Posts Tagged ‘high blood pressure’

Singing the Birthday Blues

Wednesday, June 27th, 2012

People aged 60 and over are 14 percent more likely to die on their birthdays A recent study of more than two million people found that the birthday blues bring a rise in deaths from heart attacks, strokes, falls, suicides and even cancer.  The findings – based on a study over 40 years in Switzerland – back up the idea that birthday stress has a major impact on lifespans.  The majority of the increase was attributed to heart attacks, which rose 18.6 percent on birthdays and were significantly higher for men and women.  Levels of strokes were up 21.5 per cent – primarily in women – and there was a surprisingly large increase in cancer deaths in both sexes of 10.5 per cent.

Dr Vladeta Ajdacic-Gross, a senior researcher in psychiatry at the University of Zurich, said: Birthdays end lethally more frequently than might be expected.”  One notable person who died on his birthday is William Shakespeare, who passed away in 1616 of causes unknown.

The Swiss research is confirmed by data on Canadian hospital admissions showing that strokes are more likely to occur on birthdays than other days, especially among patients with a history of high blood pressure.  A substantial rise in suicides and accidental deaths for the over-60s on birthdays was found only in men.  There was a 34.9 percent rise in suicides; 28.5 percent rise in accidental deaths not related to cars; and a 44 percent rise in deaths from falls on birthdays.  The risk increases for about four days before the big day.

It was previously thought that people are more likely to die after their birthday as the thought of reaching a milestone would help them hold on for more time.  The researchers said this theory was disproved by their findings, and they support the anniversary reaction theory – also known as the birthday blues.

Dr Lewis Halsey, a senior lecturer in environmental physiology at the University of Roehampton, said: “One interesting finding is that more suicides happen on birthdays, though only in men.  The authors suggest that this increase could be related to them drinking more alcohol on birthdays.  But perhaps men are more likely to make a statement about their unhappiness when they think people will be taking more notice of them.  Or perhaps women feel that it is unfair on others who might be celebrating with them to put them through dealing with suicide.”

American researchers have found similar increases in heart deaths on Christmas and New Year’s Day.  They list stress among possible causes — and say people having chest pain or other symptoms might wait too long to get medical help on days when they are thinking about celebrating.

America’s Healthcare System Needs Improvement: Study

Wednesday, November 2nd, 2011

The American healthcare system is not very healthy, according to a wide-ranging new assessment of the system that covers 42 measures of healthcare delivery, the United States scored just 64 out of 100.  “Costs are up sharply, access to care deteriorated, health system efficiency remains low, disparities persisted, and health outcomes fail to keep pace with benchmarks,” concluded the 2011 National Scorecard on U.S. Health System Performance. The report was issued by the Commonwealth Fund, a nonprofit healthcare policy foundation.

There are some bright spots on the report.  For one, the number of Americans who are controlling their high blood pressure rose from 31 percent in 2008 to 50 percent in 2009.  Additionally hospitals have improved their ability to care for patients with heart attacks, pneumonia, and other common conditions.

The Commonwealth Fund report also determined that the typical U.S. infant mortality rate is 35 percent higher than the top-performing states.  Other wealthy countries still have infant mortality rates that are significantly lower than the best-performing states in the United States.  If the U.S. did as well as the top-performing country in that category — France — 91,000 fewer babies would die prematurely each year, Cathy Schoen, senior vice president at Commonwealth Fund said.  “These statistics are real,” she said.  “They are real human lives.”  Other “areas of concern” include childhood obesity, preventive care and infant mortality.

Another issue is cost, an oft-cited statistic that the U.S. spends more per person on healthcare than any other country.  According to the Commonwealth Fund report, the nation in general spends twice as much as comparable countries, but doesn’t have better care to show for it.  “We are headed toward spending $1 of every $5 of national income on healthcare,” the report’s authors said.  “We should expect a better return on this investment.”  The high cost of healthcare takes a toll on personal finances, the report said.  By 2010, 40 percent of working-age adults had medical debt or difficulties paying medical bills, an increase of 34 percent when compared with 2005.

It is important to note that the majority of the report’s data is from 2007 – 2009, prior to the passage of the Patient Protection and Affordable Care Act (ACA).  The healthcare reform law is likely to lead to improved scores on some of the categories, particularly access and affordability.  For example, 25 percent of residents in 15 states lacked health insurance.  The ACA will require that all Americans have health insurance in 2014.  It also will reduce eligibility requirements for Medicaid so more low-income people will be eligible, and provide government subsidies to others who can’t buy insurance on their own.

The report’s authors remain optimistic that the health reform law will address many of the problems highlighted in the report.  This scorecard illustrates that focused efforts to change the healthcare system for the better are working and are worth the investment,” said Maureen Bisognano, president and CEO of the Boston-based Institute for Healthcare Improvement.  “If we target areas where we fall short and learn from high-performing innovators with the United States, we should see significant progress in the future,” said Dr. David Blumenthal, commission chair and professor of medicine and healthcare policy at Massachusetts General Hospital and Harvard Medical School.

Writing in the Huffington Post, a Social Epidemiologist at Columbia University, thinks that the price Americans pay for their healthcare is too high.  “It’s well known that Americans pay more for less when it comes to healthcare than just about any other country in the world.  In 2009, we spent nearly $8,000 per person to provide medical care to just over 80 percent of our population — that compares, for example, to just under $3,500 spent per person in the U.K. to provide care for the entire population.  To add injury to insult: our counterparts across the pond get an extra year of life for their $3,500 than we do for our $8,000.

“Why do we pay more for less when it comes to our health?  Every policy wonk has his theory.  Common ones include the high cost of American medical education (which is too expensive), or that permissive tort laws in the U.S. enable lawyers to profit from the health system (which is true).  But while each of these theories, and others, explain small quirks in our health system that certainly contribute to it’s gargantuan price tag, they don’t address the fundamental issue with our health system.  And that’s that our market-driven system introduces perverse financial incentives for medical providers that don’t align with the health or wellbeing of Americans.  This leads to wasted money and lost lives.

“In our healthcare system, the fundamental billing unit is the “procedure” — doctors charge per action, diagnostic or curative, taken on the part of a patient.  While, on the surface, rewarding doctors for each step they take to make a patient better may seem fair, it has disastrous consequences for the structure of our health system.  Chief among them is our top-heavy specialty physician structure,” El-Sayed concluded.

Poor Education Can Lead to Alzheimer’s

Monday, August 8th, 2011

As many as 50 percent of Alzheimer’s cases worldwide could be avoided if risk factors such as depression, obesity and smoking were eliminated, either with lifestyle changes or treatment of underlying conditions.  Even modest cuts in the level of risk factors could prevent millions of cases of the memory-robbing illness, the researchers said.  As an example, a 25 percent cut in seven common risk factors – such as poor education, obesity and smoking — could prevent as many as three million Alzheimer’s cases around the world and up to half a million in the United States alone.  The new research is being presented at the Alzheimer’s Association International Conference (AAIC) and published online in The Lancet Neurology.

“The idea here is to get a better bead on exactly how we can start untangling what the risk factors are, so that we can not only treat and modify Alzheimer’s but also start talking about prevention of Alzheimer’s,” said Mark Mapstone, associate professor of neurology at the University of Rochester Medical Center.  “The field is working very hard (to figure out) what these risk factors are so we can start heading this disease off before it starts.”

Led by Deborah Barnes of the University of California San Francisco (UCSF), the researchers revisited earlier epidemiological studies on links between Alzheimer’s and seven vital risk factors: poor education, smoking, low physical activity, depression, hypertension during mid-life, obesity and diabetes.  They estimated that these risk factors account for 17 million cases of Alzheimer’s worldwide (approximately half of the estimated 34 million cases of dementia globally) and three million of the 5.3 million estimated cases in the United States.  Some factors appeared to have a greater impact on Alzheimer’s risk than others.  The UCSF team estimated that worldwide, 19 percent of Alzheimer’s cases can be attributed to low education; 14 percent to smoking; 13 percent to physical inactivity; 10 percent to depression; five percent to mid-life hypertension; 2.4 percent to diabetes; and two percent to obesity.  In the United States, more than 20 percent of cases can be traced to low physical activity; 15 percent to depression; 11 percent to smoking; eight percent to mid-life hypertension; seven percent to mid-life obesity; seven percent to low education and three percent to diabetes.

Dr. Ronald Petersen of the Mayo Clinic said the findings have important public-health implications and will help raise awareness of the need for prevention.  The study offers “an uplifting message for aging and cognition,” he said, insofar as it suggests that lifestyle factors can be modified to alter Alzheimer’s risk, at least at the societal level.  But, with the exception of increasing physical activity, there is scant evidence that interventions are successful in altering an individual’s chances of developing Alzheimer’s.

Other studies have shown that increasing physical activity is effective.  But whether taking up crossword puzzles or losing weight impacts the path of Alzheimer’s — the pathology of which seems to begin years before symptoms appear — remains unknown.  Last year, a National Institutes of Health panel concluded – with some controversy — that the scientific evidence on lifestyle factors was negligible and said that intervention is helpful.  Petersen said that, while depression is clearly associated with Alzheimer’s, the causal direction could go either way, especially when the depression comes late in life.  “Is that really a risk factor for, or a function of, the disease?” he asked.  The question is, for the most part, irrelevant from a clinical perspective because depression should be treated anyway, Petersen said.

“Education, even at a young age, starts to build your neural networks,” so being deprived of it means poorer brain development, Barnes said.

“It gives us a little bit of hope about things we could do now about the epidemic that is coming our way.”  Alzheimer’s cases are expected to triple by 2050, to approximately 106 million globally.  “What’s exciting is that this suggests that some very simple lifestyle changes, such as increasing physical activity and quitting smoking, could have a tremendous impact on preventing Alzheimer’s and other dementias in the United States and worldwide,” Dr Barnes said.

The study could be good news for people – usually family members – who are caregivers for individuals with Alzheimer’s. “Throughout the progression, I felt quite helpless…without any cure for (Alzheimer’s disease) yet, I could only watch,” said Rick Lauber, who acted as caregiver to his father, John, who developed the disease in his 60s and died at age 76.  As his father’s caregiver, Lauber had to take on unexpected responsibilities, such as moving him three times, taking him to doctor’s appointments, paying bills and becoming his father’s Joint Guardian and Alternate Trustee.  “As an adult child and a family caregiver, caring for Dad had to one of the hardest things imaginable,” Rick Lauber said.  “Watching him decline from a healthy, active, respected academic to a shell of a man was very challenging.  Dad was changing before my eyes and I could not do anything about this.”

According to the 2011 annual Facts and Figures release from the Alzheimer’s Association, nearly 15 million Americans provide 17 billion hours of unpaid care worth $202 billion every year.

This blog is dedicated to the memory of William A. Alter, the founder of our company who passed away August 8, 2008 of complications of Alzheimer’s disease.  To read about Bill Alter’s amazing career, please click here.

Rural Family Practice Physician Chosen as Surgeon General

Friday, July 24th, 2009

President Obama has chosen a little-known family practice physician who runs a small clinic in a rural community on Alabama’s Gulf Coast as his Surgeon General of the United States.  She is Dr. Regina Benjamin,  who has spent her career tending to the healthcare needs of the poor.  According to Obama, “When people couldn’t pay, she didn’t charge them.  When the clinic wasn’t making money, she didn’t take a salary for herself.”artbenjaminnominationgi

Dr. Benjamin has committed herself to fighting the preventable illnesses that prematurely took the lives of both her parents, as well as her brother and sole sibling.  According to Dr. Benjamin, “I cannot change my family’s past, but I can be a voice to improve our nation’s healthcare for the future.”

Dr. Benjamin’s medical education was paid for by the National Health Service Corps, a federal program where students agree to pay back by working in areas that lack physicians for a specified time.  To honor that obligation, she founded the not-for-profit Bayou La Batre Rural Health Clinic in 1990 in the fishing village of Bayou La Batre, AL.  She remains the practice’s CEO.

The clinic, which was heavily damaged by Hurricanes Georges and Katrina, burned to the ground several years ago.  Every time, Dr. Benjamin rebuilt, even if it meant mortgaging her house or maxing out her credit cards.  Despite the setbacks, Dr. Benjamin remains dedicated to providing quality healthcare to the village’s 2,500 residents.

Benjamin is a stark contrast to Obama’s first nominee for Surgeon General – Sanjay Gupta, a glamorous TV personality and globe-trotting neurosurgeon who raised the hackles of Senators and withdrew his nomination.

The Surgeon General post, which is used primarily as a bully pulpit on healthcare initiatives, requires Senate confirmation.

Wellness Is a Proactive Approach to Healthcare

Wednesday, June 24th, 2009

Now is the time for healthcare providers to take a proactive approach to the well-being of their respective communities and target markets.  The American Recovery and Reinvestment Act (ARRA), signed into law by President Obama on February 17, contains $1 billion for the new Prevention and Wellness Fund.  This Fund will make available resources for funding immunization programs; infection prevention programs; and the prevention of mpj040515400001chronic diseases such as high blood pressure, diabetes and heart disease.  Based on statistics provided by the Center for Disease Control and Prevention, more than 70 million people in the United States (approximately 25 percent of our total population) live with cardiovascular disease.  Wellness programs have a direct impact on the prevention of these diseases and will be an important components of any preventative program.

Healthcare providers have historically been hesitant to invest in wellness and fitness centers due to the capital resource requirement and uncertain return on investment.  With careful planning and strategic development, these facilities can bring a substantial new revenue stream into the organization.  Skeptics may point to the Medical Fitness Association, which reports that in 2008 there were approximately 950 medically based wellness and fitness centers in the United States, with one-third reporting operating losses.

While such risks do exist, investing in wellness facilities and programs that directly address the prevention of chronic disease have the potential for more than satisfactory financial results.  If managed with a clear direction, thought and competence, these facilities can provide a financial return far more attractive than the equities market has offered in the recent past.  The resources allocated to fight chronic disease will come back tenfold in cost reductions over the long term.

Now is the time to invest in the well-being of our future.  We should not wait for another opportunity like the one Congress and President Obama have provided.  We need to take advantage of this now.