Headlines (Scroll down for complete
stories):
1. Too Much Exercise Speeds Heart Failure
2. When to Fire Your Doctor
3. Three Walks a Week Cut Heart
Risks
4. Prenatal Antidepressants Linked to Preterm Births
5. Menopause Hard on Couple’s Sex Lives
1. Too Much Exercise Speeds Heart Failure
Though exercise can be a key part of managing high blood pressure
and heart disease, new animal research suggests there can be too
much of a good thing.
In experiments with rats, researchers found that excessive
exercise worsened high blood pressure and progression to heart
failure in rats with high blood pressure.
Dr. Rebecca L. Schultz and colleagues at the University of South
Dakota, Sioux Falls, report the results in the journal Hypertension.
Regular physical activity has been linked to a lower risk of
heart disease in numerous studies. Moreover, exercise therapy has
been shown to improve both blood pressure and symptoms of heart
failure — a chronic condition in which the heart loses its ability
to pump blood efficiently, causing symptoms like breathlessness and
fatigue.
The new findings in rats are, therefore, unexpected, according to
an editorial published with the study.
The implications for humans are not yet certain, according to the
editorialists Dr. Paul Christian Schulze, of Boston University
Medical Center, and Satyam Sarma, of Brown University Medical Center
in Providence, Rhode Island. However, the findings "should raise our
awareness" of the potential harm intense exercise might do to people
with untreated high blood pressure.
Humans, as well as rats, develop high blood pressure that can
progress to heart failure. In the current study, some of the animals
were housed with a running wheel, while the others remained
sedentary.
Schultz and her colleagues found that the rats that lived with a
running wheel tended to exercise excessively. The results, over
time, were structural abnormalities in the heart and a reduced
pumping ability – all of which were worse in the active animals than
in the sedentary ones.
The reasons for the findings are unclear, according to the study
authors, but it's likely that the rats "simply exercised too much."
The study raises the possibility that "uncontrolled and excessive
exercise" may negatively affect the heart in people with high blood
pressure, potentially speeding the onset of heart failure, according
to Sarma and Schulze.
One of the questions for future studies, they note, is whether
this is true among people whose blood pressure is under control with
medication.
"Defining the fine line between beneficial and detrimental
effects of exercise requires further study," the editorialists
conclude.
SOURCE: Hypertension, August 2007.
© Reuters 2007.
Editor's Note:
2. When to Fire Your Doctor
If you and your doctor aren’t seeing eye-to-eye, it may be time
to give him the boot. Patients have many reasons for seeking help
elsewhere, but these four reasons may signal that it’s time for a
change.
Your doctor is irritated when you ask questions. It’s your right
as a patient to ask questions and to expect your doctor to give you
serious, considered answers. If you’re brushed off, it may be time
to move on.
Your doctor won’t listen to you. Your doctor should want your
input and you should work as a team to safeguard your health. If he
prescribes a treatment you’ve already tried and it didn’t work, yet
he wants you to try it again, he doesn’t believe you have any
credibility and isn’t interested in what you have to say.
Your doctor can’t — or won’t — explain your condition in terms
you can understand. If your doctor uses “doctorese” and you can’t
clearly understand your illness and treatment, you can’t take the
best possible care of yourself. Make sure your doctor can explain
your condition in plain English.
You feel your doctor doesn’t like you or you don’t like your
doctor. It happens; personalities don’t click. But if you feel bad
when you leave your appointment and have a gut feeling that your
doctor really doesn’t like you, change.
How do you make the break? Don’t decide on the basis of one
appointment. Make sure it just wasn’t a bad day for you – or the
doctor. Then, discuss your feelings with your doctor. If there’s not
a change in attitude, take a walk.
Editor's Note:
3. Three Walks a Week Cut Heart Risk
A thirty minute walk three times a week is all it takes to lower
your blood pressure and risk of heart disease. Even though some
guidelines advice moderately intense exercise five times a week,
researchers from Queen’s University, Belfast, found that three brisk
walks a week lowered blood pressure and reduced waist and hip
circumference.
Researchers divided 106 people that rarely exercised into three
groups. One group walked 30 minutes five times a week, another group
walked 30 minutes three times a week, and the third group did no
walking. While both walking groups showed decreases in blood
pressure and lost inches, the non-walking group showed no changes.
The authors of the study hope that their results will help couch
potatoes who don’t exercise at all begin to exercise gradually, and
those who feel they don’t have enough spare time to exercise
effectively to take those first healthy steps.
Editor's Note:
4. Prenatal Antidepressants Linked to Preterm Births
Antidepressant drug use during pregnancy, but not depression
itself, is associated with an increased risk of preterm birth and
lower fetal age at delivery, according to results of a study
published in the American Journal of Psychiatry.
"Depressive symptoms are not uncommon during pregnancy,
and...symptoms may occur more frequently during pregnancy than in
the postpartum period," write Dr. Rita Suri and colleagues from the
University of California, Los Angeles. Depression during pregnancy
and just after delivery "has been associated with low maternal
weight gain, increased frequency of cigarette, alcohol, and
substance use, and ambivalence about the pregnancy."
To further investigate, the researchers examined the effects of
maternal depression and antidepressant drug use on fetal age and
risk of preterm birth in a study of 90 pregnant women.
The women were divided into three groups: 49 women had major
depressive disorder and were treated with antidepressant medication
for more than 50 percent of their pregnancy; 22 women had major
depressive disorder and were briefly treated or not treated with
antidepressants during pregnancy; and a comparison group of 19
healthy pregnant women.
The average fetal age at birth was 38.5, 39.4, and 39.7 weeks in
the three groups, respectively. The groups also differed in the
rates of preterm birth (14.3 percent, 0 percent, and 5.3 percent)
and rates of admission to the special care nursery (21 percent, 9
percent, and 0 percent).
No significant between-group differences were observed in actual
infant birth weights or Apgar scores.
Based on these findings, the presence of depression per se during
pregnancy did not adversely affect outcomes. "This result was
surprising to us, as we had anticipated that depression and anxiety
during pregnancy would be associated with an increased risk of
preterm birth," Suri and colleagues write.
"The two groups of women with depression — those who were treated
with antidepressants and those who were not — had similar degrees of
depression and anxiety during pregnancy," they note.
These findings suggest that antidepressant use, rather than
mild-to-moderate depression, was associated with lower fetal age and
an increased risk of preterm birth.
SOURCE: American Journal of Psychiatry, August 2007.
Editor's Note:
5. Menopause Hard on Couple's Sex Lives
When a woman enters menopause, her sex life and that of her
partner may suffer, according to a survey in which more than half of
the women reported a decrease in sex drive and in the amount of sex
they were having since entering menopause.
Overall, 46 percent of menopausal women surveyed reported having
sex less than once per month and most women felt that this was
hurting their relationship.
"Menopausal women are having less sex and it's impacting our
relationships," Karen Giblin noted in a telephone interview with
Reuters Health. "Frankly, through the Red Hot Mamas menopause
education programs, I have heard that a lot of women would rather go
shoe shopping than have sex, and that concerns me."
The survey, including more than 1,000 women, 35 years or older,
who were just beginning, just ending, or in the middle of menopause,
was conducted between June 20 and July 2, 2007.
"We are the baby-boom generation who is now entering menopause;
we are the women who lived through the sexual revolution in the 60s
and now we are having our own sexual revolution, of a different
kind," said Giblin, the founder of the Red Hot Mamas organization
(www.redhotmamas.org), which commissioned the Sex and Menopause
Survey. The survey was sponsored by Duramed Pharmaceuticals and
conducted by Harris Interactive.
Four hundred sixty nine of these women — about 44 percent —
reported suffering from vaginal symptoms such as vaginal atrophy
(vaginal narrowing or shrinkage), which can cause vaginal dryness
and painful sex.
Eighty-eight percent of women experiencing vaginal atrophy said
it was causing them problems and 47 percent said that they have
avoided, made an excuse, or stopped having sex altogether because of
physical discomfort during intercourse.
Vaginal dryness, in particular, plagued more than half of
menopausal women surveyed and this resulted in two thirds of them
having less sex. "Seventy percent of the women did not know that
therapies are available to relieve vaginal dryness," Giblin noted.
"There are over-the-counter products to combat dryness and your
physician has a treasure chest of prescription medications to
relieve vaginal dryness," she added.
Giblin believes men need menopause education just as much as
women. "It's not only important that a woman have a thorough
understanding of the menopause process." Men should also because the
symptoms of menopause "can be very hard on relationships," Giblin
said.
"If a partner sees a decrease in sex with their partner, often
times the partner becomes resentful and feels that the woman has
lost interest and it isn't necessarily true," Giblin said. "It's
very critical for women and their significant other to stay really
connected during menopause."
© Reuters 2007.
Editor's Note:
Editor's Notes:
