled. At the end of the three-year effort, 44% were successfully controlling blood pressure.

"To my knowledge, until now no hypertension studies have targeted high-risk, young urban African-American men, who are underserved by the health care system," said Martha N. Hill, PhD, RN, dean of the nursing school. "The team approach was key to achieving control of hypertension and to retaining more than 90% of these men in the study protocol over three years' time."

The control group received less intensive care -- a phone call twice a year for counseling, referral to sources of hypertension care in the community and, like the more intensive care group, an annual visit to an outpatient clinical research center.

More than one in four Americans has high blood pressure, and that number is higher among blacks, with accompanying side effects that are often more frequent and severe.

The study, which was published in the November issue of the American Journal of Hypertension, also found decreases for both groups in smoking, eating of salty foods, unemployment, low income and lack of health insurance. Taking medication to reduce blood pressure increased for both groups.

Ipecac is out for poisons

Syrup of ipecac, the well-known home emergency treatment for inducing vomiting in children who swallow poisonous substances, should no longer be routinely stocked in medicine cabinets, according to a new American Academy of Pediatrics policy statement.

Until now, the AAP had routinely advised parents to keep a one-ounce bottle of syrup of ipecac on hand. But recent research failed to show a benefit to children treated with the medication. In addition, ipecac has been improperly used by parents and abused by people with eating disorders such as bulimia, the AAP said.

Poisoning deaths also have dramatically declined over the last 50 years, and most emergency departments have stopped using ipecac in favor of the more effective activated charcoal.

The new AAP policy statement stresses that parents should be advised to keep potential poisons locked up and out of sight and post the universal number for poison control -- 800-222-1222 -- near the phone. But parents should be told to call 911 in case of convulsions, cessation of breathing or unconsciousness.

Diet, exercise can reduce cancer risk

Lifestyle changes such as weight loss and increasing physical activity can reduce breast cancer risk factors, according to several studies presented in October at the American Assn. For Cancer Research annual Frontiers in Cancer Prevention Research meeting.

Researchers at the University of Manchester, United Kingdom, found that women who gained weight in their 20s and had a family history of breast cancer could reduce biomarkers indicating their risk for the disease by losing 5% of their body weight. A study by scientists at Yale University found that physical activity could reduce breast density, which also can predispose women to an increased breast cancer risk. Another investigation by researchers at the Oregon Health Sciences University, Portland, suggested that increasing the intake of fruit and vegetables also could have an impact.

"These studies provide us with evidence about the mechanisms by which modest changes in daily habits can alter the risk of cancer," said John Potter, MD, head of the cancer prevention research program at the Fred Hutchinson Cancer Research Center in Seattle.

FDR may not have had polio

Franklin Delano Roosevelt's paralysis may have been caused by Guillain-Barré syndrome rather than polio, according to a study appearing in the November issue of the Journal of Medical Biography.

Physicians at the University of Texas Medical Branch in Galveston argue that polio may not be the accurate diagnosis because, at 39, FDR was older than most polio victims. And, much like many people with Guillain-Barré, the paralysis ascended down his body causing extreme numbness and prolonged pain.

The fever and permanency of the paralysis, however, are consistent with a polio diagnosis.

"No one can be absolutely sure of the cause of Roosevelt's paralysis because relevant laboratory diagnostic studies were not performed or were not available at the time of his illness," said Armond S. Goldman, MD, emeritus professor in the Dept. of Pediatrics at UTMB.

Researchers noted, however, that a different diagnosis would not have changed the course of FDR's disease, because treatments for Guillain-Barré were not available at the time.