In Europe and North America, heart disease is the leading cause of death for both men and women, and despite advances in treatment and prevention, cardiologists say many more lives can be saved. In an effort to do just that, the American medical establishment is calling for a much more aggressive approach to controlling cholesterol, one of the leading causes of heart disease. Correspondent K.P. Foley has that and other news in this week's Health Report.
Physicians Call For More Aggressive Cholesterol Treatment
Washington, 18 May 2001 (RFE/RL) -- An expert panel is urging U.S. physicians to more aggressively prevent and treat high cholesterol in adults to control heart disease.
The National Cholesterol Education Program -- a component of the U.S. National Institutes of Health -- issued revised guidelines for cholesterol control this week that will affect tens of millions of Americans.
This is the first major revision of the guidelines in a decade. James Cleeman, director of the cholesterol education program, told RFE/RL the recommendations were updated because too many men and women are still at risk for a heart attack.
"The expert panel reviewed all of the evidence, including the recent evidence, and found that the risk for heart attack among millions of Americans is really much higher than had previously been recognized."
Cholesterol is a naturally occurring in the liver. It is necessary for cell growth and other functions. However, heart specialists say that too much cholesterol in the blood is a prime cause of coronary heart disease. Research has found, specifically, that a type of cholesterol called "low density lipoprotein," or LDL cholesterol, leads to the production of plaque that clogs arteries. Eating too much fat, particularly animal fat, and physical inactivity bring about high blood levels of the LDL cholesterol.
Cleeman told RFE/RL that the key changes in the guidelines are a more aggressive treatment plan and a better identification of those at high risk of heart attack. In addition, the guidelines call for the use of a thorough blood test as a first measurement of cholesterol levels, and the use of what are called "therapeutic lifestyle changes," to help lower LDL levels.
The lifestyle changes include a diet low in consumption of saturated fats -- the type of fat blamed for raising LDL levels, more physical activity, and greater efforts at weight control. Cleeman says many men and women can benefit from this type of therapy.
"We've identified about 65 million American adults who really need to lower their LDL cholesterol using TLC -- therapeutic lifestyle changes."
He also said this type of treatment can have significant benefits.
"If you add the diet and physical activity and weight control all together you can get more than a 20 percent reduction in LDL and that is really worth going for."
The goal is to reduce LDL cholesterol to below 3 millimoles per liter of blood (mmol/L). In addition, the guidelines call for raising another type of blood cholesterol -- "high density lipoprotein," or HDL cholesterol -- to a level above 1 mmol/L. HDL is believed to remove the LDL cholesterol from the blood and experts believe exercise increases HDL levels.
However, Cleeman says lifestyle changes may not be enough for those most at risk for heart attack. So the new guidelines call for greater use of cholesterol-lowering medications known as "statins," for this group. The statin drugs have been show to lower LDL by as much as 55 percent.
The U.S. guidelines are similar to those recommended by the European Society of Cardiology. The U.S. program, however, calls for even sharper reductions in dietary fat and an earlier reliance on medication therapy. (Read more at http://www.nhlbi.nih.gov/index.htm)
UN Says Asian Youth 'Woefully' Unprepared For HIV/AIDS Threat
A United Nations agency says children and adolescents in East Asia and the Pacific are, as the agency put it, woefully unprepared to deal with the threat of HIV/AIDS in the region.
The UN's Children's Fund, known by the acronym UNICEF, surveyed 10,000 children aged 9 to 17 from 17 nations in the region. UNICEF says this may be the largest and most comprehensive poll of young people ever carried out in Asia.
The children were asked, among other things, how much they knew about the infection known as the Human Immune Deficiency Virus (HIV), and the fatal condition it leads to -- AIDS. According to UNICEF, 60 percent of children 9-13 years old said they knew "absolutely nothing," about the conditions or recognized only the names. The survey found that about 25 percent of youths 14-17 reported knowing nothing about HIV/AIDS.
The UN says about 2.4 million people are already infected with HIV/AIDS in the East Asia and Pacific region. Experts say the main path that HIV used to spread throughout East Asia was the sharing of contaminated needles and other drug paraphernalia by users of illegal drugs. The UN's World Health Organization reported earlier this year that shared needle use is also mainly responsible for the rapid spread of HIV/AIDS in Russia and Ukraine.
UNICEF East Asia regional director Mehr Khan said the results of the survey should set off alarm bells in the capitals of the East Asia countries. He said AIDS knows no borders and no nation can consider itself immune to its spread. He said decisive action is needed now to teach young people the danger they face.
Study Says Drugs Cannot Reverse Effects Of Lead Exposure
Environmental health experts say a drug that cleans lead from the blood of young children does not reverse the damage to a child's brain caused by exposure to lead.
Researchers from the U.S. National Institute of Environmental Health Sciences reported their findings this week in the "New England Journal of Medicine." The study was carried out at four urban hospital centers in the cities of Baltimore, Cincinnati, Newark, and Philadelphia. The researchers followed for a three-year period 784 children considered at risk for high lead exposure.
The experts knew that the drug succimer was effective in reducing the level of lead in a child's blood. They wanted to find out if the drug prevented or reduced the adverse affects of lead. Lead exposure is known to impair cognitive development in small children. Standard intelligence test scores are significantly lower among children exposed to lead.
Lead exposure among children dropped drastically in the United States after lead was removed from automobile petrol. However, public health experts still found high blood levels of lead among children in urban areas who lived in flats and houses where lead paint had been used.
The director of the Institute of Environmental Health Sciences, Kenneth Olden, said the study results clearly show that treatment does not help the intellectual abilities of lead exposed children. He said the solution to the problem of lead exposure is prevention.
UN Appeals For $1.5 Billion To Meet Tuberculosis Control Targets
The United Nations' World Health Organization (WHO) said the 22 nations hardest hit by the tuberculosis epidemic need $1.5 billion over the next five years to meet disease control targets.
In a report released this week, the WHO says that just an extra $400 million a year would make quality medications and treatment services available to at least 70 percent of the world's eight million new TB cases. The 22 nations currently with the highest number of TB cases are chiefly in Africa and Latin America but include Russia and China.
The WHO says that most of the money to fund national TB control programs comes from the governments of the affected countries themselves. Donor funds account for less than five percent of the annual total of what the WHO says is needed.
Gro Harlem Bruntland, the WHO director-general, told an international conference this week that proper funding levels can prevent 25 million TB deaths over the next 20 years. She said that meeting international TB control goals will have a tremendous impact on public health by averting 50 million TB cases over the next two decades.
WHO Calls For Tougher Tobacco Control
The World Health Organization says current regulations on tobacco products are not protecting the health of the public.
In a paper released in Geneva this week, the UN agency called for an overhaul of the existing methods that measure the tar, nicotine, and other yields of tobacco and tobacco smoke. The WHO also urged the establishment of a new basis for measuring, regulating, and selling tobacco products globally.
WHO Director-General Gro Harlem Bruntland said cigarettes and other tobacco products are not only highly addictive but also are among the most heavily engineered consumer products on the market. However, she noted that all over the world, tobacco products are excluded from consumer protection laws such as food and drug legislation.
The WHO says four million people are killed by tobacco each year. It says this toll is expected to rise to ten million by the year 2030.