Releases Saturday 16 June 2001
No 7300 Volume 322
Please remember to credit the BMJ as source when publicising
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the source BMJ article (URL's are given under titles).
(1) HIGH BLOOD PRESSURE AND CHOLESTEROL
LEVELS INCREASE RISK OF ALZHEIMER'S
(2) STRATEGIES
TO CUT RISKY SEXUAL
BEHAVIOUR MAY
DO MORE HARM THAN
GOOD
(1) HIGH BLOOD
PRESSURE AND CHOLESTEROL
LEVELS INCREASE RISK OF ALZHEIMER'S
(Midlife vascular risk factors and
Alzheimer's disease in
later life: longitudinal, population
based study)
http://bmj.com/cgi/content/full/322/7300/1447
A combination of raised blood pressure
and high
cholesterol levels in midlife, greatly
increases the risk of
Alzheimer's disease in later life, finds
a study in this week's
BMJ. These findings suggest that more
emphasis should
be placed on identification and appropriate
treatment of
these conditions.
A total of 1449 people who took part in
a study during
the 1970s and 1980s were re-examined in
1998, aged
65-79. This included a questionnaire on
medical history
and cerebrovascular and cardiovascular
events and
vascular conditions diagnosed by a physician.
Height,
weight and blood pressure were measured
and blood
specimens were taken to determine cholesterol
levels.
People with raised systolic blood pressure
or high
cholesterol levels in midlife had a significantly
higher risk of
Alzheimer's disease in later life than
those with normal
blood pressure or cholesterol levels,
even after factors
including age, education, smoking status
and alcohol
consumption were taken into account. Participants
with
both of these risk factors in midlife
were at an even greater
risk of developing Alzheimer's disease
than those with
either of these risk factors alone.
Given that both raised blood pressure and
high cholesterol
levels can be treated, these results may
have important
implications for the prevention of dementia,
conclude the
authors.
Contact:
Miia Kivipelto, Research Fellow, Department
of
Neuroscience and Neurology, University
of Kuopio,
Finland
Email: miia.kivipelto{at}uku.fi
(2) STRATEGIES
TO CUT RISKY SEXUAL
BEHAVIOUR MAY DO MORE HARM THAN
GOOD
(A cognitive behavioural intervention
to reduce sexually
transmitted infections among gay
men: randomised trial)
http://bmj.com/cgi/content/full/322/7300/1451
Strategies aimed at changing sexual behaviour
to prevent
the transmission of HIV should not be
assumed to bring
benefit and potentially may even do more
harm than good,
finds a study in this week's BMJ. More
rigorous
evaluation of such interventions is needed,
report the
authors.
To determine the effectiveness of a brief
behavioural
intervention in reducing sexual risk behaviour
among gay
men, researchers at a sexual health clinic
in London
recruited 343 gay men with an acute sexually
transmitted
infection or who reported having had unprotected
anal
intercourse in the past year.
All men received standard management consisting
of a
brief (20 minute) one to one counselling
session about
sexual risk behaviour. Additionally, a
randomly selected
group of 175 men were invited to a one
day workshop
(intervention group). For the following
12 months, the
number of new infections diagnosed at
the clinic were
recorded and self-reported changes in
sexual behaviour
were assessed using postal questionnaires.
Although this intervention was acceptable
and feasible to
use in a busy clinic, it failed to reduce
the risk of these men
acquiring new infections. In fact, a larger
proportion of the
intervention group (31%) had at least
one new sexually
transmitted infection diagnosed at the
clinic compared with
the control group (21%) during the 12
month follow up.
The higher risk of acquiring a sexually
transmitted infection
among men in the intervention group was
unexpected, and
clearly a cause for concern, say the authors.
Even carefully
designed interventions should not be assumed
to bring
benefit and the potential for such interventions
to do more
harm than good needs to be taken seriously,
they
conclude.
Contact:
John Imrie, Senior Research Fellow, Department
of
Sexually Transmitted Diseases, Royal Free
and University
College Medical School, London, UK
Email: jimrie{at}gum.ucl.ac.uk
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