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June 16th, 2010
Hey, glad to hear you’re playing attention to me.
According to a report from the Canadian Institute for Health Information (their surprising acronym is CIHI), in a comparison of heart attack rates across Canada, BC has come out best.
In fact, BC is the best province to not get a heart attack in with a rate of 169 heart attacks for every 100000 citizens, while Newfoundland and Labrador (which used to be known as just plain old Newfoundland when I was a kid) is the worst province with a rate of 347 for every 100000 denizens of the Rock.
So, we – you – are doing great out here, and that’s terrific.
But why the vastly different rates?
Well, as a start, the most important reason is that you’ve been listening to me.
Actually, what I mean is that there is more attention paid to healthy lifestyle habits out here than in some other places in Canada, and since heart disease is pretty much a man-made condition (several terrific studies have indicated that heart attacks could be virtually eliminated by proper attention to just a few simple healthy lifestyle factors) , since a lot more of you are doing something about your lifestyles, our heart attack rates are dropping.
For example, our smoking rates are the lowest in Canada and although we can do better (the rates won’t be low enough until no one is smoking), that certainly plays a large role in our lower rates of heart attacks.
There is also the effect of climate: it’s surely easier to go out for a walk, for a run, or play a round of golf (ed. note: I don’t consider fat golfers are getting much of a workout riding those carts around between 50-yard drives, but most people don’t agree with me) in BC in January than it is in say, Saskatchewan or Quebec.
And then there is the huge factor of socio-economic disparities, since there is absolutely no doubt that the richer a population is and the more educated it is, the better its health status, which would explain some effect on say, the difference between N & L and BC, although I’m not sure how much of that would account for why we do better than Ontario and Alberta?
And a final note of huge importance: these are “global” numbers and some among us, especially most sadly, our aboriginal people, have rates of heart attacks that are much worse than these statistics indicate.
I’m Dr Art Hister
June 15th, 2010
Hot flash: an old anti-depressant drug can apparently reduce hot flashes in menopausal women.
The problem with the often troublesome symptom of hot flashes in menopausal
women is that there is no really good treatment for it.
Hormones work best, but hormones have troubling potential consequences, and all
those alternative “natural” remedies (black cohosh, soy, etc) have mixed results
at best, which means that they don’t work for most women, although if one of
those is working for you, then by all means continue to use it.
So the good news is that in a smallish study (254 women) published in the Journal
of Clinical Oncology, researchers found a pretty good improvement in self-judged
hot flashes in the women who were given the SSRI antidepressant citalopram (trade
name: Celexa) compared to women given a placebo.
So that’s good news for all women with troubling hot flashes, but particularly
perhaps for women with breast cancer who have to take Tamoxifen, which produces
hot flashes as a side effect.
Although some SSRIs (paroxetine, fluoxetine) are not permitted for use with Tamoxifen,
citalopram is OK for those women.
I’m Dr Art Hister
June 7th, 2010
A spot of good news on the autism front:
In a small (but much ballyhooed) study of kids with autism, some of their siblings and a group of normal children, researchers from Imperial College London claim to have discovered a urinary “footprint” to help diagnose autism.
The footprint is based on differences in microbes in the gut of kids with autism (autistic individuals have significantly more bowel problems than non-autistic people leading to a different microbial make-up in the gut) and, according to this study, signs of those microbes can then be identified in urine samples.
If this proves to be true in a much larger sample – and that’s a huge “if” – that would be a huge advance in understanding autism and perhaps even in dealing with it.
First, it would be a major breakthrough in diagnosis given that autism is now diagnosed only via pretty sophisticated and complicated tests.
Equally important, if autism could be identified much earlier than is normally done now (rarely before 18 months), then we can at least hope that with early intervention, we could perhaps prevent some of those kids from going on to develop one of the autistic spectrum of changes.
But as always a caveat, and one that comes from this long-suffering Vancouver hockey fan: just because you win a game or two in the preliminary round of the Stanley Cup play-offs, there is absolutely no guarantee that you will go on to win the Cup.
In other words, we can hope, but we should be too expectant yet.
I’m Dr Art Hister
June 4th, 2010
Why we shouldn’t mess around when we’re not sure what we’re doing: part 2 of a never-ending series
Two new studies remind us that we often make matters worse rather than better when we rush into areas in which we are still not sure of what we’re doing.
The first study involved the use of testosterone in women and I covered that in the last blog.
The second study was about HDL, the so-called good cholesterol.
One of the holy grails in medical research is to find a drug that will raise HDL levels because statins, which are heavily used to promote better cholesterol profiles, are really just good at lowering LDL, and the common wisdom is that we would get even better at preventing heart attacks if we could find a way to raise HDL.
But according to a recent study published in a not-too prominent journal, Atherosclerosis, Thrombosis, and Vascular Biology (I am sure studies in that journal would get more press if the editors just changed its name to something easier to remember – and type), some people – a sub-group - who have their HDL levels raised suffer a “paradoxic” effect t, that is, their risk of heart attack and stroke actually goes up.
The researchers have come up with a biochemical test to distinguish such folks, but that kind of screening is not ready for prime time yet, and besides, there must be a whole lot of other variables involved that the researchers have still not uncovered.
Best advice: if you want to raise your HDL levels, do more exercise, don’t smoke, eat properly, drink moderately, and keep your weight down.
Hey, no one has yet discovered a sub-group that’s adversely affected
by those manipulations.
I’m Dr Art Hister
June 2nd, 2010
Why we shouldn’t mess around when we’re not sure what we’re doing: part 1 of a never-ending series
Two new studies remind us that we often make matters worse rather than better when we rush into areas in which we are still not sure of what we’re doing.
The first study involved the use of testosterone in women, something that’s becoming a growth industry with lots of emphasis from many quarters (so-called “experts”) that we really should be treating lots more (all?) menopausal and post-menopausal with testosterone mostly because it raises libido and hey, in case you didn’t know it, according to some of those “experts”, low libido levels are rampant in women after menopause, this despite the fact that we clearly do not know most of the potential long-term consequences of using testosterone in women.
The reason we need to treat low libido levels is that it affects relationships negatively, and presumably, an artificial chemically-induced spike in libido levels is the answer.
So it’s interesting to note that in a study that included 24 young university students, some of the women who got testosterone ended up “less trusting” as a consequence.
If you ask me, making women less trusting will not help their relationships much.
On the other hand, I suppose that in some cases, maybe it would.
I’m Dr Art Hister
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