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February 22nd, 2010
05:48 PM ET

Report: Hypertension a neglected public health issue

By Ashley Fantz
CNN.com Writer Producer

High blood pressure is killing more Americans than ever, but it's being neglected as a public health issue and doctors are not adequately diagnosing it, according to medical experts who worked on a new report issued Monday by the Institute of Medicine, an independent, nonprofit organization based in Washington, D.C.

High blood pressure is a major contributing cause of heart disease, the nation's leading cause of death for men and women. Cancer ranks second. Heart disease killed 631,636 people and cancer killed 559, 888 people in 2006, the most recent year the Centers for Disease Control and Prevention has data available. Hypertension is the second leading cause of preventable deaths; smoking is number one, according to IOM.

The 155-page report, sponsored by the CDC, says that currently one in three people have high blood pressure - measured at 140 over 90 or higher. The figure of one in three people is an increase from 2005 when one in six adults suffered from high blood pressure, according to Dr. Corinne Husten.

An increase in blood pressure translates to a hefty price tag for health care. Hypertension prevention and control is only one of a number of programs competing for $54 million last year in the CDC’s entire Heart Disease and Stroke Prevention portfolio, the report states. The American Heart Association recently reported that the direct and indirect costs of high blood pressure as a primary diagnosis was $73.4 billion in 2009.

The former chief epidemiologist and acting director of the Office on Smoking and Health at the CDC, Huston was part of a 10-person panel of medical doctors, epidemiologists and Ph.D.s who took roughly a year to review more than 100 existing studies on high blood pressure. Many of those studies included comprehensive information from national surveys that reviewed patient medical records, she said.

"We looked at how many times a patient had been to see a clinician, and [in those instances] when high blood pressure was recorded but those patients were either not given treatment or medication, or nothing, in general, was done," Huston said.

It's unclear why doctors are not following guidelines on how to treat hypertension, panel members told reporters Monday. "A lot of people who have hypertension don't know it because clinicians aren't telling them that their numbers are high," according to the epidemiologist.

Why are more Americans suffering from high blood pressure?

"We can blame our high intake of sodium in the food we buy at grocery stores or eat in restaurants, our lack of potassium in our diets, that we don't get enough exercise," said Husten.

An adult should be consuming a teaspoon of salt a day, said David Fleming, chair of the IOM panel and the director of King County public health in Washington state. The elderly or someone already suffering from high blood pressure should get no more than two-thirds of a teaspoon of salt each day. But measuring that is, practically speaking, extremely difficult.

"One has to remember that the food you buy already has sodium in it before you use your salt shaker," he said.

The report recommends ways to address the increase in high blood pressure, including a familiar call to eat more vegetables and fruit, work out more and ask a restaurant exactly how much salt meals contain.

The CDC should also work with schools to encourage them to strengthen or implement physical fitness programs and work with food industry professionals to tamp down on the amount of salt put in food, the report advises.

The report also suggests requiring providers to allow patients to make smaller co-pays in order to get medications and have doctor visits. Another option would be to require providers to issue more rigorous treatment guidelines to doctors.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


February 22nd, 2010
05:44 PM ET

2009 H1N1 flu strain will be in next season flu vaccine

By Miriam Falco
CNN Medical News Managing Editor

The 2009 H1N1 flu virus, which has been circulating since last spring, sickened millions and killed at least 15,000 people worldwide, will be included in the next seasonal flu vaccine when it becomes available in the fall, health experts in the United States decided Monday.

Every February, the Vaccines and Related Biological Products Advisory Committee advises the Food and Drug Administration on which flu strains to include in the next flu shot or spray.

The committee is following the recommendations of the World Health Organization, Dr. Jerry Weir, the FDA's director of the Division of Viral Products, told CNN.

"This is the same process we go through every year," Weir explained. The selection is made early in the year to give flu manufacturers enough time to make enough vaccine by September or October, when health officials recommend people get vaccinated. Pharmaceutical companies need so much lead time because it's takes a long time to grow vaccines in eggs, currently the only licensed method for making flu vaccines.

"The new H1N1 strain didn't exist last February," said Weir, which is why health officials couldn't consider it for the flu vaccine for the current flu season. Once it was determined that this new type of H1N1 flu strain was circulating around the country and the world, flu manufacturers were asked to develop an additional flu vaccine to fight this virus.

The most recent estimates from the Centers for Disease Control and Prevention suggest that between 41 million and 84 million people in the Unites States have been infected with 2009 H1N1 since last April. The CDC also estimates between 183,000 and 378,000 people were hospitalized and between 8,330 and 17,160 people died from this flu since it emerged.

The agency says its estimate vary widely because not everyone who gets sick goes to the doctor, and not everyone who is hospitalized was tested for this flu and because health officials believe hospitalizations and deaths are under-reported.

The following three virus strains will be included in the 2010/2011 seasonal flu shot:

- an "A California viru," which is the pandemic virus H1N1 virus that caused so much illness in the past 10 months;
- an "A Perth virus," which is an H3N2 virus
- a "B Brisbane virus."

Weir says now that the three specific strains have been selected, manufacturers can now begin producing the new batch of seasonal flu vaccine.

For those concerned about getting the flu now, the CDC continues to recommend getting the separate H1N1 vaccine which is now widely available.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


February 22nd, 2010
10:41 AM ET

Pediatricians group issues anti-choking guidelines

By Jennifer Bixler
CNN Medical Executive Producer

Spend time with a baby or toddler and you learn that one thing is nearly universal: They love putting things in their mouth. It's one of the ways they learn about the world around them. But sometimes, curiosity can be dangerous. A study that appeared in the New England Journal of Medicine found a child dies every five days from choking. Now the American Academy of Pediatrics is calling on food manufacturers to require warning labels on foods that can cause children to choke. According to AAP, choking is the leading cause of death of children under age 3. Hot dogs, hard candy, even peanut butter are among the culprits.

“No one wants to see kids suffer,” says Dr. Gary Smith, author of the AAP’s new policy statement. (link here). “We need as a society to provide them with safe environments. There’s not a food manufacturer out there that would disagree with that.”

Smith and his colleagues are also asking food manufacturers to avoid making food in shapes and sizes that may cause children to choke. (So far, the Grocery Manufacturers Association has not commented on the recommendations.)

Smith says hot dogs pose the greatest danger. He says their shape and compressible texture will seal off a child’s airway and are hard to wedge out. Peanuts and raw carrots are also dangerous, but for a different reason. Toddlers typically don’t have molars, so they can easily choke on chunks of those hard foods.

So parents, what should you watch out for? Smith says it’s always best to err on the side of caution, but if you are going to feed your child hot dogs, for example, be sure to cut them in extremely small pieces. Also, doctors suggest waiting to introduce things like raw carrots and nuts into a child’s diet until their teeth are fully formed.

Smith hopes the food industry will take a cue from the automobile industry and make these changes. “Safety sells,” says Smith. “ You can take something like this and see it as an opportunity and not a burden … watching kids die, that’s not acceptable.”

em>CNN's Caitlin Hagan contributed to this report.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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