Blood clot risk higher in heavy women

Blood clot risk higher in heavy women

NEW YORK (Reuters Health) - Middle-aged women who are overweight or obese run a higher risk of potentially dangerous blood clots, especially after surgery, a large new study finds.

The research, which followed more than one million UK women, confirms a link between obesity and the risk of venous thromboembolism (VTE) -- blood clots in the veins, usually in the legs. If one of those clots breaks free and travels to the lungs, causing what's called a pulmonary embolism, it can prove fatal.

The findings also show that heavier women are more likely to end up needing surgery -- which is itself a major risk for VTE.

That's "not entirely unexpected," since obesity raises the risk of some medical conditions that could lead to surgery, said lead researcher Lianne Parkin, of the University of Otago in New Zealand.

"But as far as we know, our study is the first to directly examine the relationship between being overweight or obese and the likelihood of having an operation," Parkin told Reuters Health in an email.

The researchers found that for every 1,000 normal-weight women who had inpatient surgery over six years, about five developed a clot in a deep vein or a pulmonary embolism within 12 weeks of the operation.

Among overweight and obese women, that rate was seven per 1,000.

The risk of suffering a clot without surgery was far lower, but still relatively higher among heavier women.

Of normal-weight women, 0.1 out of every 1,000 developed a VTE during any 12-week period in which no surgery was done. The rate was 0.2 for every 1,000 overweight or obese women.

Overall, Parkin said, the risk of clots climbed in tandem with a woman's weight. "That suggests that the loss of even small amounts of weight is likely to be beneficial (in terms of reducing VTE risk) for women who are overweight or obese," she said.

The findings, which appear in the journal Circulation, are based on more than 1.1 million UK women who were 56 years old, on average, at the study's start. The researchers used hospital records and death certificates to track cases of VTE over six years.

During that time, 6,438 women were hospitalized for, or died from, a VTE -- with almost 1,900 forming a clot within 12 weeks of an operation. (That was out of more than 641,000 women who had at least one operation during the study period.)

Women who were overweight or obese were 22 percent more likely to need inpatient surgery versus their thinner peers.

That means more overweight women will face the chance of a surgery-related VTE, and their risk with any given surgery will be relatively higher compared with thin women.

According to Parkin's team, their figures probably underestimate the actual number of women who developed a VTE -- since clots in the leg veins may be detected and treated by a primary care doctor.

Those clots are almost always diagnosed because of symptoms, like pain in the calf, swelling in the ankle and foot and warmth over the affected area.

Treatment can include medication to keep a clot from growing or prevent new ones. Wearing compression stockings around the lower leg can also help prevent new clots.

According to Parkin, the best way for an overweight woman to cut the risk of a non-surgery-related VTE is to lose some weight. And that would come with "many other important health benefits," she pointed out.

"In addition to weight loss, though," Parkin added, "it is important to increase physical activity. Immobility is a risk factor for VTE, and overweight and obese people are often less physically active."

If you're facing surgery and have enough advance warning of it, shedding some weight is, again, a good idea, Parkin noted. In addition, you can ask your doctor what will be done to minimize any risk of post-surgery VTE.

There are different recommendations on how to help prevent surgery-related VTE, including the use of "blood-thinning" drugs. And those vary based on the type and duration of the surgery, Parkin said.

SOURCE: http://bit.ly/H2Xn9C Circulation, online March 6, 2012.

Dr. Joshua Brooks

Chiropractor Fairfax VA 22031

Rosa Family Chiropractic Fairfax for More Than Just Pain?

Rosa Family Chiropractic Care Aids in Maintaining the Wellness of Patients in Fairfax

When a new patient walks into our Fairfax office at Rosa Family Chiropractic, they are often seeking out care for a specific health problem such as neck or low back pain. But our FairfaxChiropractors treat more than an acute injury or pain. Our chiropractic care in Fairfax is useful in preventing injury and more importantly, maintaining wellness. Chiropractic wellness at Rosa Family Chiropractic Fairfax, consists of regular, periodic adjustments and treatments in order to help prevent the onset of many common disorders and ailments.

Rosa Family Chiropractic Care Promotes a Healthy Nervous System for Patients in Fairfax

The wellness principle and chiropractic in general, is based on the fact that our entire body is controlled by our brain, spinal cord, and peripheral nervous system. Our nervous system controls the health of everything from our smallest blood cells to organs like our heart, lungs, and intestines. So it makes sense that if our nervous system is not healthy, our bodies are not healthy. Joint fixations, in our spine or extremities, cause the communication between the nervous system and the rest of our body to not function properly.

Rosa Family Chiropractic Adjustments Help Patients in Fairfax Maintain Proper Health

When this communication is affected, it can cause the onset of many common health issues. Osteoarthritis, headaches, and sinus congestion are just some of the many disorders that can take place. Rosa Family Chiropractic adjustments remove the joint fixations and allow the bodies of patients in Fairfax to maintain proper health. Also, for those Fairfax patients who have received previous care for an acute injury or illness, regular wellness adjustments at Rosa Family Chiropractic of Fairfax helps to maintain the level of health and recovery achieved from your previous treatments. Rosa Family Chiropractic treats more than just pain. Rosa Family Chiropractic helps patients in the Fairfax community live a healthy, well-balanced life!


Chiropractor Fairfax VA 22031

Arthritis drugs linked to bone decay

Arthritis drugs linked to bone decay

By MATTHEW PERRONE

updated 3/8/2012 10:04:45 AM ET
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WASHINGTON — Some of the world's largest drugmakers will face an uphill battle next week in their bid to revive a class of experimental arthritis drugs that have been sidelined by safety concerns for nearly two years.

The Food and Drug Administration says there is a clear association between the nerve-blocking medications and incidences of joint failure that led the agency to halt studies of the drugs in 2010. However, the agency also notes that those side effects were less common when the drugs were used at lower doses, potentially leaving the door open for future use. The agency released its safety analysis ahead of a public meeting next week where outside experts will discuss the drugs' safety.

On Monday, Pfizer Inc., Johnson & Johnson and Regeneron Pharmaceuticals will make their case to continue studies of the drugs, with safety precautions to protect patients.
The request to restart testing is unusual, since drugmakers often abandon research on experimental drugs that appear to have safety issues. However, with more than 50 million U.S. adults diagnosed with arthritis — one in five — the potential multibillion dollar market opportunity may be too big to ignore.

If the drugs eventually win FDA approval though, they may be used for much narrower indications than initially envisioned. The FDA's proposed questions to its experts appear designed to limit any future testing of the drugs.

"Considering what is known thus far about the risks and benefit associated with this class of biologic agents, are there any populations for which further clinical development would be acceptable?" asks one agency discussion question.

Drugmakers once touted the drugs, known as nerve growth factor inhibitors, as a potential breakthrough for treating osteoarthritis, back pain and other chronic pain conditions. For more than a century doctors have treated pain with familiar painkillers like aspirin and Advil, or powerful opiate-based drugs. Both approaches can be problematic. Anti-inflammatory painkillers like Advil can cause stomach bleeding, while opiates carry a high risk of addiction
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The injectable nerve-silencing drugs offered a new approach, by blocking proteins that control sensations throughout the body.

But problems with the drugs began to emerge in the summer of 2010. Beginning in June, Pfizer halted studies of its experimental injection tanezumab in patients with osteoarthritis, low back pain and diabetic nerve pain.

The action was requested by the Food and Drug Administration, after researchers reported that osteoarthritis actually worsened in some patients, causing joint failure in some cases.

In December the FDA put a research hold on all drugs in the class after similar problems emerged, halting studies by Johnson & Johnson and Regeneron Pharmaceuticals Inc.

Regeneron was developing a compound called REGN475 in cooperation with Sanofi-Aventis. Johnson & Johnson was testing its drug fulranumab in several pain conditions. The FDA lifted its hold on a trial of the drug for cancer pain last summer, though studies for osteoarthritis remain on hold.

The drugmakers are expected to argue Monday that the joint deterioration was caused by a rare drug side effect caused by patients taking multiple painkillers simultaneously. According to briefing materials, Pfizer and J&J both found that the bone problems almost exclusively occurred in patients taking the experimental drugs along with traditional anti-inflammatory painkillers like aspirin and Advil.

The FDA's analysis published Thursday supports that theory, noting that the side effects were worst among patients taking both nerve-blocking drugs and older painkillers. However, the agency notes that Pfizer's tanezumab was associated with significant bone problems even when used alone. The FDA analyzed nearly 500 cases of bone damage reported by all three drugmakers studying the medications.

Pfizer executives are expected to argue for continued testing of the newer drugs, with restrictions on combining them with older painkillers. Additionally, if patients do not improve after taking a few doses, the drugs would be discontinued.

Chiropractor Fairfax VA 22031

New Health Rules!

By Leslie Goldman

They're the imperatives for well-being that have been drilled into us forever--"Drink eight glasses of water a day!" "Eat nine servings of fruits and veggies!" "Stay away from red meat!" But it turns out that taking care of yourself isn't quite so black-and-white, says Harvard Medical School psychologist Alice Domar, PhD, coauthor of Live a Little! Breaking the Rules Won't Break Your Health. "Research is revealing that whoever wrote the old guidelines didn't have the whole picture, and that there are more paths to optimal health than we previously thought," Domar says. Happily, the new rules are more user-friendly than the old ones. Here, four tips to live by.

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Old Rule: Drink eight glasses of water a day.
New Rule: Eat your water.

The recommendation to chug all that H2O was likely based on guidelines published in 1945. However, says Howard Murad, MD, author of The Water Secret, much of your daily requirement is contained in foods: Fruits, vegetables, beans, and cooked whole grains like oatmeal and quinoa (which soak up moisture in the pot) all deliver servings of water. And, as Murad points out, they offer the added bonus of nutrients: "Watermelon and cucumber are more than 90 percent water, but they also contain antioxidants. With a glass of water, all you get is water." You'll know you're hydrated when your urine is colorless or pale yellow and you're rarely thirsty.

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Old Rule: Eat nine servings of fruits and vegetables.
New Rule: Fill half your plate with produce.

A serving of broccoli is about five florets. A serving of raw spinach, one cup. A serving of mango, roughly the size of a fist. "It's not surprising that people get confused over what, exactly, a serving is," says Washington, D.C., dietitian Rebecca Scritchfield. Her advice: Stop counting and instead make half of every meal produce. "You don't need a big mound on your plate. Six asparagus spears at dinner, a spinach salad at lunch, and a sliced banana and some berries at breakfast should do it." And quality counts: Even two or three daily servings of deeply hued fruits and veggies (like blueberries, bok choy, or red peppers) may help reduce your risk of cancer and heart disease, Scritchfield says. "It's like darts. The goal is to hit the bull's-eye. But hitting nearby is good, too."

RELATED: 5 Contemplations for Mindful Eating

Old Rule: Avoid red meat.
New Rule: Beef in moderation can be healthy.

Red meat was long considered a heart attack on a plate because it's high in saturated fat. But a 2010 study from the Harvard School of Public Health found that the cardiovascular risk comes from processed varieties, such as sausage, hot dogs, and cold cuts--not from steak, hamburgers, and other nonprocessed cuts. (The real culprits may be salt and preservatives). Red meat is a good source of iron and immunity-boosting zinc-two nutrients some women don't get enough of. Beef (especially grass-fed) also contains high concentrations of conjugated linoleic acid, a type of fat that may decrease cancer risk and help reduce body fat.

"But not all red meats are created equal," says Leslie J. Bonci, director of sports nutrition at the University of Pittsburgh's Center for Sports Medicine. She recommends choosing very lean cuts and avoiding anything labeled "prime," as it will have more fat marbling. And try not to eat more than three 4- to 5-ounce servings (about the size of an iPhone) per week.

RELATED: Exotic Grains That Can Improve Your Health

Old Rule: Keep your BMI between 18.5 and 24.9.
New Rule: Eat healthy, exercise, and let your weight settle naturally.

Physicians use BMI (body mass index)--a ratio of your weight to your height--as a tool to diagnose obesity. But critics say BMI ignores muscle mass, and a 2011 Obesity study notes that it also ignores a person's hip circumference. "People come in different sizes and shapes," says Joanne Ikeda, nutritionist emeritus at the University of California, Berkeley. "The idea that everyone should fall under 25 is ludicrous." A person can have a high BMI and still be healthy, Ikeda argues. Research supports the theory: A Journal of the American Medical Association study found that fit women--even if they were overweight according to their BMI--were less likely to suffer a heart attack than those who were out of shape. Ikeda advises her patients to stop obsessing over their BMI, eat a nutritious diet, and log 150 minutes of exercise per week. "A healthy lifestyle results in a healthy weight."

Dr. Joshua Brooks

Chiropractor Fairfax VA 22031