Keep abreast of what your patients are currently seeing in the media with our round-up of popular news stories, available from WHF as abstracts with links to the full-text articles.

From the week of July 14, 2008

Get Your Shots: Adults Need Vaccines Too

While immunization of children in the US is at an all-time high, adults are not following through with their vaccines as they age. Various factors stand as obstacles to adult immunization, such as the high cost of adult vaccines which are not always covered by insurance plans, limited availability of adult vaccines in physicians’ offices, and a lack of education about vaccines. The Centers for Disease Control and Prevention (CDC) estimate that 70,000 American adults die each year from diseases that can be prevented with vaccines, such as influenza, pneumonia, and complications of hepatitis. Some key vaccines that the CDC recommends for adults are the tetanus vaccine, along with a booster shot once every 10 years, the vaccine for pneumonia, and the influenza vaccine. A new vaccine for shingles is also recommended for adults over the age of 60. While the vaccine costs approximately $220, it can save patients from a disease that puts patients at risk for lasting nerve pain and blindness. The HPV vaccine, which is recommended for young women aged 11 to 26 years of age, can prevent the development of human papillomavirus, which is linked to cervical cancer. People traveling abroad should also check with their doctors about additional vaccines that should be given before visiting certain countries. Measles, hepatitis A and B, typhoid fever, rabies, meningitis, yellow fever, and Japanese encephalitis are all vaccine-preventable diseases that travelers abroad have been known to contract. Public health officials are working on an educational campaign to enlighten adults on the importance of vaccines. In an effort to make vaccines more readily available, walk-in clinics at nationwide drug stores such as Walgreen’s and CVS are beginning to offer vaccines to adults.

Read the full story on wsj.com

Drugs to Build Bones May Weaken Them

The bisphosphonate class of drugs, which are used to improve bone health, recently became controversial when data emerged showing the drugs can lead to severe bone, joint, or musculoskeletal pain. Now new cases have come to light that further complicate the controversy over using bisphosphonates to prevent and treat osteoporosis. A series of case reports describe unusual leg fractures, in which the upper thighbone breaks straight across, despite little or no trauma being suffered. Such fractures are rare, and are typically only suffered after car accidents or similar traumas, or in elderly and frail individuals. The cases that were being reported, however, were in patients who had been taking bisphosphonates to promote bone building for 5 or more years. Some of the patients experienced unexplained aches before their thighbones simply snapped. In these cases, the bisphosphonates appear to have been weakening the patients’ bones, rather than slowing the process of bone thinning, as the drug is designed to do. Researchers studying the cases are emphasizing that this is a rare problem, and there is not enough data to suggest the prevention of use of bisphosphonates to treat osteoporosis. These cases may lead some doctors to rethink how much they should rely on this class of drugs as preventative medicine, however. Since all of the fractures occurred in patients taking the drug for 5 or more years, this information may also influence prescribing long-term use of bisphosphonates in the future.

Read the full story on nytimes.com

Many Women Struggle With Uncontrolled Blood Pressure

An estimated 73 million Americans suffer from high blood pressure, with women making up roughly half of that group. While high blood pressure can be a serious health threat for both men and women, women face a number of unique obstacles to controlling their blood pressure. Men are more likely than women to be prescribed aspirin, blood pressure-lowering drugs, or cholesterol-lowering drugs. This in part leads to less women reaching target goals for their blood pressure than men. Women suffering from high blood pressure are also more likely to be obese and/or have high cholesterol. Women are also affected by a lack of knowledge—heart disease is the leading killer of women in America, a fact which many women are not aware of. Uncontrolled high blood pressure can lead to systemic damage, heart attack, stroke, heart failure, kidney damage, and blindness. Still, only an estimated 60% of women with high blood pressure are taking steps to control it. The American Heart Association has an ongoing campaign to educate the public that high blood pressure and heart disease are as much a threat to women as they are to men. There are many steps women can take to help lower their blood pressure. For some, blood pressure-lowering medication may be the best option. For others, diet and lifestyle changes can help. Eating low-fat dairy items and reducing salt and fat intake can aid in lowering blood pressure, as can quitting smoking and limiting alcohol intake.

Read the full story on healthday.com

A New Way to Gauge Heart Disease Risk

Researchers have developed a quick method of determining which patients are at higher risk of cardiovascular disease by comparing blood pressure in the ankle with blood pressure in the arm. Called the ankle brachial index, this number can help easily identify people at risk of heart attack and stroke. Due to the test’s simplicity, it can be given to all patients, and catch high risk patients who do not exhibit any typical signs of heart disease or have a prior history of heart problems. The ankle brachial index is determined by looking at the ratio between the systolic pressure at the ankle and arm. In a recent study of almost 50,000 men and women published this month in JAMA, a lower ankle brachial index number was found to be a reliable indicator of cardiovascular risk. Combing this index number with other measurements currently used to assess cardiovascular disease risk, such as the Framingham risk score, may be the most accurate and reliable means of identifying high-risk patients.

Read the full story on nytimes.com