News in brief - Feb. 2, 2004

Cardiac disease factors up - Heavy drinkers use narcotics for back pain despite warnings - Asian bird flu hitting people, too - Benefits from a little exercise

Cardiac disease factors up

The number of people without a major risk factor for heart disease and stroke declined from nearly 42% to 36% over the past decade, according to a paper published Jan. 16 in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Public health officials have long been sounding alarms about the most common threats to heart health. From 1991-2001, high blood pressure, high cholesterol, diabetes and obesity rates increased significantly. Smoking, another risk factor, has not increased, but it also hasn't declined.

This article is the first of its kind to note that the pool of people without these risk factors is declining and that stroke and heart disease will be a growing burden on the health care system.

The decrease was greater in men than women and more significant in African-Americans than Caucasians. The decrease was noted in all states except Hawaii.

Authors suggested that clinicians renew their commitment to helping their patients control weight, blood pressure, cholesterol, diabetes and smoking to reverse the trend.

Heavy drinkers use narcotics for back pain despite warnings

Despite warnings about combining prescribed narcotics with alcohol, many patients with chronic back pain continue to mix the two, says a study in the December 2003 issue of Disability and Rehabilitation.

Researchers recruited nearly 300 University of Michigan Health System patients who had debilitating back pain for at least three months. Subjects underwent a comprehensive assessment including psychological and physical function tests.

The women in the study drank little, although researchers suggest that actual consumption might have been underreported. A significant number of the men were heavy drinkers and continued to take pain pills.

Authors suggested that this finding might require a physician to probe a bit deeper into a patient's drinking habits before prescribing painkillers.

"Most doctors probably do ask their patients in general terms about alcohol use, but they may not be very sophisticated in their approach to quantifying it," said Ethan Booker, MD, co-author and an emergency medicine resident at the University of Chicago.

Asian bird flu hitting people, too

The World Health Organization has joined governments across Asia in tackling an outbreak of bird flu that has killed at least three people in Vietnam and led to the slaughter of more than 1 million chickens across the region. Several more suspected human cases were being investigated in Vietnam.

Laboratory results confirmed the presence of avian influenza virus H5N1 in the three patients who died of severe respiratory illness in late December 2003 and early January 2004, and work is beginning on the development of a strain of the virus that can be used to produce a vaccine if necessary.

Avian influenza viruses do not normally infect species other than birds and pigs. But a human case of infection with the H5N1 avian virus occurred in Hong Kong in 1997, and it was determined that the virus had jumped directly from birds to humans. Concerned public health officials called for the rapid destruction of all Hong Kong poultry, and it is believed that this may have averted a pandemic.

The H5N1 strain has been partially sequenced, and all the genes were found to be of avian origin, indicating that the virus that caused the three deaths had not yet acquired human genes. The acquisition of human genes increases the likelihood that a virus of avian origin can be readily transmitted from one human to another.

Of the 15 avian influenza virus H subtypes, H5N1 is of particular concern because of its ability to rapidly mutate and its propensity to acquire genes from viruses infecting other animal species.

Benefits from a little exercise

Moderate amounts of exercise, such as walking 12 miles per week, may help prevent weight gain and can promote weight loss in nondieting individuals, according to an article in the Jan. 12 Archives of Internal Medicine.

Fifty-five percent of Americans are overweight or obese, according to the article. From 1991 to 1998, the prevalence of obesity increased by almost 50%.

Researchers from Duke University Medical Center in Durham, N.C., conducted a randomized, controlled trial in which 182 sedentary overweight men and women age 40 to 65 were assigned to either high amount/vigorous intensity exercise equivalent to jogging about 20 miles per week; low amount/vigorous intensity exercise equivalent to jogging 12 miles per week; and low amount/moderate exercise equivalent to walking 12 miles per week. A fourth group did not exercise.

The researchers found that there was a clear relationship between the amount of physical activity and the amount of weight lost, with the most weight loss accompanying the most vigorous exercise. But all subjects who exercised decreased their abdominal, waist and hip circumference measurements significantly.