Personal Health: News and Notes

Yet another study questions the value of the cholesterol-lowering drug ezetimibe, marketed by Merck as Zetia.

Previously, two major clinical trials found that even though ezetimibe decreases LDL cholesterol, it doesn't halt artery wall thickening, called atherosclerosis, and may even make it worse.

The new study, by University of Virginia Health System researchers, looked at the impact over two years of combining ezetimibe with a statin, a class of drugs that lowers cholesterol in a different way.

One group of 33 heart disease patients added ezetimibe to a statin they were already taking; their atherosclerosis progressed 4 percent per year.

A second group of 34 patients had not been on any cholesterol therapy. Half of them were assigned to take simvastatin (Merck's Zocor), while the other half took simvastatin plus ezetimibe (Merck's Vytorin).

Atherosclerosis was halted in both groups, suggesting simvastatin was the key.

The study came out online last week in the journal Atherosclerosis.

- Marie McCullough

A new study concludes high blood pressure among young American adults may be much higher than previously estimated.

The weird thing is that both the current and the previous estimates are based on information collected as part of federally funded surveys.

The latest analysis, by University of North Carolina researchers, used data from 14,000 men and women, ages 24 to 32, who were surveyed in 2008. Nineteen percent had hypertension.

In contrast, only 4 percent of young adults interviewed around the same time for a separate federal survey had high blood pressure.

The UNC researchers could not come up with an explanation for the discrepancy. Both surveys defined high blood pressure as 140/90 mmHg (millimeters of mercury).

Discordance aside, the researchers said the take-home message is that young adults and their doctors should not assume hypertension happens only to old folks.

The study came out online last week in the journal Epidemiology.

- M.M.

Type 2 diabetes is a serious disease, and adopting the right diet is a complicated matter that should never depend on any individual study, or, worse, newspaper summary of a study.

That said, researchers at the University of Alabama Birmingham have added another bit of information to the diet debate. They found that putting 69 overweight subjects on a low-fat diet for eight weeks helped them improve their body's ability to secrete insulin and properly process sugar.

The diet helped even when participants didn't lose any weight. The one used in the study derived about 27 percent of its calories from fat. A typical dinner consisted of sesame chicken with rice, snow peas and carrots; frozen broccoli; fat-free cheese; oranges; and a roll.

The research was published recently in the American Journal of Clinical Nutrition.

Results like this should be treated with extreme caution, since many foods are marketed as low-fat or non-fat, including sugary salad dressings, drinks laden with corn syrup, and sometimes even candy. Other research has pointed to food high in sugar or high fructose corn syrup as particularly damaging for diabetics. And fattening to boot.

- Faye Flam

Men with chronic obstructive pulmonary disease (COPD) may want to weigh the latest finding of risk when considering the benefits of drugs: Inhaled anticholinergic medications - a group that includes Atrovent, Combivent, and Spiriva - were linked to a signficantly higher risk of urinary retention in a study that followed more than 11,000 people for an average of 4.5 years in Ontario.

COPD affects 10 percent of people over 40, and these medications relax airway muscles to decrease breathing obstructions, the authors wrote in last week's Archives of Internal Medicine. But there had been mixed evidence that they might raise the risk of acute urinary retention, which is considered a urological emergency.

The researchers examined the records of all people with COPD age 66 and older in Ontario databases who had surgery or hospital visits for the urinary condition, and matched them against those who had not.

They found no pattern among women. But men were about 40 percent more likely to have had urinary retention if they had been using the drugs for one month or less, and 80 percent more likely if they also had an enlarged prostate. Simultaneous use of both short- and long-acting versions raised the risk more.
- Don Sapatkin