[Vol 34] Medi-Scene: Your Weekly Health News Update

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MediScene Vol 34

A new study published in the Journal of the American Heart Association states that having eight or more alcoholic beverages in a week’s time can increase the risk of high blood pressure (also called hypertension) among adults with Type 2 diabetes. Senior study author Matthew J. Singleton, M.D., M.B.E., M.H.S., M.Sc., a chief electrophysiology fellow at Wake Forest University School of Medicine in Winston-Salem, North Carolina said, “This is the first large study to specifically investigate the association of alcohol intake and hypertension among adults with Type 2 diabetes. Previous studies have suggested that heavy alcohol consumption was associated with high blood pressure, however, the association of moderate alcohol consumption with high blood pressure was unclear. Researchers collected and analyzed data of 10,000 adults (average of age 63) to study the relationship between alcohol consumption and blood pressure in Type 2 diabetes. All participants had Type 2 diabetes for an average of 10 years. Light drinking was not associated with elevated blood pressure or either stage of high blood pressure, moderate drinking was associated with increased odds of elevated blood pressure by 79%, Stage 1 high blood pressure by 66%, and Stage 2 high blood pressure by 62% heavy drinking was associated with increased odds of elevated blood pressure by 91%. Dr Singleton further added, “Though light to moderate alcohol consumption may have positive effects on cardiovascular health in the general adult population, both moderate and heavy alcohol consumption appear to be independently associated with higher odds of high blood pressure among those with Type 2 diabetes. Lifestyle modification, including tempering alcohol consumption, may be considered in patients with Type 2 diabetes, particularly if they are having trouble controlling their blood pressure. People with Type 2 diabetes are at higher cardiovascular risk, and our findings indicate that alcohol consumption is associated with hypertension, so limited drinking is recommended.”

  • Gestational diabetes could accelerate biological age of the child

A recent study explored how more than 1,000 children born to mothers in China aged on a cellular level and the findings were published in Journal Epigenetics. Children born to mothers who had diabetes during pregnancy may age faster biologically and be at an increased risk for obesity and high blood pressure. examined their exposure to gestational diabetes in utero and their DNA methylation, or epigenetic age, which indicates how experiences and exposures reflect true biological age even in early childhood. Accelerated aging, which can be determined by evaluating if a person’s estimated DNA methylation age is greater than their chronological age, has been shown to be associated with cardiovascular risks and poor health outcomes later in life. The researchers measured the epigenetic age of 1,156 children who were ages 3 to 10 in Tianjin, China, to see how it differed from their chronological age. Lead author Stephanie Shiau from Rutgers University in the US said, “These findings suggest that gestational diabetes may have long-term effects on epigenetic aging in offspring and lead to poorer cardiometabolic health outcomes.”

  • Brain atrophy in MS linked to cardiovascular risk factors

A new study presented by Raffaello Bonacchi, MD, Vita-Salute San Raffaele University, Milan, Italy, on September 11 at the 8th Joint European Committee for Treatment and Research in Multiple Sclerosis-Americas Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS-ACTRIMS) 2020 states that  presence of cardiovascular risk factors in patients with multiple sclerosis (MS) is associated with a greater degree of brain atrophy even in young patients. Dr Bonacchi said, “Our results suggest that even low levels of exposure to cardiovascular risk factors are important in MS and might affect brain atrophy — and therefore long-term disability — even in young patients. It is not only smoking. Other cardiovascular risk factors also appear to be implicated. We found a synergistic effect of the different risk factors. These are only preliminary data and need to be confirmed in other studies. but it does suggest that MS neurologists need to pay attention to comprehensive care — not just MS disease activity. They also need to be discussing lifestyle with their patients, evaluating their cardiovascular risk factors, and giving advice on stopping smoking, lowering blood pressure, cholesterol, etc.” When it came to commenting on the brain changes, Dr Bonacchi said, “Small vessel disease is widespread in the population over 50 years of age, but in this study we wanted to look at the impact of cardiovascular risk factors in younger patients with MS who are not likely to have much small vessel disease to try and see whether there is still a relationship with brain atrophy or white/gray matter lesions. This is one of the first studies to have graded degrees of risk factors and we found one stringent risk factor was associated with the same effects on brain atrophy as two less stringent risk factors. As our population is under aged 50 years, who are unlikely to have much small vessel disease, our results suggest that the influence of cardiovascular risk factors on brain atrophy in MS is not just mediated through small vessel disease and is probably also mediated by increased inflammation.”

  • Weight loss shows impressive drop in type 2 diabetes risk

Intentional loss of a median of just 13% of body weight reduces the relative risk of developing type 2 diabetes by around 40% in people with obesity, among many other health benefits, shows a large real-world study in half a million adults. Christiane Haase, PhD, Novo Nordisk, Denmark, led the work together with Nick Finer, MD, senior principal clinical scientist, Novo Nordisk. Dr Finer said, “This is powerful evidence to say it is worthwhile to help people lose weight and that it is hugely beneficial. These are not small effects, and they show that weight loss has a huge impact on health. It’s extraordinary. These data show that if we treat obesity first, rather than the complications, we actually get big results in terms of health. This really should be a game-changer for those health care systems that are still prevaricating about treating obesity seriously. Weight loss was real-world without any artificial intervention and they experienced a real-life reduction in risk of various obesity-related conditions.” Carel le Roux, MD, PhD, from the Diabetes Complications Research Centre, University College Dublin, Ireland, welcomed the study and commented on it further saying, “In the study, intentional weight loss was achieved using mainly diets and exercise, but also some medications and surgical treatments. However, it did not matter how patients were able to maintain the 10% or more weight loss as regards the positive impact on complications of obesity. It helps to consider all the weight loss options available, but also for those who are not able to achieve weight loss maintenance, to escalate treatment. This is now possible as we gain access to more effective treatments.”

  • Recovery in peripheral artery disease affected by depression

Results of a new study led by Kim G. Smolderen, PhD, a clinical health psychologist and co-director of the Vascular Medicine Outcomes Research Program, Yale University School of Medicine, New Haven, Connecticut showed that women with peripheral artery disease (PAD) are almost twice as likely as their male counterparts to have depression, and all PAD patients with depression have a much worse 1-year recovery path than those without depression. Dr Smolderen further commented on that saying, “Depression may be a significant problem that may prevent physicians from getting the treatment results they were aiming for. To maximize outcomes, clinicians should spend time detecting depression and linking patients to appropriate holistic care. Although women are at least as likely as men to develop PAD, they may experience worse functional impairment. Aside from cardiovascular risk management, PAD treatments focus on relieving symptoms and improving quality of life through medications, exercise, or invasive treatments. If it’s (depression) not treated or recognized, this might complicate their recovery from PAD or their rehabilitation process. The depression rate among women in the study is about on par with that among women in general, although in some studies, it is as high as 1 in 3, said Smolderen. Such high rates are also “seen across the cardiovascular disease spectrum.”

  • ICMR: Some plasma therapies show adverse reaction

On Tuesday, The Indian Council of Medical Research said early evidence from one of its randomised controlled trials on the efficacy of convalescent plasma for Covid-19 patients has shown the possibility of adverse reactions in some cases, even as the therapy did not reduce mortality nor did it prevent progression from moderate to severe disease. The study conducted on 464 patients across 39 hospitals in 25 districts spread over 14 states and UTs was still under peer review and full publication of the results was awaited. ICMR director general Balram Bhargava said, “Once peer review happens and we get full publication out, this data will be considered again by the national task force and joint monitoring group of the health ministry and then a decision will be taken if we should continue with this or not because at the moment, we have got permission to use plasma therapy (off label) in India. There are a few cases where some reactions can occur and, therefore, we will take a considered view once we get the full publication of this study.”

Reference links:

  1. https://health.economictimes.indiatimes.com/news/diagnostics/excessive-drinking-raise-high-blood-pressure-risk-in-adults-with-type-2-diabetes-study/78077337
  2. https://health.economictimes.indiatimes.com/news/diagnostics/gestational-diabetes-may-accelerate-childs-biological-age/78060142
  3. https://www.medscape.com/viewarticle/937276
  4. https://www.medscape.com/viewarticle/937162
  5. https://www.medscape.com/viewarticle/936647
  6. https://health.economictimes.indiatimes.com/news/industry/adverse-reaction-in-some-to-plasma-therapy-icmr/78137944

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