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Statins reduce heart disease risk even in older adults, studies find

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Nov. 10 (UPI) — Older adults benefit at least as much as young people from cholesterol-lowering medications that reduce the risk of heart attack, stroke and heart disease, according to two studies published Tuesday by The Lancet.

For every 80 people age 80 to 100 who take statins, one heart attack will be prevented, researchers say, while three times that number of people between age 50 and 59 would need to take the drugs to prevent one heart attack, the data from one study showed.

Similarly, cholesterol-lowering medications reduced the risk for heart attack and stroke in those age 75 years and older by 26% for every one-point reduction in LDL cholesterol, the second analysis found.

The drugs lowered the risk for these heart-related health events by 15% for every one-point reduction in LDL cholesterol among people age 75 and younger, according to the researchers.

“Our study provides further evidence for the cumulative burden of LDL cholesterol over a person’s lifetime and the progressive increase in risk for heart attack and cardiovascular disease with age,” study co-author Børge Nordestgaard said in a statement.

“With the proportion of people living beyond 70 years of age worldwide rapidly increasing, [there is] huge potential for … strategies aimed at lowering LDL cholesterol levels,” said Nordestgaard, a clinical professor of genetic epidemiology at Copenhagen University Hospital in Denmark.

Up to 29% of all adults in the United States, or about 70 million people, have high cholesterol, according to the U.S. Centers for Disease Control and Prevention.

Prescription statin drugs, along with diet and exercise, can help manage cholesterol, although the benefits of the drugs in older adults have been less clear based on existing research.

For their study, Nordestgaard and his colleagues analyzed data on the heart health of more than 91,000 adults who live in Denmark, including 13,779 people age 70 to 100 who were not taking statins at the beginning of the research.

Participants were tracked for roughly eight years. The number of first-time heart attacks and cases of heart disease, along with LDL cholesterol levels, were recorded for each.

A total of 1,515 first-time heart attacks and 3,389 cases of heart disease were reported among the study participants. Those age 70 and older had the highest incidence of heart attack and heart disease of any age group, the researchers said.

For example, the risk for heart attack in the overall population was increased by 34% for every one-point rise in LDL cholesterol, the data showed.

For every 42 people age 80 to 100 treated with a moderate-intensity statin, one heart attack could be prevented in the age group, the researchers said, with the preventive effect decreasing the younger people are.

The findings show that LDL cholesterol levels are an important risk factor for heart attack and heart disease in older people, contrary to earlier studies, they said.

Meanwhile, an analysis of 29 studies involving more than 244,000 adults found that cholesterol-lowering therapies were associated with a reduction in the incidence of all cardiovascular events, including death, heart attack and stroke, researchers at Brigham and Women’s Hospital in Boston reported.

Deaths from all heart disease outcomes in people age 75 and older were reduced by 15% for every one-point reduction in LDL cholesterol, and the incidence of heart attacks was lowered by 20%, the data showed.

However, the findings do not mean that people should wait to initiate treatment until they are older, the researchers said, stressing the importance of keeping LDL cholesterol well controlled as early in life as possible to prevent the build-up of cholesterol in the arteries.

“Cholesterol-lowering medications are affordable drugs that have reduced risk of heart disease for millions of people worldwide, but until now their benefits for older people have remained less certain,” study co-author Dr. Marc S. Sabatine said.

“Our analysis indicates that these therapies are as effective in reducing cardiovascular events and deaths in people aged 75 years and over as they are in younger people, [with] no offsetting safety concerns,” said Sabatine, chairman of the Thrombolysis in Myocardial Infarction Study Group at Brigham and Women’s Hospital.



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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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