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Pre-pregnancy high blood pressure rates rising in U.S., study shows

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The number of women entering pregnancy with high blood pressure has nearly doubled in a decade, new research finds.

The study found that 2% of women living in urban areas and 2.4% of women living in rural areas had high blood pressure as they started their pregnancies in 2018. When the researchers looked back at 2007, those numbers were 1.1% and 1.4%, respectively.

“High blood pressure complicated nearly 80,000 of the pregnancies studied, and this wasn’t just older women. Something concerning that we found was that there was an increase in high blood pressure in women between 15 and 24,” explained study author Dr. Natalie Cameron.

She’s a third-year internal medicine resident at Northwestern University’s Feinberg School of Medicine in Chicago.

The rates in the youngest women were still lower than in older women, age 40-44, but all of the age groups saw similar increases in high blood pressure rates between 2007 and 2018.

The researchers also saw much higher rates of pre-pregnancy high blood pressure — two to three times higher — in Black women compared to White and Hispanic women, according to Cameron.

Blood pressure levels going into pregnancy make a difference in the health of mom and baby. If a mother’s blood pressure is high in pregnancy, she faces a greater risk of complications, such as preeclampsia and preterm labor and delivery.

The risk of kidney problems and ICU admissions is also higher for women with elevated blood pressure in pregnancy, Cameron said.

Mom’s high blood pressure also ups the baby’s odds of complications, such as being born at a lower weight.

Babies born to women with high blood pressure have an increased risk of developing heart and blood vessel disease later in life, Cameron explained.

The study included data on 50 million expectant mothers in the United States between 2007 and 2018. They were between 15 and 44 years old.

According to Cameron, there wasn’t enough data to explain why these numbers are increasing. Rising rates of obesity are likely one reason. Another possibility is a lack of access to health care, especially preventive health care.

She said a lack of access to health care tends to be more of a problem for the two groups with higher rates of high blood pressure in this study — people living in rural areas and Black people.

Dr. Navid Mootabar, chair of the Department of Obstetrics and Gynecology at Northern Westchester Hospital in Mount Kisco, N.Y., is familiar with the new study.

He said he’s seen an increase in women with higher pre-pregnancy blood pressure. But, he added, “It’s unclear what exactly is making the rates go up.”

Mootabar also suspected that a lack of preventive care may play a role. “A woman’s first exposure to the health care system may be when she’s pregnant,” he said.

If you’re heading into pregnancy with high blood pressure, Mootabar stressed the importance of good blood pressure management.

“If you have high blood pressure, get preconception counseling, if you can. Try to make sure your blood pressure is optimally controlled and that you have good heart and kidney function before pregnancy,” he said.

Both Mootabar and Cameron said there are safe options for controlling blood pressure during pregnancy.

But what’s best “is preventing high blood pressure in the first place,” Mootabar said.

Cameron agreed. “I would encourage all women to establish a relationship with a primary care provider and talk about preventive measures to stay healthy throughout your lifetime. Learn to follow an optimal diet and get some activity in every day. This not only extends your life, but also your quality of life,” she said.

Cameron is scheduled to present the study on Friday at the American Heart Association’s virtual Scientific Sessions. Findings presented at meetings are typically viewed as preliminary until they’ve been peer-reviewed.

More information

Learn more about high blood pressure and women from the American Heart Association.

Copyright 2020 HealthDay. All rights reserved.



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‘Green prescriptions’ could cancel mental health benefits for some

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So-called “green prescriptions” may end up being counterproductive for people with mental health conditions, researchers say.

Spending time in nature is believed to benefit mental health, so some doctors are beginning to “prescribe” outdoor time for their patients.

That led researchers to investigate whether being in nature helps actually does help people with issues such as anxiety and depression. They collected data from more than 18,000 people in 18 countries.

The takeaway: Time in nature does provide several benefits for people with mental health conditions, but only if they choose on their own to visit green spaces.

While being advised to spend time outdoors can encourage such activity, it can also undermine the potential emotional benefits, according to the authors of the study published this month in the journal Scientific Reports.

The researchers said they were surprised to find that people with depression were spending time in nature as often as folks with no mental health issues, and that people with anxiety were doing so much more often.

While in nature, those with depression and anxiety tended to feel happy and reported low anxiety. But those benefits appeared to be undermined when the visits were done at others’ urging, the investigators found.

The more external pressure people with depression and anxiety felt to visit nature, the less motivated they were to do so and the more anxious they felt.

“These findings are consistent with wider research that suggests that urban natural environments provide spaces for people to relax and recover from stress,” said study leader Michelle Tester-Jones, a postdoctoral research associate at the University of Exeter in the United Kingdom.

But the findings also show that health care practitioners and loved ones should be sensitive about recommending time in nature for people who have mental health issues.

“It could be helpful to encourage them to spend more time in places that people already enjoy visiting, so they feel comfortable and can make the most of the experience,” Tester-Jones said in a university news release.

More information

For more on the benefits of green spaces, go to the National Recreation and Park Association.

Copyright 2020 HealthDay. All rights reserved.



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Study: Nearly half of ‘essential workers’ in U.S. at risk for severe COVID-19

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Nov. 9 (UPI) — Nearly half of those classified as “essential workers” in the United States are at increased risk for severe COVID-19, according to an analysis published Monday by JAMA Internal Medicine.

This means that more than 74 million workers and those with whom they live could be at risk for serious illness, based on disease risk guidelines developed by the U.S. Centers for Disease Control and Prevention, the researchers said.

“Many parts of the country face high and rising infection rates, [and] we should not think about work exposure and health risks in isolation, given that workers and persons at increased risk often live in the same households,” study co-author Thomas M. Selden told UPI.

“Insofar as we can reduce the prevalence of COVID-19 in our communities, we can reduce the extent to which policymakers have to choose between the economy and keeping the population safe,” said Selden, an economist with the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality.

Since the COVID-19 pandemic spread to the United States in March, states and cities across the country have instituted lockdown measures designed to limit the spread of the disease.

Many of these measures entailed closing schools and non-essential businesses, with only banks, grocery stores, pharmacies and other businesses deemed to provide vital services allowed to stay open.

For this study, Selden and his colleagues analyzed data on the U.S. workforce to examine how many people were in essential jobs, how often they were able to work at home, their risk for severe COVID-19 and the potential health risks for their household members.

Of the more than 157 million workers across the country, 72% are in jobs deemed essential — based on U.S. Department of Homeland Security criteria — and more than three-fourths of all essential workers are unable to work at home, Selden said.

Essential workers include those in the medical and healthcare, telecommunications, information technology systems, defense, food and agriculture, transportation and logistics and energy, water and wastewater industries, as well as those in law enforcement and public works, the DHS criteria stipulates.

The study notes that up to 60% of these workers have underlying health issues, placing them at increased risk for severe COVID-19 if they get infected, as defined by U.S. Centers for Disease Control and Prevention guidelines.

Those with diabetes, heart disease, high blood pressure and chronic respiratory conditions like asthma are considered to be at high risk for serious illness, the CDC says.

Based on these findings, between roughly 57 million and 74 million adults working in on-site essential jobs — and their families — are at increased risk for serious illness, Selden and his colleagues estimated.

“Policymakers face important decisions about how to balance the economic benefits of keeping workers employed and the public health benefits of protecting those with increased risk of severe COVID-19,” Selden said.

“These issues arise in the context of decisions to close segments of the economy and decisions about how to distribute vaccines, which will initially be available only with limited supply, [and] become all the more difficult when the prevalence of infection rises in parts of the country,” he said.



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Study: Hydroxychloroquine no better than placebo for hospitalized COVID-19 patients

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Nov. 9 (UPI) — COVID-19 patients treated with hydroxychloroquine showed no signs of significant improvement in “clinical status” compared with those given a placebo, a study published Monday by JAMA found.

Patients given a five-day course of the drug were scored as “category six” based on the World Health Organization’s seven-category COVID Ordinal Outcomes Scale, the same as those given a placebo, the researchers said.

Also, 28 days after they started treatment, 10.4% of those treated with hydroxychloroquine died, just slightly lower than the 10.6% fatality rate in the placebo group.

“The results show that hydroxychloroquine did not help patients recover from COVID-19,” study co-author Dr. Wesley H. Self told UPI.

“In the study, patients treated with hydroxychloroquine and those treated with a placebo had nearly identical outcomes, [so] I do not foresee any role for hydroxychloroquine in acutely ill patients hospitalized with COVID-19,” said Self, an infectious disease specialist at Vanderbilt University Medical Center.

Hydroxychloroquine is an immunosuppressive and anti-parasitic drug that is used to treat malaria.

Early in the COVID-19 pandemic, it was touted by President Donald Trump and others as a potential treatment for the virus, despite the lack of any scientific data supporting its use.

Given its effectiveness helping those sickened with malaria — a mosquito-borne infection — to recover, “there was a strong rationale for why hydroxychloroquine may have been beneficial for patients with COVID-19,” according to Self.

However, in July, the U.S. Food and Drug Administration warned against the drug’s use in the treatment of those infected with the new coronavirus, due to potentially serious heart-related side effects.

For this study, Self and his colleagues treated 433 COVID-19 patients at 34 hospitals across the United States with either the drug or a placebo for a period of five days.

Patients assigned to the hydroxychloroquine group received 400 milligrams of the drug in pill form twice a day for the first two doses and then 200 mg. in pill form twice a day for the next eight doses, for a total of 10 doses over the five days.

All of the patients were then assessed based on the WHO’s COVID Ordinal Outcomes Scale, which categorizes those infected according to disease severity.

Most of the patients in both the hydroxycholorquine group and the placebo group were in “category six,” meaning they were hospitalized and receiving extracorporeal membrane oxygenation or invasive mechanical ventilation to maintain their breathing, the researchers said.

“Our results, especially when combined from other studies conducted in the United Kingdom and Brazil, are good evidence that hydroxychloroquine does not provide benefit for patients hospitalized with COVID-19,” Self said.



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