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January
2001
Low-Sodium
DASH Diet Lowers Blood Pressure
The effect of reducing dietary
salt on controlling hypertension, or high blood pressure, has been surprisingly
controversial. But in a recent study, a collaboration of scientists,
including researchers from Harvard Medical School and the National Heart,
Lung and Blood Institute of the National Institutes of Health, suggest
that reducing salt intake may dramatically lower blood pressure in people
with or without hypertension, regardless of age, race, or gender.
The trial, known as the Low-Sodium DASH Diet study, tested the effects
on blood pressure of lower levels of sodium intake combined with the
Dietary Approaches to Stop Hypertension (DASH) diet, which is low in
fat and rich in fruits, vegetables, whole grains, and low-fat dairy
products. More than 400 subjects were assigned either a typical American
diet or the DASH diet for 12 weeks. The salt content of every participant's
diet was randomly changed every four weeks to one of three sodium levels:
high (3,300 mg), intermediate (2,400 mg), or low (1,500 mg).
The researchers found that with either diet, the lower the salt intake,
the lower the blood pressure. But at each sodium level, blood pressure
was consistently lower for those on the DASH diet. Moreover, the largest
reductions in blood pressure were found among those who followed the
DASH diet while consuming 1,500 mg of salt per day, well below the
government's recommended daily intake of 2,400 mg, or 1 1/4 teaspoons.
This combination worked best for all participants, but particularly
for patients with hypertension, whose systolic blood pressure was 11.5
millimeters of mercury (mm Hg) lower than hypertensive participants
on the control diet with a high sodium level. The beneficial effect
of a lower sodium diet was also more pronounced in women than men and
in blacks than people of other races.
Controlling blood pressure reduces the risk of developing complications
associated with hypertension, which include heart disease and stroke.
New dietary guidelines from the American Heart Association recommend
that everyone adopt an eating plan similar to the DASH diet and limit
their sodium intake to less than 2,400 mg per day. Other things you
can do to keep blood pressure in check include maintaining a healthy
body weight, cutting down on dietary fat, and staying active.
January 2001 Update
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Products
Containing Phenylpropanolamine (PPA) Pulled From Shelves
Responding to concerns that phenylpropanolamine (PPA), an ingredient
found in many over-the-counter medications, may increase risk of hemorrhagic
stroke (see the Family Health Guide online update on phenylpropanolamine),
the U.S. Food and Drug Administration has asked manufacturers to remove
drugs containing PPA from the market. The following list may not be complete
and does not include drug store and supermarket brands, so please check
the label or ask your pharmacist. You should also discard any items in
your medicine cabinet that contain PPA.
Drugs Pulled From the Market:
Acutrim Diet Gum Appetite Suppressant Plus Dietary Supplements
Acutrim Maximum Strength Appetite Control
Alka-Seltzer Plus Children's Cold Medicine Effervescent
Alka-Seltzer Plus Cold Medicine (cherry or orange flavor)
Alka-Seltzer Plus Cold Medicine Original
Alka-Seltzer Plus Cold & Cough Medicine Effervescent
Alka-Seltzer Plus Cold & Flu Medicine Effervescent
Alka-Seltzer Plus Cold & Sinus Effervescent
Alka-Seltzer Plus Night Time Cold Medicine Effervescent
BC Allergy Sinus Cold Powder
BC Sinus Cold Powder
Comtrex Deep Chest Cold & Congestion Relief
Comtrex Flu Therapy & Fever Relief Day & Night
Contac 12 Hour Cold Capsules
Contac 12 Hour Cold Caplets
Coricidin D Cold, Flu & Sinus
Dexatrim Caffeine Free
Dexatrim Extended Duration
Dexatrim Gelcaps, Dexatrim Vitamin C / Caffeine Free
Dimetapp Cold & Allergy Chewable Tablets
Dimetapp Cold & Cough Liqui-Gels
Dimetapp DM Cold & Cough Elixir
Dimetapp Elixir
Dimetapp 4-Hour Liqui-Gels
Dimetapp 4-Hour Tablets
Dimetapp 12-Hour Extentabs Tablets
Naldecon DX Pediatric Drops
Permathene Mega-16
Robitussin CF
Tavist-D 12 Hour Relief of Sinus & Nasal Congestion
Triaminic DM Cough Relief
Triaminic Expectorant Chest & Head Congestion
Triaminic Syrup Cold & Allergy
Triaminic Triaminicol Cold & Cough
January 2001 Update
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FDA
Approves Femara as First-Line Breast Cancer Treatment
On January 10, 2001, the U.S. Food and Drug Administration (FDA) approved
Femara (letrozole) as a first-line treatment for postmenopausal
women with advanced breast cancer. Femara was originally approved in
1997 to treat advanced breast cancer in women who did not respond to
standard antiestrogen drugs such as tamoxifen.
The hormone estrogen stimulates the growth of about half of all breast
cancers, known as hormone-receptor-positive breast cancers. Femara,
which works by blocking the production of estrogen, can now be used as
a principal therapy for these and hormone-receptor-unknown advanced breast
cancers. For 20 years, tamoxifen, which blocks estrogen from binding
to an estrogen receptor on cancer cells, has been used as a first-line
treatment in early and advanced breast cancer patients with hormone-receptor-positive
or hormone-receptor-unknown cancer. It has also been used to slow the
progress of tumor growth of breast cancers that have metastasized, or
spread to other parts of the body.
The recent FDA approval of Femara was based on the results of a randomized,
double-blinded, multinational clinical trial comparing Femara and tamoxifen.
It involved more than 900 postmenopausal women with locally advanced
breast cancer, breast cancer that had spread to other parts of the body,
or recurring breast cancer that could not be treated with surgery or
radiation. The trial showed that Femara increased time to progression
of the disease to 9.4 months, compared to 6 months for tamoxifen. The
gain is considerable for late-stage cancer, and it allows women to delay
more toxic chemotherapy. The side effects for both drugs were comparable
and included back, joint, and bone pain, nausea, and hot flashes.
What is not known at this point is whether Femara will have any role
in the prevention of breast cancer. Tamoxifen is often given to
hormone receptor positive breast cancer patients after surgery, to prevent
tumors from recurring and to women with a strong family history of breast
cancer to prevent the disease from developing in the first place. Femara
has not yet been approved for either of these purposes.
January 2001 Update
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Cell
Phone Use Not Likely Linked to Brain Cancer
Extensive media attention has focused on the health implications
of the use of cellular telephones. The concern has been based primarily
on anecdotal evidence that the microwave-frequency signals these
phones transmit could cause brain cancer. One recent investigation — a
National Cancer Institute (NCI) study reported this month in the New
England Journal of Medicine — found that it is highly
unlikely that the use of cell phones increases the risk of brain
tumors.
Between 1994 and 1998, the researchers examined 782 patients with
confirmed brain tumors in Phoenix, Boston and Pittsburgh hospitals.
The patients were divided into groups by tumor type and compared
with 799 controls admitted to these hospitals for other conditions.
Researchers collected data about cell phone use through personal
interviews with each of the study participants. The interviewer
asked when the participants first began using a hand-held cell
phone, when they last used one, how often and how frequently they
used these phones, the duration of a typical cell phone call, and
with which hand they usually held the handset.
Cell phone use was not significantly associated with any of the
tumor types. The percentage of controls (29%) who reported using
a cell phone more than five times was almost identical to the percentage
of brain cancer patients who reported using them (22-31% grouped
by tumor type). Risk was not higher among regular users who began
using cell phones earlier, nor did it rise significantly with the
increased duration of use, frequency of use, or total overall use.
In addition, tumors did not occur disproportionately on the side
of the head on which the cell phone was more frequently used.
The NCI authors point out, however, that since cell phones were
introduced only 20 years ago, and were not widely used until the
mid-1990s, the possibility of harm associated with long-term, heavy
use cannot be predicted. They also note that technological advances
may alter the design of future cell phones, affecting cancer risk.
Thus, the connection between cancer and cell phone use is likely
to be revisited in years to come.
January 2001 Update
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