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Lifestyle changes are important even if you take medications - harvard

Lifestyle changes are important even if you take medications

People who are prescribed medication for high cholesterol or high blood pressure may be more likely to gain weight and less likely to exercise, but for those who are on such medications, it's even more important to commit to making healthier lifestyle choices. The post Lifestyle changes are important even if you take medications appeared first on Harvard Health Blog.
harvard - 1 hour ago
Test for Coronavirus Antibodies Approved by FDA  - web md

Test for Coronavirus Antibodies Approved by FDA

The test checks for protective antibodies in a finger prick of blood, revealing whether a patient has ever been exposed to the coronavirus and now may have some immunity, The New York Times reported.
web md - 2 days ago
COMMENTARY: NYU Med Student Joins COVID Fight:

COMMENTARY: NYU Med Student Joins COVID Fight: 'Time to Step Up'

New York med schools asked fourth-year students to graduate early and volunteer to help battle COVID. One student discusses how he weighed the potential life-or-death decision to join the front lines.
web md - 2 days ago
Coronavirus Hangs Around After Symptoms Subside  - web md

Coronavirus Hangs Around After Symptoms Subside

It took about five days from the time patients were infected until symptoms appeared, and about eight days before they disappeared. Patients were contagious for one to eight days, the researchers said in a news release from the American Thoracic Society.
web md - 3 days ago
WalMart Will Check All Workers

WalMart Will Check All Workers' Temperatures

Employees with a temperature of over 100 degrees Fahrenheit will be sent home for at least three days and may be advised to seek medical treatment. The workers will be paid for showing up for work, CBS News reported.
web md - 3 days ago
In Some Cases, COVID-19 May Harm the Brain  - web md

In Some Cases, COVID-19 May Harm the Brain

It's believed the brain can be damaged by viral infection whenever a patient's immune system overreacts to the virus. This immune system hyperactivity triggers a "cytokine storm" -- an overproduction of immune cells and their activating compounds, known as cytokines.
web md - 3 days ago
How does cardiovascular disease increase the risk of severe illness and death from COVID-19? - harvard

How does cardiovascular disease increase the risk of severe illness and death from COVID-19?

Initial investigation into COVID-19 focused on its respiratory effects, but a more recent report describes serious cardiovascular complications in people with pre-existing heart disease. How does this underlying condition increase risk for these people? The post How does cardiovascular disease increase the risk of severe illness and death from COVID-19? appeared first on Harvard Health Blog.
harvard - 3 days ago
Top 10 Must-Dos in ICU in COVID-19 Include Prone Ventilation  - web md

Top 10 Must-Dos in ICU in COVID-19 Include Prone Ventilation

With new European Society of Intensive Care Medicine guidelines on caring for critically ill COVID-19 patients covering more than 50 recommendations, Medscape asked one author for his essential top 10.
web md - 3 days ago
Top 10 Tips for Diabetes Telehealth Prophetic in Face of COVID-19  - web md

Top 10 Tips for Diabetes Telehealth Prophetic in Face of COVID-19

A new article sets the stage for routine virtual diabetes visits, offering 10 top tips that will undoubtedly be of use for transforming care during the COVID-19 pandemic, and likely for long afterwards.
web md - 3 days ago
Abortion Access Shifting in Some States Amid COVID-19  - web md

Abortion Access Shifting in Some States Amid COVID-19

In addition to challenges the coronavirus pandemic already poses to women seeking healthcare, several states have included surgical abortions as restricted procedures in executive orders related to COVID-19.
web md - 3 days ago
Ranitidine (Zantac) recall expanded, many questions remain - harvard

Ranitidine (Zantac) recall expanded, many questions remain

The FDA has not yet released the results of its testing of the heartburn medication ranitidine. The testing method used by the online pharmacy that originally alerted the FDA may have affected their results. The post Ranitidine (Zantac) recall expanded, many questions remain appeared first on Harvard Health Blog.
harvard - 4 days ago
Taking Stock - positively positive

Taking Stock

My intention is to walk this part of my life’s journey with a tremendous amount of compassion for myself and others. To navigate with as much positivity as I can muster, to set the intention to come out the other side knowing myself more, connecting a bit more deeply with the world outside my door even if it is over Zoom, and realizing that when push comes to shove, we sure as hell do know how to come together when faced with a difficult time. The post Taking Stock appeared first on Positively Positive.
positively positive - 4 days ago
FDA Requests Zantac Be Pulled From the Market  - web md

FDA Requests Zantac Be Pulled From the Market

Six months after independent testing first raised the possibility that popular heartburn drug ranitidine (Zantac) might break down into the powerful carcinogen n-nitrosodimethylamine (NDMA), the FDA has asked for the removal of all ranitidine products from the market.
web md - 4 days ago
EPA Didn’t Tell Residents About Gas Risks: Report  - web md

EPA Didn’t Tell Residents About Gas Risks: Report

A new government report has rebuked the U.S. Environmental Protection Agency for failing to tell residents about the health risks they face by living near facilities that release cancer-causing ethylene oxide gas.
web md - 4 days ago
Mild COVID-19 Often Only Shows Gastro Symptoms  - web md

Mild COVID-19 Often Only Shows Gastro Symptoms

In the new study, the research team tracked data from 206 patients with mild COVID-19. Nearly one-quarter (48) had digestive symptoms only, 69 displayed both digestive and respiratory symptoms, and 89 had respiratory symptoms only.
web md - 4 days ago
COVID-19 Deaths in Italy a Lesson for the US  - web md

COVID-19 Deaths in Italy a Lesson for the US

Italy was slow to enact social distancing orders following the first reports of COVID-19 cases in the country, a factor that experts believe may have played a part in how quickly coronavirus cases overwhelmed the nation's hospitals.
web md - 4 days ago
COVID-19: More Hydroxychloroquine Data From France  - web md

COVID-19: More Hydroxychloroquine Data From France

Further promising data from the Marseille group on the impact of hydroxychloroquine for COVID-19 patients have been posted, but one French expert warns that doubts remain over the quality of the results.
web md - 4 days ago
Coronavirus on Fabric: What You Should Know  - web md

Coronavirus on Fabric: What You Should Know

If you suspect you got too close for too long, or someone coughed on you, there’s no harm in changing your clothing and washing it right away, especially if there are hard surfaces like buttons and zippers where the virus might linger.
web md - 4 days ago
What To Know If Your Surgery Has Been Put on Hold  - web md

What To Know If Your Surgery Has Been Put on Hold

"During this unprecedented pandemic, it is important to remember that your surgeon and health care team have your care and safety in mind. This is a very fluid situation that is literally changing on an hourly basis. As a result, it is reasonable to expect cancellations or changes to your care plan," Cohen and David wrote.
web md - 5 days ago
AI Might Spot At-Risk COVID-19 Patients  - web md

AI Might Spot At-Risk COVID-19 Patients

Developed by U.S. and Chinese researchers, the artificial intelligence (AI) program has been tested at two hospitals in China with 53 patients who were diagnosed in January with COVID-19. The new tool is considered experimental and is now in testing.
web md - 5 days ago
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harvard
Are polypills and population-based treatment the next big things?

Are polypills and population-based treatment the next big things?

harvard - 2 months ago

Cardiovascular disease (CVD), such as heart attack and stroke, is a leading cause of death and disability in the US. High blood pressure and high cholesterol are major risk factors for CVD, and even though they are quite common and highly treatable, they tend to be undertreated. This is especially true among those who are poor or members of a minority. Its estimated that thousands of lives could be saved each year if more people with high blood pressure and high cholesterol received treatment for these conditions.

The appeal of the polypill

One reason that high blood pressure and high cholesterol are poorly treated is that medications prescribed to treat them arent reliably taken as prescribed (the common medical expression for this is poor medication adherence). Among the most important reasons for this are that these conditions usually cause no symptoms, its hard to remember to take multiple medications or multiple doses of medications each day, medications may cause side effects, and they may be expensive.

One potential way to improve medication adherence is to combine one or more medications into a single pill, or polypill. Advantages to this approach include:

  • Lower doses of each medication may be needed, possibly reducing the incidence of troublesome side effects.
  • Multiple medications (in low doses) may be more effective than higher doses of a single medication.
  • Fewer doses are easier to remember.
  • Depending on the specific medications and doses, a polypill could be less expensive than taking several individual medications.
  • Fewer pills and lower doses of medications may require fewer office visits, blood tests, and other monitoring.

Potential downsides of the polypill

While the potential advantages of a polypill are clear, they could be outweighed by their downsides, including:

  • Side effects. Taking multiple medications, even at low doses, may lead to higher rates of side effects. If a side effect does occur, it may be impossible to know which of the medicines in the polypill is responsible.
  • Drug interactions. When combined, medications can interact, causing serious problems such as too much or too little potency, allergic reactions, or combined side effects.
  • Overtreatment. Some people need only one or two medications to treat a condition; polypills may provide more medication than is needed.
  • Cost. A polypill may be more expensive than the individual medications they contain.
  • Less dosing flexibility. Polypills have fixed doses of several medications, so it may not be possible to adjust the dose of one medication without adjusting them all.

A new polypill study focuses on those who might benefit the most

A recent study in the New England Journal of Medicine reported positive results for people taking a polypill to lower blood pressure and cholesterol. Researchers enrolled 303 people without known CVD but who were considered high-risk based on being members of a minority and having low income: 96% were African American and 75% had incomes less than $15,000/year. As a group, their estimated 10-year risk of CVD was estimated at 13%.

Half of the study subjects were randomly assigned to receive a polypill containing low-dose atorvastatin (to lower cholesterol) and three medications to lower blood pressure (amlodipine, losartan, and hydrochlorothiazide). The other half were randomly assigned to usual care (as recommended by their personal physicians) and compared to the polypill group after one year.

Those assigned to the polypill group had

  • larger reductions in blood pressure
  • larger drops in LDL (bad) cholesterol
  • excellent medication adherence. 86% of study subjects faithfully took their medication as prescribed. This is much higher than is typically observed in routine practice. Part of this high adherence might have been due to a financial incentive: all study subjects received $50 for each clinic visit, and at each visit those in the polypill group knew their remaining pills would be counted to monitor adherence. Medication adherence in the usual care group was not reported.

There were no serious medication-related side effects reported in either group. The cost of the polypill was low just $26 per study subject per month and it was provided free or nearly free of charge to study participants. However, the cost in a non-research setting could vary based on a persons insurance coverage, location of care, and which medications are included in the polypill.

While there were too few cardiovascular events in this one-year trial to know if the polypill could reduce them, the authors estimated that based on the observed reductions in blood pressure and cholesterol levels, treatment with the polypill could reduce cardiovascular events by 25%. Indeed, another recent study, this one published in The Lancet, found a reduction in major cardiovascular events with a different polypill (which included aspirin).

A word about population-based treatment

Its worth emphasizing that for those receiving the polypill in the NEJM study, researchers used population-based treatment. That means every member of a particular (generally high-risk) population was treated regardless of their individual characteristics. This is quite different from the usual approach in which physicians make treatment recommendations based on an individuals risk profile.

Population-based treatment may make sense for people who dont have access to regular medical care. But it also means that certain individuals in the population may be treated for risk factors or health conditions they dont have.

The post Are polypills and population-based treatment the next big things? appeared first on Harvard Health Blog.

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