Controlling blood pressure
Findings of a meta-analysis published in the Lancet emphasise that blood-pressure control is important and that on average, all antihypertensive drugs have similar long-term efficacy and safety. One of the most common causes of death in the developed world is cardiovascular disease (heart attacks and strokes).
Measures to prevent cardiovascular disease include not smoking tobacco, not being overweight and taking adequate exercise. It is also important that raised blood pressure be detected and treated. Some of the drugs used to lower blood pressure might have a beneficial effect on the cardiovascular system that does not depend on lowering blood pressure.
Twenty-seven trials of blood-pressure-reducing drug treatments were analysed to try to find an answer to this question. Lowering high blood pressure turned out to be the important effect of all drug treatments. The hypothesis that angiotensin-converting-enzyme inhibitors might affect outcome beyond their blood-pressure-lowering effect remains unproven.
Decrease in meningococcal disease
New research from Alder Hey, the children's hospital in Liverpool, has shown a sharp fall in the risk of dying from meningococcal disease. The research tracked 123 children with meningococcal disease admitted to the regional paediatric intensive care unit at the hospital between 1995 and 1998.
Eleven of the children died, giving a death rate of just under nine per cent. A validated scoring system to assess likely risk of death according to severity of the disease indicated that the death rates should have been almost 25 per cent.
The authors conclude that death rates from meningococcal disease have slumped; why this should be is less clear. They suggest that, over the past decade, awareness of the disease has heightened, which is likely to mean earlier recognition and treatment, with a better outcome. And the introduction of the meningococcal C vaccine has also had an impact. But they add that while group-C meningococcal disease might be on the decline, the incidence of other forms of meningococcal disease has increased.
Genetic make-up and asthma
Genes are likely to have a much bigger role than environmental factors in asthma, according to recently published research on twins.
The UK, Australia and New Zealand have the world's highest rates of asthma, with between 17 and 30 per cent of the population affected. The research involved a survey of the parents of 4,910 four-year-old twins, all of whom had been born in England and Wales between 1994 and 1995.
Identical twins share all their genetic make-up, but non-identical twins share only half. Therefore, if identical twins have similar rates of asthma, genetic factors could be at work.
The results showed that identical twins had more similar reported rates of asthma than non-identical twins. The authors found that genes accounted for by far the largest share of asthma prevalence, at 68 per cent. Being exposed to the same environmental allergens accounted for just 13 per cent, while different environmental exposure accounted for 19 per cent.
The authors conclude that environmental factors such as family diet and air pollution are likely to be much less important than genetic make-up.
Identifying genetic diseases
Researchers at the Dublin base of Hitachi, the Japanese electronics company, have pioneered a software application that permits rapid statistical analysis of multiple DNA samples. The information extracted will allow laboratories and pharmaceutical companies better to identify the genes that cause various diseases and illnesses, and thus identify genetic trends in their incidence. The software technology is currently being piloted at the school of clinical medicine of Trinity College, Dublin, at St James's Hospital.
Workplace health
Employee health is the focus of this year's Irish Heart Week, which runs from November 5th to 11th. Dr Gregor Breucker, the head of the European Information Centre (a World Health Organisation centre for workplace-health promotion in Essen, Germany), will discuss the economic impact of workplace-health promotion at a conference on employee health at the Burlington Hotel, in Dublin, on Wednesday. Details of the Irish Happy Heart at Work programme, which addresses healthy catering practices, smoking-control policy, stress handling and physical activity, will also be presented. More information from 01-6685001, or e-mail mcrotty@irishheart.ie
Compiled by Dr Muiris Houston and Sylvia Thompson
lifelines@irish-times.ie