Marion County Medical Center

Health Shorts

December 2007

Cut Back on Smoking? Just Quit
If you’ve tried unsuccessfully to quit smoking, you have probably considered cutting back as an option. Forget it.
In one study, subjects who cut their cigarette smoking in half had 2.4 percent more toxins in their blood than heavier smokers. Another study of 51,000 smokers found that those who cut back to half a pack a day over 20 years had the same death rate from heart disease as those who continued to smoke a full pack a day.

The authors believe that smokers who cut back simply inhaled more deeply to get the nicotine they wanted. Studies also suggest a possible saturation level of some toxic chemicals in cigarette smoke.
[SOURCE: “Could smoking less be safe?” Women’s Heart Advisor Supplement, April, 2007, Cancer Epidemiology, Biomarkers and Prevention]

Early Smoking, Early Heart Disease
Smoking in early life increases the risk for heart disease 15 years later, according to results of the CARDIA (Coronary Artery Risk Development in Young Adults) study.

Among young white and African-American males and females followed for 15 years, those developing the greatest degree of calcium deposits in their coronary arteries had smoked more cigarettes and had higher blood pressure when initially tested. Coronary artery calcium is considered highly predictive of heart disease.
[SOURCE: C.M. Loria, et al, “Early adult risk factor levels and subsequent coronary artery calcification: the CARDIA study,” Journal of the American College of Cardiology, 2007;49:2013-2020]

Is Your Baby a Chain Smoker?
If you smoke yourself, you may as well be letting your infant or toddler light up. About 35 percent of American children live in homes where someone smokes in the home, and these children have detectable levels of cotinine, a byproduct of nicotine, in their blood.

A recent study examining urine levels of cotinine in 10- to 12-week-old infants found levels 5.58 times higher in babies of smokers compared to non-smokers. Having a mother who smoked increased cotinine levels by a factor of four; having a father who smoked increased levels by a factor of two.

Children who “smoke” have a high risk of ear and lung infections, asthma, allergies and bronchitis as well as stunted development.
[SOURCE: Joene Hendry, “Nicotine byproduct found in babies of smokers,” Reuters Health, November 13, 2007; American Lung Association, “Secondhand smoke fact sheet,” June, 2007]

Tobacco Marketers Are Winning
About 21 percent of Americans smoke. That number has not changed since 2004 and Centers for Disease Control officials claim that anti-smoking efforts are flagging because of lack of federal and state funding.

The tobacco industry spends $3.50 per person each year to convince Americans to smoke while federal and state anti-smoking campaigns allocate less than half that amount. The CDC points out that “cigarette smoking remains the leading preventable cause of disease and death in the United States, resulting in approximately 438,000 deaths annually.”
[SOURCE: Maggie Fox, “U.S. smoking rate stalled at 21 percent, CDC says,” Reuters Health, November 8, 2007]

Diuretics Reduce Risk of Alzheimer’s
Older persons taking potassium-sparing diuretics had a more than 70 percent reduced risk of Alzheimer’s disease, according to a study published in Archives of Neurology [July, 2006].

Subjects taking other blood pressure medications had a reduced risk of Alzheimer’s disease, but somewhat less than that of potassium-sparing diuretics.
[SOURCE: “Antihypertensives demonstrate benefit in reducing Alzheimer’s disease risk,” Formulary, July, 2006]

Lower Doses Mean Fewer Side Effects

Recommended dosages of diuretic medications have declined rather dramatically–from 200 milligrams/day of hydrochlorothiazide in the early 1960s to about 25 milligrams/day today, for example. As the doses have come down, so has the risk of side effect such as increases in cholesterol. At the doses now typically prescribed, one study concluded that thiazide diuretics are “effectively lipid neutral alone or in combination” with other medications.
[SOURCE: Matthew R. Weir, Marvin Moser “Diuretics and beta-blockers: is there a risk for dyslipidemia?” American Heart Journal, 139(1):174-184, 2000]

Burns Don’t Increase Risk of Cancer
A long-term follow-up study of more than 16,000 patients with thermal or chemical burn injuries found no increased risk of skin cancer, even among those with the most severe burns and longest periods of follow up.

Burn patients actually had a lower than expected incidence of some types of skin cancer. Researchers believe the burn patients may have been more likely to protect themselves because of discomfort associated with sun exposure.
[SOURCE: Michelle Rizzo, “Burn injuries not seen to raise risk of skin cancer,” Reuters Health, November 15, 2006; Epidemiology, November, 2006]

Immersion Burns–Keep Kids Safe
An adult’s skin can tolerate temperatures as high as 111 degrees Fahrenheit for fairly long periods, but a child will suffer severe burns in three seconds in water hotter than 120 degrees.

Placing a child–or an elderly person–in a bath tub filled with water that’s too hot is particularly dangerous since large areas of the body can be burned. The longer the person is in the tub, the greater the injury.

Be sure to test the water with a sensitive area of your own skin before placing a child in the tub. And make sure your hot water heater is set for temperatures lower than 120 degrees if you have a child or older adult in your home.
[SOURCE: Richard F. Edlich, et al, “Burns, thermal,” emedicine from WebMD, article last updated October 3, 2007]

Carelessness Leads to Burn Injuries
Nearly 90,000 adolescents and children suffer burns each year serious enough to require emergency treatment. Nearly half of these occur in residential fires–usually resulting from carelessness. Another 25 percent are scalding injuries.

Products implicated in burn injuries involving adolescents and children 14 years and younger include hair curlers, curling irons, room heaters, ovens and ranges, irons, gasoline and fireworks.
[SOURCE: Jerome F.X. Naradzay, et al, “Burns, thermal,” emedicine from WebMD, last updated November 15, 2006]

ACE Inhibitors Helpful for CHF
Over time, high blood pressure can damage the pumping ability of the heart and lead to congestive heart failure, a disorder that results in a buildup of fluids that can congest the lungs and cause swelling of the feet and ankles.

For persons with hypertension, diuretics have been found effective in preventing heart failure. Once heart failure has developed, however, many doctors prescribe ACE inhibitors to reduce blood pressure and improve kidney function. Heart patients with diabetes may also benefit from ACE inhibitors because of their beneficial effect on the kidneys.
[SOURCE: “ACE inhibitors: who needs them?” Cleveland Clinic Women’s Heart Advisor Supplement, April, 2007]

Artery Disease in Legs Increases Risk of Heart Attack and Stroke
If the arteries in your legs are diseased, you are also likely to have coronary artery disease and a high risk of having a heart attack or stroke.
The classic sign of diseased arteries in the legs (known as peripheral artery disease or PAD) is leg pain that comes on when you’re walking or climbing stairs and goes away when you rest. Many persons, however, have no symptoms.

About 60 percent of persons with PAD also have blockages in one or more coronary arteries. Individuals with PAD are six times more likely than others to die of a heart-related cause.
[SOURCE: “Leg blockages increase heart attack and stroke risk,” Cleveland Clinic Women’s Heart Advisor, April, 2007]

Reducing Your Risk after an MI
With better treatment, more Americans are surviving a heart attack. The bad news is that 38 percent of heart attack patients still die and those who survive have a 10 percent risk of dying within a year of a heart-related cause. A heart attack survivor is four to six times more likely than other Americans to die suddenly from cardiac arrest.

For heart attack survivors, most doctors recommend cardiac rehabilitation, which has been found to lower the risk of heart-related death by 26 percent compared to usual care. Primarily through exercise, diet and education, cardiac rehab aims at helping the patient lower cholesterol, control blood pressure, reduce body weight, stop smoking and increase functional ability.
[SOURCE: B arry A. Franklin, “Preventing reinfarction: changing behavior after the MI, part 1,” Consultant, May 1, 2007]

Don’t Take Prehypertension Lightly
Normal blood pressure is anything below 120/80 mm/Hg and readings even slightly above that are pre-hypertension (120-140/80-90 mmHg). At lower levels of pre-hypertension, patients might be advised to exercise more, reduce sodium intake, lose weight and eat more fruits and vegetables. When blood pressure remains elevated, doctors may prescribe medication. According to one study, pre-hypertension triples a person’s risk of a heart attack.
[SOURCE: Richard S. Lang, Cleveland Clinic Men’s Health Advisor, June, 2006]

The Bare Truth about Baldness
Men under age 55 with male pattern baldness–especially involving the crown of the head–have a higher incidence of heart attacks than other men. This increased risk is probably caused in part by their higher levels of dihydrotestosterone, a male hormone that is associated with male pattern baldness.
[SOURCE: Peter W.F. Wilson and William B. Kannel, “Is baldness bad for the heart?” JAMA, 269.n8: 1035(2).