News Briefs
News Briefs
NIH funds study to prevent cardiovascular disease
Two divisions of the National Institutes of Health are collaborating on a nine-year, $108 million study aimed at preventing cardiovascular disease in diabetics.
The National Heart, Lung and Blood Institute and the National Institute of Diabetes, Digestive and Kidney Diseases in Bethesda, MD, will recruit 10,000 patients for the study beginning in October 2000.
"This is the most important clinical trial ever done addressing the prevention of heart disease in people with diabetes. The results will affect the treatment of millions of patients with diabetes for decades to come," says David C. Goff Jr., MD, PhD, associate professor of public health services and internal medicine at Wake Forest University School of Medicine in Winston-Salem, NC, one of seven hubs for the study.
"The biggest question we’re looking at is whether tight glycemic control reduces the risk of macrovascular disease," says Lawton Cooper, MD, MPH, medical officer of the NHLBI’s Divi-sion of Epidemiology and Clinical Application, also in Bethesda. Investigators plan to study the effectiveness of intensive control of blood pressure and cholesterol.
Recent theories say patients without heart disease should have blood pressure below 130/85 mm Hg and below 120/80 mm Hg if they have heart disease.
There are also recommendations that low-density lipoprotein cholesterol should be below 100 in patients without heart disease and below 75 in patients with heart disease. Some think all diabetic patients should be treated as though they already have heart disease, since the risk of cardiovascular disease is doubled to quadrupled for that population.
Cooper says he does not expect any interim results to be released unless there are findings of major impact. Regional coordinating centers are at Wake Forest University in Winston-Salem, NC, Veteran’s Administration Hospital in Memphis, TN, Columbia University in New York City, University of Minnesota in Minneapolis, Case Western University in Cleveland, University of Washington in Seattle, and McMaster University in Hamilton, Ontario, Canada.
It’s not too late for flu and pneumonia shots
Only a bit more than half the people with diabetes are getting flu shots, and only 33.2% have ever had a pneumococcal vaccination, according to the latest statistics released by the Centers for Disease Control and Prevention in Atlanta.
Although the 1997 statistics still fall short of the 60% vaccination goal by 2000 for people at high risk of complications, including diabetics, they reflect a significant improvement over the 1993 statistics. Those figures showed only 40% of diabetics received flu shots and only 21% had ever received a pneumonia vaccination.
Because of compromised immune systems, diabetics are three times more likely to contract pneumonia or the flu. However, CDC officials say many clinicians are not aware of the risk to diabetics and fail to encourage their patients to get their vaccinations.
CDC officials urge all diabetics to receive an annual flu shot. Diabetics and anyone with a chronic disease should have a pneumonia shot and everyone over 65 should have one every five years, according to Stephanie Benjamin, PhD, an epidemiologist with the CDC’s Council of State and Territorial Epidemiologists in Atlanta. "It seems our awareness campaign encouraging patients to get flu shots is working," she says.
State-by-state figures showed that the lowest flu vaccination rate is 29.1% in Puerto Rico and the highest is in Maine, with 79.9%. Rates for pneumococcal vaccination range from 22% in Alabama and Puerto Rico to 48.6% in Montana.
Patient privacy bill lapses, HHS offers its plan
The deadline for Congress to approve patient privacy legislation has passed, and the U.S. Department of Health and Human Services (HHS) has issued its proposed regulation on the matter.
However, it is expected that Congress will still take up the issue during this session with a compromise Senate bill which industry sources say satisfies most of their concerns.
Under the Health Insurance Portability and Accountability Act of 1996, Congress gave itself three years to pass a comprehensive medical privacy law. That deadline passed Aug. 21, but legislators said they will still take up the issue.
HHS has issued proposed regulations that are subject to public comment and can still be superseded by legislation if and when it is passed.
Health care professionals have argued that too much privacy can interfere with the highest standards of treatment of patients. On the other side of the issue, opponents fear too much access to medical records can lead to discrimination on account of a patient’s health status.
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