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Older adults urged to cut risk of ‘silent killer’ with home BP checks



Often referred to as the ‘silent killer’ as it shows few if any symptoms, high blood pressure is responsible for 7.5 million deaths worldwide every year.

Left untreated, it puts people at risk of stroke, heart disease, and heart attack – especially those aged 50-plus.

Yet only 48% of those in this age group who take blood pressure medications or have a health condition that’s affected by hypertension, regularly check their own, according to a team of researchers from the University of Michigan in the US.

Of these, only 55% own a blood pressure monitor.

Some said they don’t use it, and among those who do, only around half shared their readings with a healthcare provider.

But they were 10 times more likely to check their blood pressure outside of a health care setting than those who don’t own a monitor.

Among the 62% who said a healthcare provider encouraged them to check their blood pressure at home, they were three-and-a-half times more likely to do so.

The researchers, who analysed data from 1,247 randomly selected people aged between 50-80 as part of the University of Michigan’s National Healthy Poll on Ageing, argue that their findings suggest patients should be informed about the importance of blood pressure monitoring and making their readings known to clinicians.

It’s a view shared by Blood Pressure UK, which holds a Know Your Numbers! Week every September. The focus of this year’s campaign which runs until September 10, is on home blood pressure monitoring.

The organisation believes it is important for the public to know their blood pressure numbers in the same way most people know their weight and height.

This lack of knowledge isn’t just a problem for older age groups. A new consumer poll conducted by the London-based charity to coincide with this year’s awareness week has revealed that 63% of 30-50 year-olds don’t know their current blood pressure numbers and could be living with undiagnosed hypertension, increasing their chances of stroke, heart attack, and heart failure which, ironically, are amongst their most feared health conditions.

Unhealthy lifestyles and poor diet are contributing to more young people in their 30s, 40s, and 50s being diagnosed with hypertension and around one in three of the UK population is now living with high blood pressure.

Blood Pressure UK estimates around 6.5 million people remain undiagnosed.

Since high blood pressure is largely symptomless and the single biggest preventable cause of death not just in the UK but in many other developed countries, the charity says the more people who test themselves, the more chance there is of controlling it and avoiding unnecessary premature death.

A home blood pressure monitor is the easiest way to do this.

Phil Pyatt, CEO of Blood Pressure UK, commented: “Given high blood pressure does not show any clear symptoms – hence being dubbed the ‘silent killer’ – all adults, regardless of their age, need to take control of their health by checking their blood pressure regularly, either at home, at a pharmacy or at their GP.

“Furthermore, simple improvements in diet and lifestyle such as eating less salt, more fruit and vegetables, and doing more exercise can really help keep blood pressure down.”

Professor Graham MacGregor, chairman of Blood Pressure UK, added: “Half of all strokes and heart disease are due to high blood pressure which can easily be reduced, particularly by reducing your salt intake and if necessary, taking tablets which rarely have side effects.

“This will reduce your risk of developing a heart attack, heart failure, or a stroke, which can either be fatal or cause life-changing disabilities. This is completely avoidable; it is not the time to dither and delay – it could save your life.”

There is now substantial evidence supporting the use of home blood pressure monitoring. It has been shown to give a better reflection of blood pressure, avoiding so-called ‘white coat syndrome’ when a person’s blood pressure is raised due to the stress of being in a medical environment like a GP surgery, or pharmacy.

What’s more, it allows patients to monitor their condition more easily in the long term.

According to NHS England, regular home blood pressure monitoring across a population of 50,000 patients could prevent up to 500 heart attacks and 745 strokes over five years.

Research studies also show that eating too much salt is a major cause of high blood pressure, particularly when associated with age.

Cutting one gram of salt from the average daily salt intake would help reduce blood pressure.

In the UK this would equate to approximately 6,000 fewer deaths from strokes and heart attacks each year.


Europe: Improving access to early-stage lung cancer care



Europe: Improving access to early-stage lung cancer care

Researchers from Amsterdam UMC Cancer Center Amsterdam have looked at inequalities in access to early-stage lung cancer care in Europe.

Early-stage lung cancer has stark differences between European countries regarding access and reimbursement.

There are also differences in reimbursement times and indications between the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA).

Researchers from Amsterdam UMC Cancer Center Amsterdam analysed the landscape, publishing their results in The Lancet Regional Health Europe as part of a series on the latest developments in the treatment of this lung cancer.

“Tackling inequalities in access to care must be a common European priority,” says Amsterdam UMC pulmonologist Idris Bahce. In collaboration with colleagues from seven European countries, Bahce used a literature review to map out the latest developments and analyse access to these new treatments from a European perspective.

“The existing differences in healthcare systems and reimbursement structures between European countries threaten to exacerbate healthcare inequalities at both European and national level. We therefore call for a collective European approach to reduce these inequalities,” says Bahce.

He suggests measures such as more international cooperation between the EMA and other registration authorities, harmonising cost-effectiveness procedures in European countries, a more critical evaluation of reimbursement criteria and improving multidisciplinary collaborations around the patient.

The standard treatment for fit patients with early-stage lung cancer has always been surgery, sometimes combined with pre- or post-operative chemotherapy. Recently, the EMA has approved new treatments such as immunotherapy, which appear to significantly improve survival rates after surgery. More approvals of innovative treatments are expected, potentially further exacerbating existing inequalities within Europe.

In addition to the Dutch hospitals Amsterdam UMC and Erasmus MC, colleagues from Spain, France, Germany, England, Italy and Poland also contributed to this international study as well as a Review and a Viewpoint in The Lancet Regional Health Europe.

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Study looks at link between adversity and cognitive decline



A new paper has examined the relationship between childhood adversity and psychiatric decline, as well as adult adversity and psychiatric and cognitive decline. 

The findings revealed just one instance of adversity in childhood can increase cases of mental illness later in life. It also revealed that adverse events in adults can lead to a greater chance of both mental illness and cognitive decline later in life. 

The paper has been published by Saint Louis University associate professor of health management and policy in the College for Public Health and Social Justice, SangNam Ahn, Ph.D., in Journal of Clinical Psychology.

Ahn stated: “Life is very complicated, very dynamic. I really wanted to highlight the importance of looking into the lasting health effect of adversity, not only childhood but also adulthood adversity on health outcomes, especially physical health and psychiatric and cognitive health. 

“There have been other studies before, but this is one of the first that looks into these issues comprehensively.” 

Ahn, along with his team of researchers, examined data from nearly 3500 individuals over the course of 24 years. The group took the longitudinal data and evaluated it using a list of lifetime potential traumatic events.

The research team included childhood adversity events such as moving due to financial difficulties, family requiring financial help, a parent experiencing unemployment, trouble with law enforcement before the age of 18, repeating school, physical abuse and parental abuse of drugs or alcohol. 

Adulthood adversity events included the death of a child, the death of a spouse, experiencing a natural disaster after age 17, firing a weapon in combat, a partner abusing drugs or alcohol, being a victim of a physical attack after age 17, a spouse or child battling a serious illness, receiving Medicaid or food stamps and experiencing unemployment. 

The study determined that nearly 40% of all individuals experienced a form of childhood adversity, while that number climbed to nearly 80% for adulthood adversity. Those who experienced childhood adversity were also 17% more likely to experience adulthood adversity. Only 13% of individuals sampled reported two or more forms of childhood adversity, while 52% of adults experienced two or more forms of adult adversity. 

In cases of either childhood adversity or adulthood adversity, researchers found individuals who experienced adversity were also more likely to experience anxiety and depression later in life, and in the case of adulthood adversity, were also more likely to experience cognitive decline later in life. 

Individuals with one childhood adversity experience saw a 5% higher chance of suffering from anxiety, and those with two or more childhood adversity experiences had 26% and 10% higher chances of depression and anxiety, respectively. Individuals who experienced two adulthood adversities had a 24% higher chance of depression, while also experiencing a 3% cognitive decline later in life. 

While most of the results were expected or unsurprising, one area that stood out to Ahn was education. Those individuals studied who reported higher levels of education saw a reduction in the number of adversity experiences. Ahn hopes to study this avenue more to learn how education may be able to mitigate or prevent these declines. 

“Before including education, there was a significant association between childhood adversity and cognitive impairment,” Ahn said. 

“But when including education as a covariate, that significant association disappeared. Interesting. So there were important implications here. Education and attending school, people could be better off even if they were exposed to childhood adversity. They’re likely to learn positive coping mechanisms, which may help avoid  relying on unhealthy coping mechanisms, such as smoking or excessive drinking or drug use.

“Education is quite important in terms of health outcomes. If I am educated, I’m likely to get a better job, have a higher income, and live in areas with less crime. I’m likely to buy gym membership or regularly exercise. I’m likely to shop at Whole Foods and get proper nutrition. All of which help combat these adversities we hinted at in the study. So the education and health outcomes are already closely related, and that is what we saw in our study.”

Ahn also encourages clinicians and everyday people alike to discuss their stress. Clinicians can learn more about their patients and have a better approach when it comes to their physical and mental health, while others could potentially relate to shared experiences. But through awareness and recognition, these adverse experiences could potentially have less serious, lasting effects. 

“Public health is very interested in stress,” Ahn said. “But we’re still examining how daily stress impacts our long term health outcomes. So to see the effects here in the study, I want people to pay attention to their stress and proactively address it. Clinicians should have deep discussions with their patients about their stress and mental state. And those topics can be approached in other areas too, like the classroom or the dining room table. The more we are aware of stress and discuss our stress, the better we can handle any adversities we find in life.”

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New tool to explore mechanisms of age-related diseases



New tool to explore mechanisms of age-related diseases

A new screening tool has been developed that will investigate the mechanisms behind conditions such as cancer, arthritis, neurodegeneration and cardiovascular disease.

Wellcome Sanger Institute researchers and their collaborators at Open Targets and EMBL’s European Bioinformatics Institute (EMBL-EBI) have developed the screening tool called scSNV-seq.

The tool has been designed to uncover how genetic changes affect gene activity that can lead to diseases such as cancer, autoimmunity, cardiovascular disease and neurodegenerative diseases such as Alzheimer’s and Parkinson’s. 

The tool enables the investigation of thousands of DNA mutations identified by genetic studies in one experiment, and will help to guide the development of advanced diagnostics and treatments.

scSNV-seq allows the rapid assessment of the impact of thousands of genetic changes in cells that have never been screened before, directly connecting these changes to how those same cells operate. 

This technique helps researchers to pinpoint mutations that contribute to disease, which will offer crucial insights for developing targeted therapies.

In a new study, published in Genome Biology, the team applied scSNV-seq to the blood cancer gene, JAK1, accurately assessing the impact of JAK1 mutations.

The assessment revealed for the first time that certain mutations caused a “halfway house” phenotype cycling between different states which was not possible under previous approaches.

The technique is designed to demonstrate versatility across cell types, including hard-to-culture primary cells like T cells and stem-cell derived neurons, as well as various editing methods such as base editing and prime editing. 

Applied on a large scale, scSNV-seq could transform understanding of the genetic changes driving cancer and decoding genetic risk for Alzheimer’s, arthritis, diabetes and other complex diseases.

Dr Sarah Cooper, first author of the study at the Wellcome Sanger Institute, stated: “In an era where the rate of genetic variant discovery outpaces our ability to interpret their effects, scSNV-seq fills a major gap for studying challenging cells like T cells and neurons. 

“We are already using it to shed light on the impact of Alzheimer’s and Parkinson’s risk variants on brain cells.”

Dr Andrew Bassett, senior author of the study at the Wellcome Sanger Institute, said: “Our technique is able to directly connect effects of mutations to how a cell behaves, revealing downstream impacts that previous technologies alone cannot deliver. 

“The technique speeds up the identification of causal genetic mutations, which will allow better diagnosis and deepens our molecular understanding of diseases, paving the way for more targeted and effective treatments.”

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