Although it’s too soon to recommend dropping by Starbucks before hitting the gym, a new study suggests that caffeine can help reduce the post-workout soreness that discourages some people from exercising.
In a study to be published in the February issue of The Journal of Pain, a team of University of Georgia researchers finds that moderate doses of caffeine, roughly equivalent to two cups of coffee, cut post-workout muscle pain by up to 48 percent in a small sample of volunteers.
Lead author Victor Maridakis, a researcher in the department of kinesiology at the UGA College of Education, said the findings may be particularly relevant to people new to exercise, since they tend to experience the most soreness.
“If you can use caffeine to reduce the pain, it may make it easier to transition from that first week into a much longer exercise program,” he said.
Maridakis and his colleagues studied nine female college students who were not regular caffeine users and did not engage in regular resistance training. One and two days after an exercise session that caused moderate muscle soreness, the volunteers took either caffeine or a placebo and performed two different quadriceps (thigh) exercises, one designed to produce a maximal force, the other designed to generate a sub-maximal force. Those that consumed caffeine one-hour before the maximum force test had a 48 percent reduction in pain compared to the placebo group, while those that took caffeine before the sub-maximal test reported a 26 percent reduction in pain.
Caffeine has long been known to increase alertness and endurance, and a 2003 study led by UGA professor Patrick O’Connor found that caffeine reduces thigh pain during moderate-intensity cycling. O’Connor, who along with professors Kevin McCully and the late Gary Dudley co-authored the current study, explained that caffeine likely works by blocking the body’s receptors for adenosine, a chemical released in response to inflammation.
Despite the positive findings in the study, the researchers say there are some caveats. First, the results may not be applicable to regular caffeine users, since they may be less sensitive to caffeine’s effect. The researchers chose to study women to get a definitive answer in at least one sex, but men may respond differently to caffeine. And the small sample size of nine volunteers means that the study will have to be replicated with a larger study.
O’Connor said that despite these limitations, caffeine appears to be more effective in relieving post-workout muscle pain than several commonly used drugs. Previous studies have found that the pain reliever naproxen (the active ingredient in Aleve) produced a 30 percent reduction in soreness. Aspirin produced a 25 percent reduction, and ibuprofen has produced inconsistent results.
“A lot of times what people use for muscle pain is aspirin or ibuprofen, but caffeine seems to work better than those drugs, at least among women whose daily caffeine consumption is low,” O’Connor said.
Still, the researchers recommend that people use caution when using caffeine before a workout. For some people, too much caffeine can produce side effects such as jitteriness, heart palpitations and sleep disturbances.
“It can reduce pain,” Maridakis said, “but you have to apply some common sense and not go overboard.”
Tuesday, January 9, 2007
Monday, January 8, 2007
MRI of the ankle changes patient treatment and improves referring physician confidence in diagnosis
MR imaging can make a dramatic difference in the management of patients with ankle pain, changing treatment in about one-third of the patients, a new study finds.
The study, of 91 patients, found that MR changed the management plans of 35% of patients, said Philip W.P. Bearcroft, MD, of Cambridge University Hospitals in England. "This is itself is significant, but more significant is the fact that before an MRI was done, 65 of the 91 patients were scheduled to undergo surgery. After an MRI was done, nine of those patients were treated nonsurgically," Dr. Bearcroft said.
Dr. Bearcroft and his colleagues conducted the study in conjunction with an orthopedic foot and ankle surgeon at a regional teaching hospital. The surgeon noted his proposed treatment plan for each patient before and after an MR examination. The surgeon also noted the potential diagnoses for each injury. Before an MR examination was done, the surgeon indicated an average 2.3 possible diagnoses per patient. "After MRI was performed, the number of diagnoses per patient was reduced to 1.2," said Dr. Bearcroft. MRI increased the referring physician's confidence in his diagnoses, Dr. Bearcroft said. "In 66% of the MRI examinations performed, the referring surgeon felt that his understanding of the patient's disease had either depended upon or had been substantially improved by MRI," he added.
"This study is a bit different than the traditional radiological study," Dr. Bearcroft said. "Most studies relate to improving technique or look at the accuracy and predictive value of imaging techniques. This one was designed to determine if we really make a difference to the referring physician and the patient," he said.
The study, of 91 patients, found that MR changed the management plans of 35% of patients, said Philip W.P. Bearcroft, MD, of Cambridge University Hospitals in England. "This is itself is significant, but more significant is the fact that before an MRI was done, 65 of the 91 patients were scheduled to undergo surgery. After an MRI was done, nine of those patients were treated nonsurgically," Dr. Bearcroft said.
Dr. Bearcroft and his colleagues conducted the study in conjunction with an orthopedic foot and ankle surgeon at a regional teaching hospital. The surgeon noted his proposed treatment plan for each patient before and after an MR examination. The surgeon also noted the potential diagnoses for each injury. Before an MR examination was done, the surgeon indicated an average 2.3 possible diagnoses per patient. "After MRI was performed, the number of diagnoses per patient was reduced to 1.2," said Dr. Bearcroft. MRI increased the referring physician's confidence in his diagnoses, Dr. Bearcroft said. "In 66% of the MRI examinations performed, the referring surgeon felt that his understanding of the patient's disease had either depended upon or had been substantially improved by MRI," he added.
"This study is a bit different than the traditional radiological study," Dr. Bearcroft said. "Most studies relate to improving technique or look at the accuracy and predictive value of imaging techniques. This one was designed to determine if we really make a difference to the referring physician and the patient," he said.
Higher folate levels linked to reduced risk for Alzheimer's disease
Individuals who take in higher levels of the nutrient folate through both diet and supplements may have a reduced risk of developing Alzheimer's disease, according to a report in the January issue of Archives of Neurology, one of the JAMA/Archives journals.
By the year 2047, the prevalence of Alzheimer's disease is expected to quadruple, according to background information in the article. Delaying the onset of this neurodegenerative disease would significantly reduce the burden it causes. Researchers suspect that elevated levels of the amino acid homocysteine in the blood, which is linked to a higher risk for cardiovascular disease and stroke, may also increase the risk for Alzheimer's disease. Folate, vitamin B12 and vitamin B6, are important in the body's processing of homocysteine--therefore, deficiencies in these nutrients increase homocysteine levels and may contribute to cardiovascular disease, stroke and dementia.
José A. Luchsinger, M.D., Columbia University Medical Center, New York, and colleagues examined, interviewed and assessed the diets of 965 individuals without dementia between 1992 and 1994 and then followed them for an average of 6.1 years to see if they developed Alzheimer's disease. The participants had an average age of 75.8 and 70.2 percent were women, 32.6 percent African-American, 45.3 percent Hispanic and 22.1 percent white.
During the follow-up period, 192 of the participants developed Alzheimer's disease. When the individuals were divided into four groups based on the total level of folate they took in through food and supplements and the analysis was adjusted for patient characteristics, comorbid diseases and B12 and B6 intake, the risk of Alzheimer's disease was lower in the groups with higher intake. Neither dietary folate nor supplements alone were significantly linked to Alzheimer's disease risk; only the two in combination appeared to produce an effect. Levels of the vitamins B12 and B6 were not associated with Alzheimer's disease risk.
Higher folate intake was modestly correlated with lower homocysteine levels, "indirectly suggesting that a lower homocysteine level is a potential mechanism for the association between higher folate intake and a lower Alzheimer's disease risk," the authors write.
Definitive conclusions about the role of folate in the development of Alzheimer's disease cannot yet be made, they continue. The findings of this study are in contrast to those of some other research, and other compounds (such as hormones) perceived to reduce the risk for dementia in observational studies did not do so in randomized trials. "Thus, the decision to increase folate intake to prevent Alzheimer's disease should await clinical trials," they conclude.
By the year 2047, the prevalence of Alzheimer's disease is expected to quadruple, according to background information in the article. Delaying the onset of this neurodegenerative disease would significantly reduce the burden it causes. Researchers suspect that elevated levels of the amino acid homocysteine in the blood, which is linked to a higher risk for cardiovascular disease and stroke, may also increase the risk for Alzheimer's disease. Folate, vitamin B12 and vitamin B6, are important in the body's processing of homocysteine--therefore, deficiencies in these nutrients increase homocysteine levels and may contribute to cardiovascular disease, stroke and dementia.
José A. Luchsinger, M.D., Columbia University Medical Center, New York, and colleagues examined, interviewed and assessed the diets of 965 individuals without dementia between 1992 and 1994 and then followed them for an average of 6.1 years to see if they developed Alzheimer's disease. The participants had an average age of 75.8 and 70.2 percent were women, 32.6 percent African-American, 45.3 percent Hispanic and 22.1 percent white.
During the follow-up period, 192 of the participants developed Alzheimer's disease. When the individuals were divided into four groups based on the total level of folate they took in through food and supplements and the analysis was adjusted for patient characteristics, comorbid diseases and B12 and B6 intake, the risk of Alzheimer's disease was lower in the groups with higher intake. Neither dietary folate nor supplements alone were significantly linked to Alzheimer's disease risk; only the two in combination appeared to produce an effect. Levels of the vitamins B12 and B6 were not associated with Alzheimer's disease risk.
Higher folate intake was modestly correlated with lower homocysteine levels, "indirectly suggesting that a lower homocysteine level is a potential mechanism for the association between higher folate intake and a lower Alzheimer's disease risk," the authors write.
Definitive conclusions about the role of folate in the development of Alzheimer's disease cannot yet be made, they continue. The findings of this study are in contrast to those of some other research, and other compounds (such as hormones) perceived to reduce the risk for dementia in observational studies did not do so in randomized trials. "Thus, the decision to increase folate intake to prevent Alzheimer's disease should await clinical trials," they conclude.
Wednesday, January 3, 2007
State of Childhood Asthma, United States: 1980-2005
A new report on childhood asthma released today by the Centers for Disease Control and Prevention (CDC) shows that death rates for asthma among children under age 18 have declined since 1999, while doctor visits for the condition have more than doubled over the past decade.
In 2005, nearly 9 percent of children - 6.5 million children under age 18 - were reported to currently have asthma. The percentage of children who had asthma more than doubled between 1980 and 1995, from 3.6 percent to 7.5 percent. In 2001, CDC introduced a more precise measurement of asthma and the five years since then the trend has remained stable at historically high levels.
Other highlights:
After increasing steadily between 1980 and 1998, asthma death rates among children have for the most part declined since 1999. A change in the way causes of death are coded resulted in a sizable one-year decline between 1998 and 1999, but since then the asthma death rate for children has fallen from 3.2 deaths per 1 million children under age 18 in 1999 to 2.5 deaths per 1 million in 2004.
Asthma-related visits to physician offices have increased sharply since the early 1990's, from less than 40 visits per 1,000 children under age 18 in 1990 to 89 visits per 1,000 in 2004.
Among race/ethnic groups, Puerto Rican and non-Hispanic black children were reported to have the highest percentages of asthma (19.2 and 12.7 respectively).
According to 2003 data, children with at least one asthma attack in the previous year (nearly 4 million children) missed a cumulative total of 12.8 million school days due to asthma.
Asthma-related emergency department visits for children have remained fairly stable from 1992 to 2004 (103 visits per 10,000 children in 2004 compared to 97.6 visits per 10,000 in 1992).
Among the 37 states for which data were available, the states with the highest percentage of children with asthma were: Massachusetts, Hawaii, Oklahoma, Maryland, and Rhode Island. The states with the lowest percentage of children with asthma were: Utah, California, Iowa, Tennessee, and Washington.
"The State of Childhood Asthma, United States: 1980-2005" is available at www.cdc.gov/nchs.
In 2005, nearly 9 percent of children - 6.5 million children under age 18 - were reported to currently have asthma. The percentage of children who had asthma more than doubled between 1980 and 1995, from 3.6 percent to 7.5 percent. In 2001, CDC introduced a more precise measurement of asthma and the five years since then the trend has remained stable at historically high levels.
Other highlights:
After increasing steadily between 1980 and 1998, asthma death rates among children have for the most part declined since 1999. A change in the way causes of death are coded resulted in a sizable one-year decline between 1998 and 1999, but since then the asthma death rate for children has fallen from 3.2 deaths per 1 million children under age 18 in 1999 to 2.5 deaths per 1 million in 2004.
Asthma-related visits to physician offices have increased sharply since the early 1990's, from less than 40 visits per 1,000 children under age 18 in 1990 to 89 visits per 1,000 in 2004.
Among race/ethnic groups, Puerto Rican and non-Hispanic black children were reported to have the highest percentages of asthma (19.2 and 12.7 respectively).
According to 2003 data, children with at least one asthma attack in the previous year (nearly 4 million children) missed a cumulative total of 12.8 million school days due to asthma.
Asthma-related emergency department visits for children have remained fairly stable from 1992 to 2004 (103 visits per 10,000 children in 2004 compared to 97.6 visits per 10,000 in 1992).
Among the 37 states for which data were available, the states with the highest percentage of children with asthma were: Massachusetts, Hawaii, Oklahoma, Maryland, and Rhode Island. The states with the lowest percentage of children with asthma were: Utah, California, Iowa, Tennessee, and Washington.
"The State of Childhood Asthma, United States: 1980-2005" is available at www.cdc.gov/nchs.
CDC Reports Binge Drinking is Common among High School Students and Tied to Other Risky Behaviors
Binge drinking is common among high school students in the United States and is strongly associated with sexual activity, violence, and other risky behaviors, according to a new study, Binge Drinking and Associated Health Risk Behaviors Among High School Students, released by the Centers for Disease Control and Prevention (CDC) and published in the January 2007 issue of Pediatrics.
The study analyzed data from the 15,214 high school students who completed the 2003 Youth Risk Behavior Survey. CDC scientists found 45 percent of the students reported past-month alcohol consumption, and 64 percent of students who drank reported binge drinking (defined as having five or more drinks of alcohol in a row). High school boys and girls who drank alcohol had similar rates of binge drinking: 67 percent and 61 percent, respectively. Among students who engaged in binge drinking, 69 percent reported doing so on more than one occasion in the past 30 days.
The researchers also found that the likelihood of engaging in other risk behaviors - including sexual activity, smoking, and physical fighting - was greater for binge drinkers than for drinkers who did not binge and for nondrinkers.
“Our study clearly shows that it’s not just that students drink alcohol, but how much they drink that most strongly affects whether they experience other health and social problems,” said Dr. Jacqueline Miller, Medical Officer on the CDC’s Alcohol Team and the lead author of the report. “It also underscores the importance of implementing effective strategies to prevent underage and binge drinking, such as enforcing the minimum legal drinking age and reducing alcohol marketing to youth, which can help us change social norms regarding the acceptability of underage and binge drinking.”
Compared to nondrinkers, drinkers who did not binge drink were more than twice as likely to be sexually active; more than four times as likely to smoke cigarettes; and more than twice as likely to have been in a physical fight. And the likelihood was greater still for binge drinkers. Binge drinkers were more than five times as likely as non-drinkers to be sexually active; more than 18 times as likely to smoke cigarettes; and more than four times as likely to have been in a physical fight. The likelihood of engaging in these and other risky behaviors, including marijuana use and suicide attempts, increased with the frequency of binge drinking. Binge drinking was also strongly associated with poor school performance.
The study analyzed data from the 15,214 high school students who completed the 2003 Youth Risk Behavior Survey. CDC scientists found 45 percent of the students reported past-month alcohol consumption, and 64 percent of students who drank reported binge drinking (defined as having five or more drinks of alcohol in a row). High school boys and girls who drank alcohol had similar rates of binge drinking: 67 percent and 61 percent, respectively. Among students who engaged in binge drinking, 69 percent reported doing so on more than one occasion in the past 30 days.
The researchers also found that the likelihood of engaging in other risk behaviors - including sexual activity, smoking, and physical fighting - was greater for binge drinkers than for drinkers who did not binge and for nondrinkers.
“Our study clearly shows that it’s not just that students drink alcohol, but how much they drink that most strongly affects whether they experience other health and social problems,” said Dr. Jacqueline Miller, Medical Officer on the CDC’s Alcohol Team and the lead author of the report. “It also underscores the importance of implementing effective strategies to prevent underage and binge drinking, such as enforcing the minimum legal drinking age and reducing alcohol marketing to youth, which can help us change social norms regarding the acceptability of underage and binge drinking.”
Compared to nondrinkers, drinkers who did not binge drink were more than twice as likely to be sexually active; more than four times as likely to smoke cigarettes; and more than twice as likely to have been in a physical fight. And the likelihood was greater still for binge drinkers. Binge drinkers were more than five times as likely as non-drinkers to be sexually active; more than 18 times as likely to smoke cigarettes; and more than four times as likely to have been in a physical fight. The likelihood of engaging in these and other risky behaviors, including marijuana use and suicide attempts, increased with the frequency of binge drinking. Binge drinking was also strongly associated with poor school performance.
Hybrid Molecule Causes Cancer Cells to Self-Destruct
Lab Tests of Sugar and Short-Chain Fatty Acid Combo Point to New Strategy to Combat Disease
By joining a sugar to a short-chain fatty acid compound, Johns Hopkins researchers have developed a two-pronged molecular weapon that kills cancer cells in lab tests. The researchers cautioned that their double-punch molecule, described in the December issue of the journal Chemistry & Biology, has not yet been tested on animals or humans. Nevertheless, they believe it represents a promising new strategy for fighting the deadly disease.
"For a long time, cancer researchers did not pay much attention to the use of sugars in fighting cancer," said Gopalan Sampathkumar, a postdoctoral fellow in the university's Department of Biomedical Engineering and lead author of the journal article. "But we found that when the right sugar is matched with the right chemical partner, it can deliver a powerful double-whammy against cancer cells."
Sampathkumar and his colleagues built upon 20-year-old findings that a short-chain fatty acid called butyrate can slow the spread of cancer cells. In the 1980s, researchers discovered that butyrate, which is formed naturally at high levels in the digestive system by symbiotic bacteria that feed on fiber, can restore healthy cell functioning.
Efforts to use butyrate as a general drug for tumors elsewhere in the body, however, have been hindered by the high doses of the compound needed to effectively eradicate cancer. To get around this problem, scientists have tried to make butyrate more potent by modifying it or joining it to other compounds. Usually, the results have been disappointing because the molecular partner added to butyrate to improve delivery to the cancer cells often produced unsafe side effects.
In some of the less successful experiments, designed to avoid toxic side effects, researchers used innocuous sugar molecules such as glucose to carry butyrate into the cells. The Johns Hopkins team tried a different tack. "We didn-)t think they chose the right partner molecule," said Kevin J. Yarema, an assistant professor of biomedical engineering who supervised the project. "Our insight was to select the sugar partner to serve not just as a passive carrier but as additional ammunition in the fight against cancer."
The researchers focused on a sugar called N-acetyl-D-mannosamine, or ManNAc, for short. The team created a hybrid molecule by linking ManNAc with butyrate. The hybrid easily penetrates a cell's surface, then is split apart by enzymes inside the cell. Once inside the cell, ManNAc is processed into another sugar known as sialic acid that plays key roles in cancer biology, while butyrate orchestrates the expression of genes responsible for halting the uncontrolled growth of cancer cells.
Although the study of the exact molecular mechanism is in its early stages, the researchers believe the separate chemical components work together to bolster the cancer-fighting power of butyrate. The double attack triggers cellular suicide, also called apoptosis, in the cancer cells.
To find out whether this butyrate-ManNAc hybrid alone would produce the positive results, the researchers tested three other sugar-butyrate combinations and a butyrate salt compound with no sugar attached. The four other formulas and the butyrate-ManNAc hybrid were each added to lab dishes containing cancer cells. After three to five days, cancer growth had slowed in all of the dishes. After 15 days, however, cancer growth had resumed in dishes treated with four of the compounds. But in samples treated with the butyrate-ManNAc hybrid, all of the cancer cells had died.
The researchers also wanted to find out whether administering the two parts of the hybrid independently would achieve the same result. But in these experiments, the cancer cells did not self-destruct. The researchers suspect this is because the hybrid molecules more easily penetrate the surface of the cell than the individual chemicals. Once the components are inside, the researchers believe the partners help enzymes to resume the normal assembly of sugar molecules and correct aberrant gene expression patterns, two processes that go awry when cancer occurs.
Now that they've identified the butyrate-ManNAc molecule as a potential cancer fighter, the Johns Hopkins team members are expanding their research, looking for new drug-delivery methods and preparing for animal testing. The researchers believe the hybrid molecule will have minimal effect on healthy cells. Through the Johns Hopkins Technology Transfer Office, they have filed an application for a U.S. patent covering this class of compounds.
By joining a sugar to a short-chain fatty acid compound, Johns Hopkins researchers have developed a two-pronged molecular weapon that kills cancer cells in lab tests. The researchers cautioned that their double-punch molecule, described in the December issue of the journal Chemistry & Biology, has not yet been tested on animals or humans. Nevertheless, they believe it represents a promising new strategy for fighting the deadly disease.
"For a long time, cancer researchers did not pay much attention to the use of sugars in fighting cancer," said Gopalan Sampathkumar, a postdoctoral fellow in the university's Department of Biomedical Engineering and lead author of the journal article. "But we found that when the right sugar is matched with the right chemical partner, it can deliver a powerful double-whammy against cancer cells."
Sampathkumar and his colleagues built upon 20-year-old findings that a short-chain fatty acid called butyrate can slow the spread of cancer cells. In the 1980s, researchers discovered that butyrate, which is formed naturally at high levels in the digestive system by symbiotic bacteria that feed on fiber, can restore healthy cell functioning.
Efforts to use butyrate as a general drug for tumors elsewhere in the body, however, have been hindered by the high doses of the compound needed to effectively eradicate cancer. To get around this problem, scientists have tried to make butyrate more potent by modifying it or joining it to other compounds. Usually, the results have been disappointing because the molecular partner added to butyrate to improve delivery to the cancer cells often produced unsafe side effects.
In some of the less successful experiments, designed to avoid toxic side effects, researchers used innocuous sugar molecules such as glucose to carry butyrate into the cells. The Johns Hopkins team tried a different tack. "We didn-)t think they chose the right partner molecule," said Kevin J. Yarema, an assistant professor of biomedical engineering who supervised the project. "Our insight was to select the sugar partner to serve not just as a passive carrier but as additional ammunition in the fight against cancer."
The researchers focused on a sugar called N-acetyl-D-mannosamine, or ManNAc, for short. The team created a hybrid molecule by linking ManNAc with butyrate. The hybrid easily penetrates a cell's surface, then is split apart by enzymes inside the cell. Once inside the cell, ManNAc is processed into another sugar known as sialic acid that plays key roles in cancer biology, while butyrate orchestrates the expression of genes responsible for halting the uncontrolled growth of cancer cells.
Although the study of the exact molecular mechanism is in its early stages, the researchers believe the separate chemical components work together to bolster the cancer-fighting power of butyrate. The double attack triggers cellular suicide, also called apoptosis, in the cancer cells.
To find out whether this butyrate-ManNAc hybrid alone would produce the positive results, the researchers tested three other sugar-butyrate combinations and a butyrate salt compound with no sugar attached. The four other formulas and the butyrate-ManNAc hybrid were each added to lab dishes containing cancer cells. After three to five days, cancer growth had slowed in all of the dishes. After 15 days, however, cancer growth had resumed in dishes treated with four of the compounds. But in samples treated with the butyrate-ManNAc hybrid, all of the cancer cells had died.
The researchers also wanted to find out whether administering the two parts of the hybrid independently would achieve the same result. But in these experiments, the cancer cells did not self-destruct. The researchers suspect this is because the hybrid molecules more easily penetrate the surface of the cell than the individual chemicals. Once the components are inside, the researchers believe the partners help enzymes to resume the normal assembly of sugar molecules and correct aberrant gene expression patterns, two processes that go awry when cancer occurs.
Now that they've identified the butyrate-ManNAc molecule as a potential cancer fighter, the Johns Hopkins team members are expanding their research, looking for new drug-delivery methods and preparing for animal testing. The researchers believe the hybrid molecule will have minimal effect on healthy cells. Through the Johns Hopkins Technology Transfer Office, they have filed an application for a U.S. patent covering this class of compounds.
Tuesday, January 2, 2007
Men with hypertension who drink moderate amounts of alcohol may have a lower risk of heart attack
Hypertension affects some 65 million people in the United States, making it a massive public health burden. It's associated with a twofold increased risk of cardiovascular disease (CVD) and total mortality. Studies have shown that moderate consumption of alcohol, up to a limit of one to two drinks a day, may decrease the risk of CVD and total mortality. Drinking more than two drinks a day, however, may increase the risk of hypertension.
Previous studies that looked at the relationship between hypertension and CVD mortality showed a link between moderate consumption and lower CVD mortality in individuals with hypertension. But no prior studies had examined whether moderate consumption was associated with non-fatal myocardial infarction (MI), such as a heart attack or stroke, and none had repeatedly collected information on individual drinking habits. In a new, long-term study, researchers at the Harvard School of Public Health (HSPH), Beth Israel Deaconess Medical Center and Dutch research institute TNO Quality of Life and Wageningen University, the Netherlands, found that, among hypertensive men, moderate alcohol consumption was associated with a decreased risk of fatal and non-fatal heart attack. The researchers also found that rates of stroke and death from heart disease and all causes did not differ for hypertensive men who drank moderate amounts of alcohol and those who drank no alcohol.
"This was the first study to our knowledge that examined the risk of heart attacks among men with high blood pressure who drank moderately. Because excess alcohol intake clearly increases blood pressure, many men with hypertension are counseled not to drink, but our results suggest that may not be necessary if men drink safely and responsibly," said lead author Joline Beulens, a PhD-fellow at TNO Quality of Life and Wageningen University and a visiting scholar at HSPH when the study began.
The study appears in the January 2, 2007, issue of the Annals of Internal Medicine.
The researchers analyzed data from 11,711 hypertensive men from the Health Professionals Follow-Up Study, which was launched in 1986. Every four years, participants filled out a survey and noted the frequency with which they drank beer, red wine, white wine and liquor. Cases of non-fatal MI, fatal heart disease and stroke were documented from 1986 to 2002.
The results showed that, during that time span, 653 cases of total MI were documented, 279 fatal and 374 non-fatal. The authors found that consuming one to two drinks a day was associated with a decreased risk of fatal and non-fatal MI. No association was observed between alcohol consumption and risks of cardiovascular and total mortality. The study also investigated whether men changed their alcohol consumption after hypertension was diagnosed and whether specific alcoholic beverages or number of drinking days per week influenced the risk of heart attack.
Prior research has shown that one way alcohol consumption decreases the risk of heart disease is by increasing the levels of HDL cholesterol and possibly thinning the blood. Although those mechanisms were not the focus of this study, the relationship between alcohol drinking and lower heart attack risk remained after accounting for many differences between drinkers and non-drinkers, including their diet, physical activity and weight. Very light drinkers who consumed less than one drink every two to three days did not have lower risk than non-drinkers. However, because drinking three or more drinks a day increases blood pressure, it is important to adhere to the USDA guideline of one to two drinks a day or less.
The study's limitations include that only male health care professionals participated, so it is not known whether the findings apply to women or men in different occupations.
"It is important for all individuals with high blood pressure to discuss their alcohol intake with their physicians, as heavy consumption, even occasionally, can raise blood pressure. However, our results suggest that men with high blood pressure seem to have the same lower risk associated with moderate drinking that other men do," said Kenneth Mukamal, internist at Beth Israel Deaconess Medical Center and associate professor of medicine at Harvard Medical School.
Previous studies that looked at the relationship between hypertension and CVD mortality showed a link between moderate consumption and lower CVD mortality in individuals with hypertension. But no prior studies had examined whether moderate consumption was associated with non-fatal myocardial infarction (MI), such as a heart attack or stroke, and none had repeatedly collected information on individual drinking habits. In a new, long-term study, researchers at the Harvard School of Public Health (HSPH), Beth Israel Deaconess Medical Center and Dutch research institute TNO Quality of Life and Wageningen University, the Netherlands, found that, among hypertensive men, moderate alcohol consumption was associated with a decreased risk of fatal and non-fatal heart attack. The researchers also found that rates of stroke and death from heart disease and all causes did not differ for hypertensive men who drank moderate amounts of alcohol and those who drank no alcohol.
"This was the first study to our knowledge that examined the risk of heart attacks among men with high blood pressure who drank moderately. Because excess alcohol intake clearly increases blood pressure, many men with hypertension are counseled not to drink, but our results suggest that may not be necessary if men drink safely and responsibly," said lead author Joline Beulens, a PhD-fellow at TNO Quality of Life and Wageningen University and a visiting scholar at HSPH when the study began.
The study appears in the January 2, 2007, issue of the Annals of Internal Medicine.
The researchers analyzed data from 11,711 hypertensive men from the Health Professionals Follow-Up Study, which was launched in 1986. Every four years, participants filled out a survey and noted the frequency with which they drank beer, red wine, white wine and liquor. Cases of non-fatal MI, fatal heart disease and stroke were documented from 1986 to 2002.
The results showed that, during that time span, 653 cases of total MI were documented, 279 fatal and 374 non-fatal. The authors found that consuming one to two drinks a day was associated with a decreased risk of fatal and non-fatal MI. No association was observed between alcohol consumption and risks of cardiovascular and total mortality. The study also investigated whether men changed their alcohol consumption after hypertension was diagnosed and whether specific alcoholic beverages or number of drinking days per week influenced the risk of heart attack.
Prior research has shown that one way alcohol consumption decreases the risk of heart disease is by increasing the levels of HDL cholesterol and possibly thinning the blood. Although those mechanisms were not the focus of this study, the relationship between alcohol drinking and lower heart attack risk remained after accounting for many differences between drinkers and non-drinkers, including their diet, physical activity and weight. Very light drinkers who consumed less than one drink every two to three days did not have lower risk than non-drinkers. However, because drinking three or more drinks a day increases blood pressure, it is important to adhere to the USDA guideline of one to two drinks a day or less.
The study's limitations include that only male health care professionals participated, so it is not known whether the findings apply to women or men in different occupations.
"It is important for all individuals with high blood pressure to discuss their alcohol intake with their physicians, as heavy consumption, even occasionally, can raise blood pressure. However, our results suggest that men with high blood pressure seem to have the same lower risk associated with moderate drinking that other men do," said Kenneth Mukamal, internist at Beth Israel Deaconess Medical Center and associate professor of medicine at Harvard Medical School.
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