Common Blood Pressure Drugs should not be combined

Thousands of Canadians with high blood pressure are taking a combination of drugs that increases their risk of sudden cardiac death, kidney disease and other complications, the Heart and Stroke Foundation warned Friday.

Under new Canadian guidelines, patients taking a combination of ACE inhibitors and Angiotensin II Receptor Blockers (ARBs) should not stop taking the medications on their own, but should see their family doctor as soon as possible to discuss whether to change treatment.

Angiotensin Converting Enzyme or ACE inhibitors such as Ramipril are a type of blood pressure medication that helps widens blood vessels, making it easier for blood to flow through.

Angiotensin II Receptor Blockers (ARBs) block the action of a peptide called angiotensin, which causes blood vessels to narrow, helping to relax the blood vessels and lower blood pressure.

Combination stresses kidneys

"There is a synergy that happens when you use this particular drug combination but, unfortunately, it is not a synergy that benefits patients," said Toronto nephrologist Dr. Sheldon Tobe, a spokesperson for the Heart and Stroke Foundation and an executive member of the committee that drafted the new guidelines.

Commonly used blood pressure medications in Canada ACE Inhibitors

Benazepril (Lotensin®)

Captopril (Capoten®)

Cilazapril (Inhibace®)

Enalapril (Vasotec®)

Fosinopril (Monopril®)

Lisinopril (Prinvil®, Zestril®)

Perindopril (Coversyl®)

Ramipril (Altace®)

Trandolapril (Mavik®)

Angiotension Receptor Antagonist (ARB)

Candesartan (Atacand®)

Eprosartan (Teveten®)

Irbesartan (Avapro®)

Losartan (Cozaar®)

Telmisartan (Micardis®)

Valsartan (Diovan®)

Source: Canadian Hypertension Education Program

"When you put the two drugs together, you don't get any additional protection against heart attacks and strokes and you get more negative side-effects," he added.

The drug combination is a major source of stress on the kidneys, said Margaret Moy Lum-Kwong, a spokersperson for the Heart and Stroke Foundation of Ontario who leads the group's high blood pressure strategy.

The side-effects may include fainting, diarrhea and elevated levels of potassium that could result in the need for dialysis, or death.

"The good news is that for patients who are on this particular combination treatment, that once you stop the combination, the risk is eliminated," Lum-Kwong said.

She added that people should know what medications they are on and why..

As many as 175,000 Canadians with high blood pressure may be currently treated with this combination of medications.

Most people with hypertension need to take two or more drugs and adopt a healthier lifestyle, according to the committee that draws up guidelines, the Canadian Hypertension Education Program.

But a Canadian-led trial, called On Target, published in the New England Journal of Medicine in April 2008 found the drug combination was only marginally better at lowering blood pressure than either drug alone, and patients taking both experienced more side-effects such as kidney problems.

The trial included 25,620 people who were age 55 or older with vascular disease or high-risk diabetes.

In updating the guidelines, the committee also considered other studies to understand the scope of the potential problem, Lum-Kwong said.

High blood pressure affects one in five Canadians, according to the foundation.

Artificial good cholesterol to clean arteries using Gold

Will Help Body Excrete LDL

Chicago: US researchers have developed a synthetic form of good cholesterol known as HDL they hope will be able to keep levels of bad cholesterol in check.
    The compound, which has a tiny core of gold, is manufactured using nanotechnology, and its developers think it has the potential to rid the body of excess bad cholesterol. "The idea is you take this and effectively just urinate it out," said Chad Mirkin of Northwestern University in Chicago, whose study was published on Monday in the Journal of the American Chemical Society.
    Mirkin, director of Northwestern's International Institute for Nanotechnology, said the molecule mirrors the size and structure of high-density lipoprotein, or HDL.
    It is comprised of a carefully sized gold particle swathed in fat molecules known as lipids and capped off with a protein layer. It is designed to attract and trap low-density lipoprotein, or LDL, the bad kind of cholesterol that can build up in arteries and cause heart attacks and strokes.
    Powerful drugs known as statins can help lower LDL levels, but they do little to raise levels of protective HDL cholesterol. "The hope is this will be a material that doesn't have side effects, that allows you to do what the statins don't do. That is raise the HDL level, which might be able reverse a lot of the damage and plaques that are already there," Mirkin said.
    Current drugs that raise levels of HDL, such as niacin, cause unpleasant side effects like flushing. And while many drug companies are working to develop better HDL-raising drugs, few have succeeded. "HDL is a natural nanoparticle, and we've successfully mimicked it," Mirkin said. REUTERS

WALK THE ‘GREEN’ TALK...

Architect Niteen Parulekar speaks about conserving energy

 It is clear that human activity has caused most of the past century's environmental problems. Amidst melting ice caps, dwindling forests and rising sea levels, both humans and wildlife are trying to sustain and survive. According to scientists, human activities are contributing to global warming by adding large amounts of greenhouse gases to the atmosphere. They argue that a narrow ten-year window of opportunity remains to set these things right. If this window is missed, temperature rise of above two degrees celsius could see the disappearance of the Himalayan glaciers that provides water and food for over two billion people. A report warns of clear and present danger of some islands disappearing and the annual damage costs of up to seven per cent of the gross domestic product (GDP) of small island states like Fiji.
    Our patterns of consumption have a direct impact on our environment. On a daily basis and at an individual level, these patterns include factors that define our lifestyle which includes our choices of food, the transportation we use, the home we live in, the energy we consume and the commodities we choose. The solution to the problem lies in our determined choices and every little step we take everyday. Most of these obligations can be fulfiled right at home. Traditionally, practices such as like switching off lights, turning off taps and recycling of plastic milk bags and newspaper help. These basic patterns embodied in the Indian culture might have arisen out of the need for conservation and lack of resources of a developing country. With the current global climatic crisis, we have to consciously practice these indigenous ideologies; be it at home, work or on the streets. It has required to remain sustainable be it energy or lifestyle.
    A report states that 1.6 billion poor people across the world still rely on wood and animal dung for fuel and 930 million of them live in East and South Asia. While they are left in the dark, rich countries are running up the energy bills. If every poor person on the planet had the same energy-rich lifestyle as the Western nations, nine planets would be needed to safely cope with the pollution. While there is so much to learn from the West, we have sometimes been blind imitators or selective to choose the shortcoming of the western style consumerism which is far from sustainable. Developing countries are getting shortchanged and the worst impact of environmental destruction is getting passed onto the poor and the most vulnerable populace of the world.
    Consuming organic food and buying indigenous products is an excellent example of a sustainable lifestyle. Ancient Indian gurus have preached for thousands of years with a message to live in harmony with the environment and have respect for all living creatures. Environmentalists today are giving the same message. It is important to encourage individuals who make an effort to incorporate solar panels in their homes, invest in energybased appliances or double glazing for homes, use fuelefficient vehicles and alternative transportation options, commit to home composting and recycling of daily waste. The encouragement could be in the form of incentives such as tax breaks and discounts for similar green techniques or products.
    One of the definitions of sustainability is development that meets the needs of the present generation without compromising the ability of future generations to meet their own needs. The obligations arising from this mean that all humans have the right to an environment that is adequate for their health and well being. The world is moving ahead at an unprecedented pace driven by new emerging economies like India and China. In this context there is no precedent in the history of our world to decisively affect the global environmental problems. The responsibility also does lie with architects. Niteen Parulekar Architects Pvt. Ltd. actively pursues green design and encourages sustainable design professionals in their enterprise. They also conduct inhouse green awareness and educational workshops. Architect Niteen Parulekar is the Managing Director of NPAPL. Phone number: Tel: 66660777. E-mail at: niteen.parulekar@npapl.com or log on to: www.npapl.com.

Niteen Parulekar

Getting detoxed!

Eesha Koppikhar shares her eight-day experience with BT

— GLACXY FERRAO

What is Detox?
    Detox, short for detoxification, is the removal of potentially toxic substances from the body. The term is used to refer to diets, herbs, and other methods of removing environmental and dietary toxins from the body for general health. However, it is also primarily thought of as a treatment for alcohol or drug dependence. Detox is a sample two-week detox diet plan to support detoxification by increasing elimination from the body, cleansing the body, enhancing circulation to clear toxic substances, eliminating foods from the diet that require detoxification or are allergenic, etc.
Eesha Koppikhar's Detox Programme
    Recently Eesha was in no mood to celebrate the New Year after the Mumbai terror attacks. So she decided to herald it in a unique way by undergoing a detox programme at a place in Andheri for eight days. The actress kept her energy levels high by playing basketball, doing martial arts training, and also indulging in core strengthening exercises. "Chef Maxie designed a special menu for me full of healthy foods like vegetable juices, salads, etc," she tells us. She underwent functional training, too, over there. "I indulged myself in the different types of massages. It was a rejuvenating and relaxing experience and I'm feeling healthier than ever."

NATURE’S SEEDS FOR HEALTHY TEETH

BT tells you about the smart fruits that are good for your whites

DR SHANTANU JARADI

 The bite that's better for you. We have only been thinking that fruits are nutritious for healthy living. Who would have thought that they not only help in living healthy but also give you long-lasting healthy teeth. Eating five portions of fruits a day helps us to keep our teeth healthy.
    So, what fruits could be good for your teeth and help you to keep your teeth healthy?
Apples:
An apple a day not only keeps doctor away but can also serve to give you long-lasting teeth. Eating apples rather than drinking juice does your teeth and gums a great favour. By doing this, you are actually stimulating, cleaning and strengthening your teeth while reducing the amount of sugar you are consuming.
    Good and healthy teeth are necessary for oral health and having good teeth makes you look younger. That is why you should visit a dentist regularly to help prevent problems before they get out of hand.
    Avoid misery from tooth decay and gulp in nature's free gifts that will imbibe in you not only a hale and hearty lifestyle but also healthy, long-lasting teeth.

Watermelon: C for yourself
A hefty 25 per cent of the daily value for Vitamin C could be found in two cups of watermelon. An essential vitamin healthy for your teeth and gums, Vitamin C helps in the absorption of iron. It also has antioxidant properties, helping to prevent cell damage by neutralising "free radicals" — molecules believed to be associated with dental aging. Studies have shown that people who eat foods high in vitamin C such as watermelon have lower rates of suffering from gum disease. A growing body of evidence suggests that people who eat enough fruit and vegetables to meet the daily requirements for vitamin C have healthier teeth than those who don't eat enough of these important foods.

Strawberry:
Strawberry is very effective in making teeth strong and clean. Strawberries have many properties such as bleaching and cleansing the teeth. These are very useful to remove tea and coffee stains from the teeth. So, don't forget to gulp in some strawberries between your meals. Strawberries packed with Vitamin C, iodine and pectin are not just delicious but also kind on your teeth as they are less acidic.

Bananas:
Go bananas! Have a banana rather than a handful of sweets and always aim to eat five pieces of fruit or vegetable a day.

Oranges:
Eat plenty of oranges for the Vitamin C which promotes healthy teeth and gums and aids the absorption of iron. Interestingly, chewable Vitamin C can cause enamel loss from teeth.

STRONG BITES: Eating apples rather than drinking juice does your teeth and gums a great favour

Vicks VapoRub harmful to toddlers, says study

New Delhi: Vicks VapoRub—India's most trusted over-thecounter remedy against cough and cold for over half a century—can cause harm if used on toddlers. American researchers on Tuesday warned parents against using the popular remedy on children under two years of age saying it could cause "serious respiratory distress''.
    Researchers from Wake Forest University reported in Chest, the journal of the American College of Chest Physicians, that the mentholbased ointment causes a young child's airways to swell and fill with mucus, triggering severe breathing problems because of the small size of their nasal airways.
    Officials from P&G told TOI that the product's label already advises against its use in children below two years. It also clearly states that the ointment should not be used inside the nostrils. 'Most parents unaware of risk as they don't see label'
New Delhi: US researchers have warned of the adverse effects of Vicks VapoRub on toddlers. Lead author of the Wake Forest University study Bruce Rubin said, "The ingredients in Vicks can be irritants, causing the body to produce more mucus. Infants have airways that are much narrower than those of adults, so any increase in mucus or inflammation can narrow them more severely.'' According to Rubin's study, in which he used ferrets which have airways similar to humans, exposure to Vicks increased mucus secretion in both normal and inflamed airways.
    During the study, the researchers added a high dose of VapoRub to windpipes that had been removed from ferrets killed for other research. "Those windpipes secreted 63% more mucus than windpipe specimens that had not been incubated with VapoRub,'' Rubin reported.
    Although the product label warns against use on toddlers, many parents continue to use it on their sick children below two years. Rubin said, "Most parents aren't aware of the risks as most people don't read the warning label.''
    Sumeet Vohra, marketing director, P&G India, said, "Vicks VapoRub has a long-standing history of being safe and effective when used according to package directions. Its safety and efficacy has been demonstrated in multiple human clinical trials, including more than a thousand children between one month to 12 years." He added that a survey showed that seven out of 10 doctors trusted Vicks when they had a cold. About 60% of Indian families also took Vicks. VapoRub has about 5% of the Indian respiratory health market. TNN

A bitter fruit for better weight loss

lose weight temporarily, but most gain it all back in the long run.

Could grapefruit — touted for years as a weight loss wonder — actually work? Possibly. In one 12-week study, obese people who ate half a grapefruit before each of three daily meals shed more pounds.
    Show Me the Grapefruit: In the study, whole grapefruit also took a bite out of insulin resistance in folks with metabolic syndrome — a constellation of conditions that can raise the risk for several serious health problems.
    Go Whole: Although grapefruit juice and grapefruit capsules also may have pound-shedding potential, whole fruit was clearly the winner in the study — because the whole fruit has appetite-controlling fibre.
Combine Your Efforts:
Exercise and a calorie-controlled diet remain the true cornerstones of weight loss, but if grapefruit helps, great! However, if you're taking medications of any kind, talk to your doctor before adding grapefruit to the mix. Try these other tips: Walking has the highest stick-to-it rate of any exercise. Be sane. Fad diets may help some people

WONDER FOOD: Grapefruit has appetite-controlling fibre

Top-selling mouthwash brands linked to oral cancer

Melbourne: Australian health experts have warned that top-selling mouthwashes can cause oral cancer and should be pulled from supermarket shelves immediately. The experts issued the warning after investigating latest scientific evidence linking alcohol-containing mouthwashes to the deadly disease.
    The investigation concludes that there is now 'sufficient evidence' that "alcohol-containing mouthwashes contribute to the increased risk of development of oral cancer".
    The mouthwash contains ethanol, which is believed to allow cancer-causing substances to permeate the lining of the mouth more easily and cause harm. Acetaldehyde, a toxic byproduct of alcohol that may accumulate in the oral cavity when swished around the mouth, is also believed to be carcinogenic. Listerine, the nation's biggestselling mouthwash and a brand endorsed by the Australian Dental Association (ADA), contains as much as 26% alcohol.
    Lead review author Michael McCullough said alcohol-containing mouthwash should be reclassified as prescription-only and carry written health warnings. McCullough, who's also chair of the ADA's therapeutics committee, is calling on the ADA to reassess its approval on mouthwashes containing alcohol. ANI

Smoking ban improves a city’s health

 Does banning smoking in public places improve public health? Yes, a new study finds, and the effects are large and long-lasting.
    A municipal smoke-free ordinance took effect in Pueblo, Colorado, in 2003, and researchers tracked the incidence of heart attacks, comparing rates in the city with those in its surrounding county and a neighbouring county where there were no smoking bans.
    In the 18 months preceding the ban, rates in the city and surrounding areas were identical and declining slowly. But in the year and a half after the new law took effect, hospitalizations for heart attack decreased 27% in the city, while remaining unchanged in the other two districts. After 18 more months, through June 2006, rates in the city were 41% lower than before the ordinance was passed.
    Dr Christine Nevin-Woods, the executive director of the local health department, said, "We're finding that, surprisingly, smoking ordinances are bringing down heart attack rates significantly." NYT NEWS SERVICE

Hormone Therapy Linked to Brain Atrophy in Older Women

 

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Getty Images

By Anne Harding

MONDAY, Jan. 12, 2008 (Health.com) — Not too long ago, millions of postmenopausal women were taking estrogen as part of hormone therapy to protect their hearts, prevent cancer, and keep their brains sharp.

But two new studies in the journal Neurology show that not only does hormone replacement therapy increase the risk of heart attack, stroke, blood clots, and breast cancer in women over the age of 65, but it also shrinks their brains.

"This is extra-double-triple reason not to go on estrogen after 65," says Constantine Lyketsos, MD, of the Johns Hopkins Bayview Medical Center in East Baltimore, Md. Dr. Lyketsos, an expert on dementia treatment, was not involved in the research.

Experts say the findings should not be cause for alarm among younger women who are taking estrogen according to the current guidelines. The U.S. Food and Drug Administration recommends that women who take hormones to treat hot flashes and other menopausal symptoms start doing so as early as possible, at the lowest effective dose, for the shortest time possible. (Women who haven't had a hysterectomy need to take a combination of estrogen and progestin, because estrogen alone increases the risk of cancer of the lining of the uterus; women who've had their uterus removed can take estrogen alone.)

There is good evidence that for younger women, estrogen can actually help defog the brain, improve mental function, and possibly even protect against Alzheimer's disease decades later, says Pauline Maki, PhD, who runs a research program on steroid hormones' effect on cognitive function at the University of Illinois at Chicago. She was not involved with the new studies.

One of the most plausible explanations for this paradox is the "healthy cell bias of estrogen." In other words, estrogen is good for healthy cells, and bad for unhealthy cells, she explains. In her own research, Maki has shown that women who experience an unusually high number of hot flashes during menopause have worse verbal memory.

"What I think happens is that women's brains during hot flashes, while they're not sleeping as well, the brain material is still fine," Maki says. "When you introduce estrogen to these women, you're introducing it into a healthy cell, and the results cognitively are generally beneficial."

Older women's brain cells are likely to be in worse shape than younger women's, especially if their mental faculties are already fading. "The scenario that seems to arise is one where [hormone therapy] at the dose of this trial is harmful to the frailest brains, but perhaps not to the strongest ones," Giovanni Frisoni, of the National Center for Research and Care of Alzheimer's Disease in Brescia, Italy, says. Dr. Frisoni has studied estrogen's effects on brain volumes, but was not involved in the new research.