Norvasc May Not Be Optimal for Blacks With Hypertension
African Americans who are using calcium channel blockers such as Norvasc to control high blood pressure should be switched to other classes of drugs, such as ACE inhibitors or beta-blockers, because those drugs are more effective at preventing kidney disease, according to the National Institutes of Health.
Blacks are especially prone to kidney damage caused by hypertension. While they constitute 12.6% of the U.S. population, blacks account for nearly 30% of patients treated for kidney failure. Hardest hit are those ages 25 to 44, who are 20 times more vulnerable to hypertension-related kidney failure than whites.
The results come from a major study of 1,094 African American patients sponsored by NIH. In one segment of the study, Norvasc was being compared with the ACE inhibitor Altace and the beta-blocker Toprol in patients who had some protein in their urine, a sign of early kidney damage. The NIH announced Oct. 13 that it was halting that part of the study early because the two other drugs were much better than Norvasc at slowing progression to kidney damage.
Dr. Lawrence Agodoa of NIH cautioned, however, that patients should not stop taking Norvasc, because it is an effective means of lowering blood pressure. Instead, they should talk with their doctor who, ideally, will switch them to one of the other drugs. He also said Norvasc can be used in addition to other drugs to help control blood pressure.
Chicken Soup: The Folklore May Be Right
Your grandmother was right: Chicken soup is good for a cold, researchers say.
Scientists at Nebraska Medical Center in Omaha found that chicken soup--at least the homemade variety--has an anti-inflammatory activity that could ease the symptoms of upper respiratory tract infections.
Chicken soup has been regarded as a remedy for colds since the time of the Egyptian Jewish physician and philosopher Moses Maimonides in the 12th century. It is so widely recommended in the Jewish tradition that it is often referred to as Jewish penicillin, bohbymycetin or bobamycin. But until now there has been little science demonstrating the benefits of this popular folk remedy.
Dr. Stephen Renard and his colleagues studied the ability of chicken soup and its components to block the activity of neutrophils--white blood cells that eat up bacteria and cellular debris and which are released in great numbers by viral infections such as colds. Blocking that activity could, theoretically, reduce inflammation and thereby reduce cold symptoms.
In a laboratory study, the team reported in the October issue of Chest that the homemade chicken soup, made from Renard’s grandmother’s recipe, effectively blocked the activity of neutrophils. Some commercial soups, such as Knorr chicken noodle soup and Campbell’s Home Cooking and Healthy Request chicken soups, were even more effective. But others, such as Campbell’s ramen noodles and Cup o’ Noodles, showed no benefit at all.
C-Section Seems Better for Breech Deliveries
A caesarean section is safer than a normal vaginal delivery for full-term babies who are in the breech position--with the baby ready to be born feet or buttocks first, Canadian researchers have found.
Between 3% and 4% of pregnancies result in a breech delivery, and pediatricians are split over which form of delivery is best. The new study provides the first hard evidence discriminating between the two.
A team led by Dr. Mary Hannah of the Sunnybrook and Women’s College Health Sciences Centre in Toronto studied 2,088 women at 121 clinics in 26 countries. Half were randomly assigned to a planned caesarean birth and half to a planned vaginal birth. Five women dropped out of the study.
Of the 1,041 women assigned planned caesarean section, the team reported in the Oct. 21 Lancet (https://www.thelancet.com), 90% were delivered in that manner. And among the 1,042 women assigned to vaginal birth, 57% delivered vaginally. Infant death, during or after birth, and serious infant illness were three times higher in the planned vaginal birth group than in the planned caesarean section group, 5% versus 1.6%. The reduction in risk from planned caesarean section was much greater in countries with a low rate of infant death during birth than in countries with a high rate.
Enzyme Flagged as Heart Risk Predictor
Scottish researchers have confirmed that a recently described enzyme in the blood is an independent predictor of heart attack risk. The enzyme is called phospholipase A2, but its role is not yet known. It appears to help break down fat, may promote inflammation and could contribute to the buildup of deposits inside blood vessels that lead to blockages. High levels of the enzyme apparently increase risk.
Researchers led by Dr. Chris J. Packard of the Glasgow Royal Infirmary studied blood samples from 580 men with high cholesterol levels and compared them with samples from 1,160 healthy men. The high-cholesterol samples were collected as part of a study of the cholesterol-lowering drug pravastatin.
The team reported in the Oct. 19 New England Journal of Medicine that the 20% of the men with the highest phospholipase A2 levels had twice the risk of a heart attack or other cardiovascular problem as those in the lowest 20%, independent of all other variables.
Drug Appears Safe for Diabetes in Pregnancy
A widely used drug called glyburide can be safely used to control diabetes that develops during pregnancy, according to New York researchers. Physicians had previously believed that glyburide might cause birth defects and had cautioned against its use by pregnant women. As an alternative, pregnant women had to rely on insulin injections to control their symptoms. About 10% of women develop gestational diabetes. In about half the cases, it can be controlled by diet and exercise, but the other women normally need medication.
A team headed by Dr. Oded Langer at St. Luke’s-Roosevelt Hospital studied 404 women at clinics in San Antonio. Half took insulin, and half took glyburide. The drug was not given during the first three months of pregnancy for fear of birth defects, but gestational diabetes usually appears only in the last six months anyway.
They reported in the Oct. 19 New England Journal of Medicine (https://www.nejm.com) that insulin controlled blood sugar levels in 88% of the women, while glyburide controlled sugar levels in 82% of women. The researchers found no differences in the health of the babies in the two groups.
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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.
