Press releases Monday 29 June to Friday 3 July 2009
Please remember to credit the BMJ
as source when publicising an article and to tell your readers that they can
read its full text on the journal's website (http://www.bmj.com).
(1) Study recommends statins for healthy people at risk of heart disease
(2) Researchers call for more prudent use of antibiotics in young children
(3) High risk of dementia for middle-aged people living alone
(4) It's the climate, stupid: NHS health & climate event at your desk
(1) Study recommends statins for healthy people at risk of heart disease
(Research: The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials)
http://www.bmj.com/cgi/doi/10.1136/bmj.b2376
Statins should be given to people without established cardiovascular disease but with risk factors such as high blood pressure and diabetes, concludes a study published on bmj.com today.
Cardiovascular disease is the leading cause of death and disability in the Western world. The benefits of statin therapy in patients with established cardiovascular disease (known as secondary prevention) have been clearly demonstrated, but it is still not clear whether treating lower risk people without established disease (known as primary prevention) would also be worthwhile.
The benefit of treating people aged over 65, women, and those with diabetes is also uncertain.
So an international team of researchers investigated whether statins reduce deaths and major cardiovascular and cerebrovascular events, such as heart attacks and strokes, in people without established heart disease.
They analysed the results of ten large trials involving over 70,000 patients. All the trials compared statin therapy with placebo or control group and tracked patients for an average of four years. Differences in study design and quality were taken into account to minimise bias.
Compared to controls, statins cut deaths from all causes by 12% and cut the risk of major events by 30% in patients without established heart disease.
No significant treatment differences were found between men and women, elderly and young patients, and those with and without diabetes. There was also no evidence of an increased risk of cancer with statin therapy.
These results are very much in line with previous studies on the effects of statins in secondary prevention, say the authors.
From the current data, it is not possible to exactly define one group of people who would benefit most from long term statin use, but they suggest that men over 65 years with risk factors, or older women with diabetes and risk factors, constitute the highest risk group.
Further work is needed to improve the identification of these people and to accurately assess their risk. But, given the favourable of long term statin treatment, it would be wrong to deny these benefits to people at increased risk for cardiovascular disease, they conclude.
Contact:
Dr Jasper Brugts, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
Email: j.brugts@erasmusmc.nl
Young children who are given antibiotics to treat acute ear infections are 20% more likely to suffer from recurrent ear infections, finds research published on bmj.com today.
This survey of parents whose young children took part in a Dutch trial of antibioitics for acute ear infections shows that nearly two thirds (63%) who were given antibiotics had a recurrence of the infection within three years. This compares with only a 43% recurrence rate in children who were given a placebo at the time of initial infection.
The study is the first to assess the long term effects of antibiotics in children with acute otitis media (ear infection) and supports calls for judicious prescription of antibiotics.
Acute otitis media is one of the most common infections in childhood and is the most frequent reason for children to take antibiotics. Current guidelines recommend prescribing antibiotics to children with severe illness and in those younger than two years of age with severe infection. For most other children with acute otitis media, initial observation is recommended.
The trial was conducted across 53 general practices in the Netherlands and included 168 children aged six months to two years of age.
In 2000, three and a half years after the start of the trial, parents of the participating children were sent a questionnaire asking if their child had suffered a recurrence of acute otitis media. In the amoxicillin group, 47 out of the 75 children had suffered at least one recurrent episode, compared with only 37 out of 86 in the placebo group.
This means that children in the amoxicillin group had a 2.5 times higher risk of recurrent acute otitis media than children in the placebo group.
The survey was likely to be unbiased because it included most (70%) of the parents, and because none of them had known at the time of the trial which treatment - either antibiotic or placebo - their children had received.The association remained even after adjusting the results for other factors, such as allergy and a previous tendency to have recurrent ear infections. It should be noted however that 30% of children in the placebo group had to undergo ear, nose, and throat surgery on initial infection, compared with only 21% in the amoxicillin group.
The researchers suggest that the difference in recurrence rates between the two groups could be due to a weakening of the children's natural immune response system, as a result of taking antibiotics at the initial stage of infection. They argue antibiotic use may cause an 'unfavourable shift' towards the growth of resistant bacteria.
They also suggest that, whilst antibiotics may reduce the length and severity of the initial ear infection, their use may encourage doctors' attendance in future episodes and antibiotic resistance.
This is another argument for judicious use of antibiotics in children with acute otitis media, they conclude.
Contacts:
Maroeska Rovers, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands
Email: m.rovers@umcutrecht.nl
Or
Roger Damoiseaux, General Practitioner, General Practice de Hof van Blom, Hattem, Netherlands
Email: rdamoiseaux@hotmail.com
(3) High risk of dementia for middle-aged people living alone
(Research: Association between mid-life marital status and cognitive function in later life: population based cohort study)
http://www.bmj.com/cgi/doi/10.1136/bmj.b2462
(Editorial: Dementia and marital status at mid-life and late life)
http://www.bmj.com/cgi/doi/10.1136/bmj.b1690
Middle-aged people living alone have twice the risk of developing dementia and Alzheimer's disease in later life compared with married or cohabiting people, while being widowed or divorced in mid-life carries three times the risk, according to a study led by Miia Kivipelto from the Swedish medical university Karolinska Institutet and published on bmj.com today.
As life expectancy is increasing in various regions of the world, dementia is becoming a growing public health concern. In 2005 an estimated 25 million people had dementia, and the number is expected to reach 81.1 million in 2040.
While there have been a number of studies linking being in a couple to good health and longevity this is one of the first studies to focus on mid-life marital status and the risk of dementia.
So researchers based in Finland and Sweden interviewed a random sample of 2,000 men and women who took part in the cardiovascular Risk Factors, Aging and Dementia study. The participants came from two regions in Eastern Finland.
Individuals were initially surveyed at around 50 years of age and again around 21 years later. Participants were divided into the following groups: married/cohabitant, single, divorced or widowed. The team also investigated whether there was a link between living alone and being a carrier of the apolipoprotein E e4 gene variant (or allele), the known genetic risk factor for Alzheimer's disease.
The results reveal that people living without a partner during middle age had a much higher risk of developing cognitive impairment in late life compared to those living with a partner. Individuals who are widowed at this age are three times more likely to develop dementia. The study also concludes that carriers of apolipoprotein E e4 gene variant who lose their partners and remain living alone have the highest risk of developing Alzheimer's disease.
The authors say these results are important for preventing dementia and cognitive impairment and that "supportive intervention for individuals who have lost a partner might be a promising strategy in preventive health care."
These results also add to a growing body of evidence for the general importance of social factors in sustaining healthy brain functioning, they conclude.
This study strengthens the hypothesis that the development of cognitive impairment and dementia is a long process that is affected by various factors throughout life, writes researcher and epidemiologist Catherine Helmer in an accompanying editorial.
She believes that to understand the link between marital status and dementia, future research should focus on the stress caused by a separation and satisfaction with relationships. She also suggests that the findings could lead to preventive strategies that encourage unmarried, especially widowed, people to increase their social engagement by taking part in cultural, social, and sporting activities.
Contacts:
Research: Miia Kivipelto, Associate Professor, Aging Research Centre, Karolinska Institute, Stockholm, Sweden
Email: Miia.Kivipelto@ki.se
Or
Krister Håkanson, Research Fellow
Email: krister.hakansson@ki.se
Or
Sabina Bossi, Press Officer
Email: sabina.bossi@ki.se
Editorial: Editorial: Catherine Helmer, Researcher, Epidemiologist, Université Victor Segalen, Bordeaux Cedex, France
Email: catherine.helmer@isped.u-bordeaux2.fr
(4) It's the climate, stupid: NHS health & climate event at your desk
On 7 July 2009 at 13:00hrs UK time, Fiona Godlee, editor of the British Medical Journal, will chair a webcast on climate change & the NHS.
Fiona and other leading figures will be discussing the impact of the environmental film The Age of Stupid and how much the NHS has to gain from taking climate change seriously. The panel discussion will be followed by a brief Q&A session.
To register your attendance, click here: http://www.visualwebcaster.com/event.asp?id=59903
Please register by 5pm on 3 July as places are limited.
FOR ACCREDITED JOURNALISTS
For more information please contact:
Emma Dickinson
Tel: +44 (0)20 7383 6529
Email: edickinson@bmj.com
Press Office telephone : 020 7383 6254 (Weekdays : 0900hrs - 1800hrs)
British Medical Association
BMA House, Tavistock Square, London WC1H 9JP
and from:
the EurekAlert website, run by the
American Association for the Advancement of Science (http://www.eurekalert.org)
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