High Blood Pressure, Cholesterol May Contribute to Alzheimer's

TIMES MEDICAL WRITER

As if there weren't already enough good reasons to lower your blood pressure and cholesterol levels, here's one more: It can help you avoid Alzheimer's disease. A new Finnish study indicates that hypertension and high cholesterol levels raise the risk of Alzheimer's and that the two together are even more deadly.

Dr. Miia Kivipelto and colleagues at the University of Kuopio studied 1,449 people, ages 69 to 79, who had been examined in health studies in 1972, 1977, 1982 or 1987. They reported in the June 16 issue of the British Medical Journal (http://www.bmj.org) that, independent of other risk factors, those who had high blood pressure at the initial examination were 2.3 times as likely to develop Alzheimer's as those with normal pressure. Those with high cholesterol levels were 2.1 times as likely to develop Alzheimer's; those with hypertension and high cholesterol were 3.5 times as likely to develop it. Given that high blood pressure and high cholesterol can be controlled, the findings could lead to increased prevention of the debilitating and deadly disorder.

Urinary Tract Infections May Jeopardize Fetuses

Pregnant women who have an untreated urinary tract infection during the third trimester of pregnancy are more likely to have a mentally retarded child or to undergo stillbirth, according to a new study. There is no increased risk if the infection is treated promptly, but some women prefer not to expose their fetuses to the antibiotics--thereby inadvertently increasing the risk of damage to the unborn child.

Dr. Suzanne McDermott of the University of South Carolina School of Medicine tracked the birth records of more than 80,000 mothers and children. The children were evaluated for mental retardation up to the age of 8. The team reported in the May issue of Journal of Family Practice (http://www.jfponline.org) that there was a 40% increased risk of mental retardation among children of mothers with an untreated urinary tract infection. Fetal death was twice as likely among those women as well.

Risk of Heart Attacks Linked to Air Pollution

Brief exposure to elevated levels of fine particulate air pollution can temporarily increase the risk of heart attack, especially among people who already have heart disease, according to Boston researchers. Previous studies have shown an increased incidence of hospital admissions during periods of increased pollution, but the new study is the first to chart the time-course of exposure.

Dr. Murray Mittleman of Beth Israel Deaconess Hospital and his colleagues interviewed 722 heart attack victims shortly after their admission to area hospitals, then correlated the time of attack with air pollution levels. They reported in the June 12 issue of Circulation: Journal of the American Heart Assn. (http://circ.ahajournals.org) that the participants had a 50% increased risk of heart attack in the two hours following exposure to high levels of fine particulates. The risk slowly declined until it returned to normal 24 hours after the exposure.

The fine particulates create an inflammatory response in the lungs that triggers a systemic inflammatory response that affects the heart. The exposure also turns on the clotting system, increasing the likelihood of clot formation and restricted blood flow.

Drug Paired With Clot-Buster Helpful

Clot-busting drugs have been the standard of care for heart attacks since the 1980s, although angioplasty is rapidly becoming a viable alternative. A new study suggests that the efficacy of clot-busters can be improved by adding a second drug called abciximab, which inhibits the ability of platelets to aggregate and form clots.

A team headed by Dr. Eric J. Topol of the Cleveland Clinic Foundation studied 16,588 patients in the first six hours after a heart attack. Half were given a clot-buster called reteplase, and half were given reteplase plus abciximab, trade-named ReoPro. The team reported in the June 16 Lancet (http://www.thelancet.com) that those receiving reteplase and abciximab had a slightly lower death rate, 468 to 488, than those receiving reteplase alone. But there were also fewer nonfatal second heart attacks with the combination--about 12 fewer per 1,000 patients treated--less need for emergency angioplasty and fewer major complications.

Unusually, the paper listed more than five pages of authors--physicians who participated in the study. In fact, the list of authors was longer than the study itself.

In a second study in the same journal, a team headed by Dr. Maarten L. Simoons of University Hospital Rotterdam, the Netherlands, observed no benefit at all from using abciximab alone. They studied 7,600 patients, who received either a placebo, a low dose of abciximab, or a higher dose. The death rates were slightly higher--but not significantly so--among the patients receiving the drug.

Spinal Cord Treatment Having Some Success

Israeli physicians said last week that preliminary results from a clinical trial showed some success at repairing severed spinal cords and restoring movement in paralyzed people.

The technique, developed by Dr. Michal Schwartz of the Weizmann Institute of Science, involves injecting white blood cells called macrophages into the spinal cord at the damaged region. Tests in animals have shown that about 60% are improved by the treatment. Macrophages help heal and regenerate tissues.

Dr. Valentin Fulga of Proneuron Biotechnologies (Israel) Ltd. told the Reuters news service that he treated Melissa Holley, an 18-year-old American, last year after she was left a paraplegic in an automobile accident. Two of her vertebrae were crushed and her spinal cord was severely damaged.

Twelve months later, Fulga said, she has regained movement in her toes and legs and has bladder control, improving her quality of life and reducing chances of the urinary tract infections that are a common cause of death among paraplegics. The company will treat six patients in the first stages of the study.

Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.

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