High cholesterol riskier for middle-aged men than women

Main Category: Cholesterol
Also Included In: Men's Health;  Heart Disease
Article Date: 20 Aug 2013 - 0:00 PDT Current ratings for:
High cholesterol riskier for middle-aged men than women

High cholesterol levels are much more risky for middle-aged men than middle-aged women when it comes to having a first heart attack, a new study of more than 40,000 Norwegian men and women has shown.

The study, just published in the September issue of Epidemiology, shows that being a middle-aged male and having high cholesterol levels results in a negative synergistic effect that the researchers did not observe in women. However, current clinical guidelines for treating high cholesterol levels do not differentiate between men and women.

Middle age risks for men

"Our results suggest that in middle age, high cholesterol levels are much more detrimental for men than women, so that prevention efforts in this age group will have a greater potential to reduce the occurrence of a first heart attack in men," said Erik Madssen from the Norwegian University of Science and Technology's (NTNU) Department of Circulation and Medical Imaging, who was first author of the paper with Lars Erik Laugsand, also from NTNU.

The researchers used data from the second Nord-Trøndelag Health Study, a county-wide survey carried out in 1995-1997 in Nord Trøndelag, Norway, that included blood sample collection from 65,000 people. Because the researchers hypothezised that female sex hormones could possibly protect women with respect to the prevalence of first heart attacks, they restricted their analysis to participants who were younger than 60 years old at the time of the survey.

More than three times more heart attacks

In the end, the researchers had information from 23,525 women and 20,725 men who fit this category. During the nearly 12 years of follow-up on the participants who were younger than 60 years when the survey was conducted, there were 157 new cases of heart attacks in women and 553 in men.

They also conducted a secondary analysis of participants who were 60 years old or older at the time of the survey, which gave them another 20,138 individuals for the analysis. However, there was no evidence of a negative synergistic effect in male participants in this age group.

"Our findings suggest that middle-aged men with an unfortunate cholesterol profile have a significant additional risk of myocardial infarction than what previously has been thought," Madssen and Laugsand said. "Thus, these men should be treated more aggressively than what often is the case today, so that more infarctions can be prevented and lives can be saved."

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Risk of Acute Myocardial Infarction: Dyslipidemia More Detrimental for Men than Women

Madssen, Erik; Laugsand, Lars Erik; Wiseth, Rune; Mørkedal, Bjørn; Platou, Carl; Vatten, Lars; Janszky, Imre; Epidemiology. 24(5):637-642, September 2013.

Norwegian University of Science and Technology

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Joint symptoms in postmenopausal women not reduced by calcium plus vitamin D supplementation

Main Category: Arthritis / Rheumatology
Also Included In: Menopause;  Nutrition / Diet
Article Date: 20 Aug 2013 - 0:00 PDT Current ratings for:
Joint symptoms in postmenopausal women not reduced by calcium plus vitamin D supplementation

A team of investigators systematically analyzed the effect of calcium and vitamin D supplementation on joint symptoms in a rigorous and controlled study of postmenopausal women. They found that supplementation did not reduce the severity of joint symptoms reported by the participants. Their results are published in the Journal of the Academy of Nutrition and Dietetics.

The influence of low calcium and vitamin D deficiency on joint symptoms has been studied with mixed results. Only some observational studies have associated vitamin D with knee osteoarthritis and results from full-scale randomized trials have been sparse. "In the current study, we addressed for the first time in a full-scale, randomized clinical trial setting, the clinically relevant question of whether postmenopausal women using calcium and vitamin D supplements in currently recommended dosage would experience any favorable effect on joint pain or swelling, common symptoms in postmenopausal women," says lead investigator Rowan T. Chlebowski, MD, PhD, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center in Torrance, California.

Using data from the Women's Health Initiative (WHI) calcium plus vitamin D supplementation trial, researchers identified a subgroup of 1,911 postmenopausal women for the current study, who had been randomized to receive calcium carbonate with vitamin D3 daily or placebo and had undergone serial joint symptom assessment. Responses to a questionnaire provided qualitative information on joint pain and joint swelling before entry and two years after randomization.

Between the daily supplement use and placebo groups, joint pain and swelling at baseline entry was comparable, at more than 70 percent. After two years, analysis revealed no statistically significant difference for the frequency or severity of joint pain or swelling.

The research team also evaluated data to determine the potential for interaction with age, BMI (body mass index), physical activity, non-protocol calcium and vitamin D supplement use, race/ethnicity, and hormone therapy. Investigators found no interaction with age, BMI, race/ethnicity, or physical activity. No significant interaction was evident with non-protocol vitamin D supplement use at entry. However, participants using non-protocol calcium supplements at entry reported less joint pain compared with those in the placebo group. The influence of calcium and vitamin D supplementation individually on joint symptoms was not determined because both were provided combined in a single pill in this trial.

Dr. Chlebowski concludes, "Joint symptoms are relatively common in postmenopausal women. However, daily supplementation with 1,000 mg of calcium carbonate and 400 IU of vitamin D3 in a randomized, placebo-controlled clinical trial setting did not reduce the self-reported frequency or severity of joint symptoms."

Dr. Chlebowski and his team add that these findings do not speak against current recommendations for vitamin D intakes for bone health and fracture risk reduction.

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As many as 1 in 5 women don't believe their breast cancer risk

Main Category: Breast Cancer
Also Included In: Genetics;  Psychology / Psychiatry
Article Date: 19 Aug 2013 - 1:00 PDT
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As many as 1 in 5 women don't believe their breast cancer risk

Despite taking a tailored risk assessment tool that factors in family history and personal habits, nearly 20 percent of women did not believe their breast cancer risk, according to a new study from the University of Michigan Comprehensive Cancer Center.

Most of the women who didn't believe their risk numbers said they did not feel it took into account their family history of cancer or their personal health habits. The tool did ask relevant questions about the individual's family and personal history.

"If people don't believe their risk numbers, it does not allow them to make informed medical decisions," says senior study author Angela Fagerlin, Ph.D., associate professor of internal medicine at the University of Michigan Medical School and a research scientist at the VA Ann Arbor Center for Clinical Management Research.

"Women who believe their risk is not high might skip chemoprevention strategies that could significantly reduce their risk. And women who think their risk should be higher could potentially undergo treatments that might not be medically appropriate, which can have long-term ramifications," she adds

The findings, published in Patient Education and Counseling, are part of a larger study looking at how to improve patients' understanding of risk information.

Some 690 women who were at above-average risk of developing breast cancer completed a web-based decision aid that included questions about age, ethnicity, personal history of breast cancer, and number of first-degree relatives who had had breast cancer. The women then were told their five-year risk of developing breast cancer and given information about prevention strategies.

After receiving this information, the women were asked to recall their risk of breast cancer within the next five years. If they answered incorrectly, they were asked why: they forgot, made a rounding error or disagreed with the number. The researchers found that 22 percent of women who misreported their risk said they disagreed with the numbers.

The most common reason women said they disagreed with their risk was that their family history made them either more or less likely to develop breast cancer. Many believed that because an aunt or father had cancer, it increased their risk. Only first-degree female relatives - mother, sister, daughter - impact a person's breast cancer risk. Others felt a lack of family history meant their cancer risk should be very low.

One-third of women cited a gut instinct that their risk numbers just seemed too high or too low.

"We've put so much fear in people about breast cancer so they feel at high risk," says lead study author Laura D. Scherer, Ph.D. "We found that many women assumed certain factors should impact their risk, like cancer history in distant or male relatives, but those factors don't put a woman at increased risk.

"We have a trend toward personalized medicine and individualized medicine, but if people don't believe their personalized risk numbers, they're not going to get the best medical care for them," says Scherer, who is now at the University of Missouri. She completed the research while at the University of Michigan.

Breast cancer statistics: 234,580 Americans will be diagnosed with breast cancer this year and 40,030 will die from the disease, according to the American Cancer Society

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Belief in numbers: When and why women disbelieve tailored breast cancer risk statistics, doi:10.1016/j.pec.2013.03.016

Additional authors: Peter A. Ubel, Duke University; Jennifer McClure, Group Health Research Institute; Sharon Hensley Alford, Henry Ford Health System; Lisa Holtzman, University of Michigan; Nicole Exe, University of Michigan

Patient Education and Counseling, Vol. 92, No. 2, pp. 253-259, August 2013

University of Michigan Health System

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African-American women who experience racism at increased risk for adult-onset asthma

Main Category: Respiratory / Asthma
Also Included In: Women's Health / Gynecology;  Psychology / Psychiatry
Article Date: 19 Aug 2013 - 1:00 PDT Current ratings for:
African-American women who experience racism at increased risk for adult-onset asthma

According to a new study from the Slone Epidemiology Center (SEC) at Boston University, African-American women who reported more frequent experiences of racism had a greater likelihood of adult-onset asthma compared to women who reported less frequent experiences.

The study, which currently appears on-line in the journal Chest, was led by Patricia Coogan, DSc, senior epidemiologist at SEC and research professor of epidemiology at Boston University School of Public Health.

This study followed 38,142 African-American women, all of whom are participants in the Black Women's Health Study (BWHS), between 1997 and 2011. They completed health questionnaires every two years. In 1997 and 2009 they provided information on their experiences of "everyday" racism, like poor service in stores or restaurants, and "lifetime" racism, which was discrimination encountered on the job, in housing and by police.

The results indicate that as experiences of everyday and lifetime racism increased, the incidence of adult-onset asthma also rose, up to a 45 percent increase in women in the highest compared to the lowest category of the racism measures. Furthermore, the incidence of asthma was increased even more in women who were in the highest category of everyday racism in both 1997 and 2009, and who may have had more consistent experiences of racism over time.

"This is the first prospective study to show an association between experiences of racism and adult-onset asthma," said Coogan. "Racism is a significant stressor in the lives of African American women, and our results contribute to a growing body of evidence indicating that experiences of racism can have adverse effects on health." The hypothesized mechanism linking experiences of racism to asthma incidence is stress and its physiological consequences, particularly effects on the immune system and the airways. "Given the high prevalence of both asthma and of experiences of racism in African Americans, the association is of public health importance," she added.

BWHS is the largest follow-up study of the health of African American women in the United States. Led by researchers at the Slone Epidemiology Center, the BWHS has followed 59,000 African-American women through biennial questionnaires since 1995 and has led to a better understanding of numerous health conditions that disproportionately affect African-American women.

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Experiences of Racism and the Incidence of Adult-Onset Asthma in the Black Women’s Health Study, Chest. 2013. doi:10.1378/chest.13-0665

Boston University Medical Center Funding for this study was provided by the National Institutes of Health's National Heart, Lung, and Blood Institute (grant award #HL107314) and the National Cancer Institute (grant award #CA058420).

Boston University Medical Center

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Hypnotic relaxation therapy improves sexual health for postmenopausal women with hot flashes

Main Category: Menopause
Also Included In: Psychology / Psychiatry;  Sexual Health / STDs
Article Date: 19 Aug 2013 - 1:00 PDT Current ratings for:
Hypnotic relaxation therapy improves sexual health for postmenopausal women with hot flashes

Hypnotic relaxation therapy improves sexual health in postmenopausal women who have moderate to severe hot flashes, according to Baylor University researchers who presented their findings at the American Psychological Association's recent annual meeting.

The study, which examined sexual comfort, sexual satisfaction and sexual pleasure, is a first step toward a safe and effective alternative toward hormone replacement therapy, which carries associated risks of cancer and heart disease, said Gary Elkins, Ph.D., director of Baylor's Mind-Body Medicine Research Laboratory and a professor of psychology and neuroscience in Baylor's College of Arts & Sciences.

The conclusion was based on a study funded by the National Institutes of Health. For the study, 187 women were randomly assigned to receive either five weekly sessions of hypnotic relaxation therapy or supportive counseling, said lead researcher Aimee Johnson, a doctoral student in psychology and neuroscience at Baylor University.

Led by researchers at Baylor's Mind-Body Medicine Research Laboratory, all study sessions were conducted by master's-level therapists trained in clinical hypnosis. Participants in the hypnotic relaxation therapy group received a hypnotic induction followed by suggestions for relaxation, coolness and mental imagery. Participants who received sessions of supportive counseling discussed their symptoms with a trained therapist but did not receive any hypnosis.

Women completed questionnaires at the beginning of the study, at the end of treatment and at a 12-week follow-up. They also were asked to complete a self-report questionnaire assessing the extent to which hot flashes interfered with sexual intimacy. The decrease in estrogen that accompanies menopause is associated with hot flashes, night sweats, weight gain and vaginal dryness, discomfort or pain.

"The most common complaints are being too tired, anxiety, depression, hot flashes and the fear of close contact," Elkins said. Because warmth that comes from closeness can trigger a hot flash, some women grow to fear intimacy, he said.

At treatment's end, women who had received hypnotic relaxation therapy reported significantly higher sexual satisfaction and pleasure, as well as less discomfort. This improvement also was seen at the 12-week follow-up assessment.

"Women's sexual health improved, whether because of sleeping better, less stress or fewer hot flashes, or perhaps other unknown mechanisms," Elkins said.

Researchers noted that postmenopausal sexual health can be affected by factors other than hot flashes, among them fatigue, self-esteem, a partner's health, relationship quality and a lack of interest by either or both partners.

For many women -- among them those who have had breast cancer -- hormone replacement therapy is not an option for menopause-related symptoms. Estrogen, for example, has been associated with more rapid growth of breast cancer.

Previous research by Elkins has shown that clinical hypnosis can effectively reduce hot flashes and associated symptoms among postmenopausal women, including a lessening of anxiety and depression.

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Association between childhood physical abuse and obesity in women

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Women's Health / Gynecology
Article Date: 15 Aug 2013 - 1:00 PDT Current ratings for:
Association between childhood physical abuse and obesity in women

Women with a history of childhood physical abuse are more likely to become obese adults, according to a new study by University of Toronto researchers.

Results indicate that women who were physically abused in childhood were more likely to be obese than women from non-abusive homes.

"After adjusting for age and race, childhood physical abuse was associated with 47% higher odds of obesity for women" says lead author Esme Fuller-Thomson, Professor and Sandra Rotman Endowed Chair in the University of Toronto's Factor-Inwentash Faculty of Social Work. "Among men, obesity wasn't associated with childhood physical abuse."

"We had anticipated that the association between childhood physical abuse and obesity among women would be explained by factors including depression and anxiety, adult socio-economic position, alcohol abuse, and other childhood adversities, such as having a parent addicted to drugs or alcohol," says study co-author and doctoral student Deborah Sinclair. "However, even after taking into account all these factors, women from physically abusive families still had 35% higher odds of obesity."

The study could not determine the reason for the relationship between childhood physical abuse and women's obesity. "It is unclear why childhood physical abuse is associated with adult obesity among women but not men; it may reflect gender differences in coping mechanisms," says study co-author and doctoral candidate Sarah Brennenstuhl.

This research appears online this month in the journal Obesity Facts. Researchers examined the association between childhood physical abuse and adult obesity in a representative sample of 12,590 adults, drawn from the 2005 Canadian Community Health Survey. Of these, 976 reported being physically abused by someone close to them before they turned 18 and 2,786 were classified as "obese" based on a body mass index of 30 or greater which was calculated from self-report of respondents' height and weight.

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Personal website chronicling improves depressive symptoms in women with breast cancer

Main Category: Breast Cancer
Also Included In: IT / Internet / E-mail;  Depression
Article Date: 14 Aug 2013 - 2:00 PDT
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Personal website chronicling improves depressive symptoms in women with breast cancer

Adults increasingly are conveying their personal experience with serious disease online, but do such chronicles help the authors or their audience? In the first known study of its kind, UCLA researchers have discovered that creating a personal website to chronicle the cancer experience and communicate with the author's interpersonal circle can reduce depressive symptoms, increase positive mood, and enhance appreciation for life in women diagnosed with breast cancer. Published online ahead of print in the Journal of Clinical Oncology, the study was led by Annette Stanton, member of the Jonsson Comprehensive Cancer Center and professor of psychology and psychiatry/biobehavioral sciences.

Explaining the impetus for the study, Stanton said, "From our own and others' previous research, we know that expressing emotions surrounding the experience and gaining social support can be helpful for people diagnosed with cancer, and we know that interpersonal interventions can be useful." However, most interpersonal interventions to promote quality of life in adults diagnosed with cancer involve the patient's partner, primary caregiver, or other cancer patients. "Our goal in this research was to provide a platform on which breast cancer survivors could reflect on their experiences, as well as communicate with and leverage support from their existing social networks, especially friends and family," Stanton said. "The idea for this trial really took off when I met two sisters who had created personal websites for each other when each was diagnosed with cancer."

In Project Connect Online (PCO), a randomized trial conducted with 88 breast cancer survivors, Stanton and colleagues led three-hour workshops in which women created personal websites. Women randomly assigned to the control group were offered the workshop six months later. All participants completed standard measures of psychological status before being assigned to their respective groups and six months after selection.

In the PCO workshops conducted with small groups, women learned about potential uses of the websites, such as expressing emotions related to cancer, providing medical status updates, and letting others know what would be helpful. Women also proactively considered common concerns of website authors, including the pressure to be positive or eloquent. They then engaged in hands-on website creation and at the end of the three-hour sessions had created their websites and authored their first posts. According to Stanton, "We worked closely with a website developer so participants had several choices for how their sites looked, but all sites had the same functions. It was inspiring to see women of so wide an age range (28 to 76 years old) and of such varied computer experience develop their websites in just a few hours."

The women assigned to PCO found their websites particularly valuable for telling the stories of their cancer experiences, expressing emotions, and reducing how much information they had to repeat for family and friends. Visitors to the websites found them useful for providing updates on the authors' health and for helping visitors feel emotionally close to authors. The women in PCO demonstrated statistically significant improvement in depressive symptoms, positive mood, and life appreciation. The effects were particularly strong for women in active medical treatment, most of whom had advanced (metastatic) disease. Women are more often motivated to tell their stories, express cancer-related emotions, garner support, and keep others informed during active medical treatment and the often unpredictable course of metastatic disease than those who have completed their medical treatments for cancer. "We are encouraged by these positive findings," Stanton said, "especially for cancer survivors with the most need, those in active medical treatment or with more advanced disease. Our next step is to gain support for a larger test of Project Connect Online."

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Project Connect Online: Randomized Trial of an Internet-Based Program to Chronicle the Cancer Experience and Facilitate Communication, Annette L. Stanton, Elizabeth H. Thompson, Catherine M. Crespi, John S. Link and James R. Waisman, Journal of Clinical Oncology, Published online before print August 12, 2013, doi: 10.1200/JCO.2012.46.9015

This research was supported by the Susan G. Komen for the Cure Foundation, the Breast Cancer Research Foundation and the National Institutes of Health.

UCLA's Jonsson Comprehensive Cancer Center

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Oxytocin affects men and women differently in social contexts

Main Category: Endocrinology
Also Included In: Public Health
Article Date: 02 Aug 2013 - 1:00 PDT Current ratings for:
Oxytocin affects men and women differently in social contexts

"The Love Hormone", Oxytocin affects men and women differently in social contexts- in men it improves the ability to identify competitive relationships whereas in women it facilitates the ability to identify kinship. "These findings are in agreement with previous studies on the social differences between the sexes: women tend to be more communal and familial in their behavior, whereas men are more inclined to be competitive and striving to improve their social status", said Prof. Simone Shamay-Tsoory from the Dept. of Psychology at the University of Haifa who led the research.

The hormone Oxytocin is released in our bodies in various social situations, and it is better known as "The Love Hormone" since our bodies release it at high concentrations during positive social interactions such as falling in love, experiencing an orgasm or giving birth and breastfeeding. In her previous researches, Prof. Shamay-Tsoory discovered that the hormone is also released in our body during negative social interactions such as jealousy or gloating.

In the current study, conducted with the help of research students Meytal Fischer-Shofty and Yechiel Levkovitz, researchers tried to find out what effect Oxytocin would have on women's and men's accurate perception of social interactions. 62 men and women aged 20-37 years participated in the current research. Half of the participants received an intranasal dose of Oxytocin while the other half received a placebo. After a week, the groups switched with participants undergoing the same procedure with the other substance (i.e. Placebo or Oxytocin).

Following treatment, video clips showing various social interactions were screened. Participants were asked to analyze the relationships presented in the clips by answering questions that focused mainly on indentifying relationships of kinship, intimacy and competition. Participants were expected to base their answers, among other things, on gestures, body language and facial expressions expressed by the individuals in the clips.

The results showed that Oxytocin improved the ability of all the participants to better interpret social interactions in general. When the researchers examined the differences between the sexes they discovered that following treatment with Oxytocin, men's ability to correctly interpret competitive relationships improved, whereas in women it was the ability to correctly identify kinship that improved. Surprisingly, researchers discovered that "The Love Hormone" doesn't help women or men to better identify intimate situations. According to them, since the ability to correctly identify intimate situations was substantially low among all participants in the study, there is evidence to say that correctly identifying an intimate relationship between two people is intricate and complicated.

"Our results coincide with the theory that claims the social-behavioral differences between men and women are caused by a combination of cultural as well as biological factors that are mainly hormonal", concluded Prof. Shamay-Tsoory.

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Gender gap in stroke treatment likely due to delay by women seeking care

Main Category: Stroke
Also Included In: Women's Health / Gynecology
Article Date: 29 Jul 2013 - 0:00 PDT Current ratings for:
Gender gap in stroke treatment likely due to delay by women seeking care

Women with clot-caused strokes are less likely than men to arrive at the hospital in time to receive the best treatment, according to a European study reported in the American Heart Association journal Stroke.

In the study, 11 percent of women with acute ischemic strokes were treated with the clot-dissolving medication alteplase, compared with 14 percent of men. Study participants included 5,515 patients at 12 hospitals in the Netherlands.

Researchers found no gender gap when they looked only at patients who arrived at the hospital within four hours of the onset of symptoms in this study. Forty-two percent of men and women arriving within the four-hour window received alteplase.

"Our study showed that women in the Netherlands were treated just as often with thrombolytic agents as men once they arrived in time for treatment," said Inger de Ridder, M.D., lead author of the study and AIOS Resident of Neurology at Erasmus University Medical Center in Rotterdam, The Netherlands.

The gender gap in treatment may be due to delays in getting to the hospital, researchers said. Women arrived at the hospital an average 27 minutes later than men, and a smaller percentage of women (27 percent) than men (33 percent) arrived at the hospital within the four-hour window.

Furthermore, women in the study were an average four years older and may consequently have been more likely to live alone, which would make it more difficult to summon help. Stroke severity was similar for men and women.

"More education about stroke symptoms is needed, and also more research to find out why women arrive later at the hospital," de Ridder said.

The findings may also apply to patients in the United States, researchers said.

Stroke symptoms include: drooping or numbness in the face; weakness or numbness in the arms; and speech difficulty. Stroke is the No. 4 cause of death and the leading preventable cause of disability in the United States.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our stroke section for the latest news on this subject.

Unequal Access to Treatment With Intravenous Alteplase for Women With Acute Ischemic Stroke, Inger de Ridder, MD, Maaike Dirks, MD, PhD, Louis Niessen, MD, PhD, Diederik Dippel, MD, PhD and on behalf of the PRACTISE Investigators, Published online before print July 25, 2013, doi: 10.1161/?STROKEAHA.113.002263

Author disclosures are on the manuscript.

The Netherlands Organization for Health Research and Development funded the study.

American Heart Association

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