6/15/10

Hormone patch may be safer for women

(Reuters) - Women who want to use hormone replacement therapy may be less likely to have a stroke if they use low-dose patches instead of pills, Canadian researchers reported on Thursday.


Their study of British women showed that those who used estrogen patches to control symptoms of menopause did not have any higher risk of stroke than women who did not use HRT.

The study, published in the British Medical Journal, adds to a very slowly growing body of evidence that could rehabilitate the use of HRT, which plummeted in 2002 after the publication of the Women's Health Initiative study, which found an increased risk of ovarian cancer, breast cancer, strokes and other health problems from hormone therapy.

Sales of U.S. market leader Wyeth's combined estrogen-progestin therapy Prempro have fallen by about 50 percent since 2001 to around $1 billion a year. Wyeth is now owned by Pfizer.

But many experts who studied HRT said there was some evidence that if women took a lower dose and if they took HRT by means other than a pill, the risks might not be as high.

Samy Suissa of McGill University in Montreal and colleagues used Britain's national medical database to pick out 15,700 women over 50 who had strokes and nearly 60,000 who had not.

Women who had used low-dose transdermal patches to get their HRT had almost precisely the same risk of stroke -- very slightly less, in fact -- than women who used no HRT.

"I think that these are promising findings," said Dr. JoAnn Manson of Brigham and Women's Hospital and Harvard Medical School in Boston, who helped lead the Women's Health Initiative and who was not involved in Suissa's study.

Suissa's team found that 7.7 percent of stroke patients had been given a prescription for some form of HRT within the previous year of their stroke. And 6.9 percent of women who did not have a stroke got some form of HRT.

"The risk of stroke was not increased with use of low estrogen dose patches compared with no use, whereas the risk was increased with high dose patches," Suissa's team wrote.

HRT pills raised the risk of stroke by 25 percent to 30 percent, regardless of the formulation. High-dose patches raised the risk by 88 percent.

Delivering low doses of hormones through the skin bypasses the liver and may reduce the whole-body effects, Suissa's team said in their report, available at: here

Menopause can cause serious symptoms, including debilitating hot flashes, sleep disturbances and a lack of energy. Women also become more susceptible to heart disease, osteoporosis and some cancers after menopause.

Experts in HRT and menopause say women should be able to choose to use hormones to treat these symptoms but should take the lowest dose possible for the shortest possible time. Before 2002 HRT was regularly prescribed to prevent heart disease and osteoporosis but the experts now recommend against this.
Manson said the ongoing Women's Health Initiative study will look at different doses of hormones. Her team found two years ago that low-dose HRT pills did not raise the risk of stroke and said more study is needed to be sure.

"If there was an option that didn't raise the risk of stroke, that would be a tremendou breakthrough," Manson said in a telephone interview.

Makers of HRT patches include Novogyne, a joint venture of Novartis Pharmaceuticals Corp and Noven Pharmaceuticals Inc, which was acquired last year by Japan's Hisamitsu Pharmaceutical Co Inc and Janssen-Cilag, part of Johnson & Johnson.


Source : http://www.reuters.com/article/idUSTRE6526DW20100603
regards, taniafdi ^_^

Toothbrushing Less Than Twice a Day Linked to Increased CV Risk

News Author: Sue Hughes


June 7, 2010 — Individuals who do not brush their teeth twice a day have an increased risk of heart disease, a new study shows [1].

The study was published online May 27, 2010 in BMJ; corresponding author is Prof Richard Watt (University College London, UK).

The researchers note that while it has been established that inflammation in the body (including mouth and gums) plays an important role in the buildup of atherosclerosis, this is the first study to investigate whether the number of times individuals brush their teeth has any bearing on the risk of developing heart disease.

They analyzed data from more than 11 000 adults who took part in the Scottish Health Survey, in which individuals were asked about lifestyle behaviors such as smoking, physical activity, and oral health routines. Questions asked included how often they visited the dentist and how often they brushed their teeth (twice a day, once a day, or less than once a day). Information was also collated on medical history and family history of heart disease and blood pressure. Blood samples were taken from a subgroup of participants and tested for C-reactive protein (CRP) and fibrinogen levels. The data gathered from the interviews were linked to hospital admissions and deaths.

Results showed generally good oral hygiene practices, with 62% of participants saying they visited the dentist every six months and 71% reporting that they brushed their teeth twice a day. After adjustment for established risk factors, it was found that participants who reported less frequent toothbrushing had an increased risk of heart disease compared with people who brushed their teeth twice a day. Participants who had poor oral hygiene also had increased levels of CRP and fibrinogen.

Hazard Ratio for Cardiovascular Events (Fatal and Nonfatal) Relative to How Often Teeth Are Brushed Each Day
Frequency of toothbrushing HR* (95% CI)
Twice a day 1.0
Once a day 1.3 (1.0–1.5)
Less than once a day 1.7 (1.3–2.3)
p for trend 0.001
*Adjusted for age, sex, socioeconomic group, smoking, physical activity, visits to dentist, body-mass index, family history of cardiovascular disease, hypertension, and diabetes
 
The researchers say: "To the best of our knowledge, this is the first study to show an association between a single-item self-reported measure of toothbrushing and incident cardiovascular disease in a large representative sample of adults without overt cardiovascular disease."

They add: "Our study suggests a possible role of poor oral hygiene in the risk of cardiovascular disease via systemic inflammation. Raised inflammatory and homoeostatic responses as well as lipid metabolism disturbance caused by periodontal infection might be possible pathways underlying the observed association between periodontal disease and the increased risk for cardiovascular disease."

But they note that further studies are needed to confirm whether the observed association between oral health behavior and cardiovascular disease is in fact causal or merely a risk marker.

References
  1. de Oliveira C, Watt R, and Hamer M. Toothbrushing, inflammation, and risk of cardiovascular disease: Results from Scottish Health Survey. BMJ 2010; DOI:10.1136/bmj.c2451. Available at: http://www.bmj.com.

regards, taniafdi ^_^

6/15/10

Hormone patch may be safer for women

(Reuters) - Women who want to use hormone replacement therapy may be less likely to have a stroke if they use low-dose patches instead of pills, Canadian researchers reported on Thursday.


Their study of British women showed that those who used estrogen patches to control symptoms of menopause did not have any higher risk of stroke than women who did not use HRT.

The study, published in the British Medical Journal, adds to a very slowly growing body of evidence that could rehabilitate the use of HRT, which plummeted in 2002 after the publication of the Women's Health Initiative study, which found an increased risk of ovarian cancer, breast cancer, strokes and other health problems from hormone therapy.

Sales of U.S. market leader Wyeth's combined estrogen-progestin therapy Prempro have fallen by about 50 percent since 2001 to around $1 billion a year. Wyeth is now owned by Pfizer.

But many experts who studied HRT said there was some evidence that if women took a lower dose and if they took HRT by means other than a pill, the risks might not be as high.

Samy Suissa of McGill University in Montreal and colleagues used Britain's national medical database to pick out 15,700 women over 50 who had strokes and nearly 60,000 who had not.

Women who had used low-dose transdermal patches to get their HRT had almost precisely the same risk of stroke -- very slightly less, in fact -- than women who used no HRT.

"I think that these are promising findings," said Dr. JoAnn Manson of Brigham and Women's Hospital and Harvard Medical School in Boston, who helped lead the Women's Health Initiative and who was not involved in Suissa's study.

Suissa's team found that 7.7 percent of stroke patients had been given a prescription for some form of HRT within the previous year of their stroke. And 6.9 percent of women who did not have a stroke got some form of HRT.

"The risk of stroke was not increased with use of low estrogen dose patches compared with no use, whereas the risk was increased with high dose patches," Suissa's team wrote.

HRT pills raised the risk of stroke by 25 percent to 30 percent, regardless of the formulation. High-dose patches raised the risk by 88 percent.

Delivering low doses of hormones through the skin bypasses the liver and may reduce the whole-body effects, Suissa's team said in their report, available at: here

Menopause can cause serious symptoms, including debilitating hot flashes, sleep disturbances and a lack of energy. Women also become more susceptible to heart disease, osteoporosis and some cancers after menopause.

Experts in HRT and menopause say women should be able to choose to use hormones to treat these symptoms but should take the lowest dose possible for the shortest possible time. Before 2002 HRT was regularly prescribed to prevent heart disease and osteoporosis but the experts now recommend against this.
Manson said the ongoing Women's Health Initiative study will look at different doses of hormones. Her team found two years ago that low-dose HRT pills did not raise the risk of stroke and said more study is needed to be sure.

"If there was an option that didn't raise the risk of stroke, that would be a tremendou breakthrough," Manson said in a telephone interview.

Makers of HRT patches include Novogyne, a joint venture of Novartis Pharmaceuticals Corp and Noven Pharmaceuticals Inc, which was acquired last year by Japan's Hisamitsu Pharmaceutical Co Inc and Janssen-Cilag, part of Johnson & Johnson.


Source : http://www.reuters.com/article/idUSTRE6526DW20100603
regards, taniafdi ^_^

Toothbrushing Less Than Twice a Day Linked to Increased CV Risk

News Author: Sue Hughes


June 7, 2010 — Individuals who do not brush their teeth twice a day have an increased risk of heart disease, a new study shows [1].

The study was published online May 27, 2010 in BMJ; corresponding author is Prof Richard Watt (University College London, UK).

The researchers note that while it has been established that inflammation in the body (including mouth and gums) plays an important role in the buildup of atherosclerosis, this is the first study to investigate whether the number of times individuals brush their teeth has any bearing on the risk of developing heart disease.

They analyzed data from more than 11 000 adults who took part in the Scottish Health Survey, in which individuals were asked about lifestyle behaviors such as smoking, physical activity, and oral health routines. Questions asked included how often they visited the dentist and how often they brushed their teeth (twice a day, once a day, or less than once a day). Information was also collated on medical history and family history of heart disease and blood pressure. Blood samples were taken from a subgroup of participants and tested for C-reactive protein (CRP) and fibrinogen levels. The data gathered from the interviews were linked to hospital admissions and deaths.

Results showed generally good oral hygiene practices, with 62% of participants saying they visited the dentist every six months and 71% reporting that they brushed their teeth twice a day. After adjustment for established risk factors, it was found that participants who reported less frequent toothbrushing had an increased risk of heart disease compared with people who brushed their teeth twice a day. Participants who had poor oral hygiene also had increased levels of CRP and fibrinogen.

Hazard Ratio for Cardiovascular Events (Fatal and Nonfatal) Relative to How Often Teeth Are Brushed Each Day
Frequency of toothbrushing HR* (95% CI)
Twice a day 1.0
Once a day 1.3 (1.0–1.5)
Less than once a day 1.7 (1.3–2.3)
p for trend 0.001
*Adjusted for age, sex, socioeconomic group, smoking, physical activity, visits to dentist, body-mass index, family history of cardiovascular disease, hypertension, and diabetes
 
The researchers say: "To the best of our knowledge, this is the first study to show an association between a single-item self-reported measure of toothbrushing and incident cardiovascular disease in a large representative sample of adults without overt cardiovascular disease."

They add: "Our study suggests a possible role of poor oral hygiene in the risk of cardiovascular disease via systemic inflammation. Raised inflammatory and homoeostatic responses as well as lipid metabolism disturbance caused by periodontal infection might be possible pathways underlying the observed association between periodontal disease and the increased risk for cardiovascular disease."

But they note that further studies are needed to confirm whether the observed association between oral health behavior and cardiovascular disease is in fact causal or merely a risk marker.

References
  1. de Oliveira C, Watt R, and Hamer M. Toothbrushing, inflammation, and risk of cardiovascular disease: Results from Scottish Health Survey. BMJ 2010; DOI:10.1136/bmj.c2451. Available at: http://www.bmj.com.

regards, taniafdi ^_^