PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Study examines use of diagnostic tests in adolescents with hypertension

2012-07-24
(Press-News.org) CHICAGO – A study of adolescents with hypertension enrolled in the Michigan Medicaid program suggests that guideline-recommended diagnostic tests – echocardiograms and renal ultrasonography – were poorly used, according to a report published Online First by Archives of Pediatrics & Adolescent Medicine, a JAMA Network publication.

Hypertension is a growing problem for adolescents because of the association between obesity and hypertension. Current pediatric guidelines recommend laboratory tests and renal ultrasonography for all pediatric patients with hypertension to rule out renal (kidney) disease. The guidelines also recommend echocardiograms to assess target organ damage. But little is known about echocardiogram use among adolescents in comparison with other recommended diagnostic tests (renal ultrasonography) and nonrecommended, but more readily available tests, such as electrocardiograms (EKGs), according to the study background.

Esther Y. Yoon, M.D., M.P.H., and colleagues of the University of Michigan, Ann Arbor, examined echocardiogram use in adolescents and compared it with EKG and renal ultrasonography use in an analysis of administrative claims data from the Michigan Medicaid program from 2003 to 2008.

There were 951 adolescents with "essential" hypertension (i.e., the cause is unknown) who had antihypertensive pharmacy claims: 24 percent (226) had echocardiograms; 22 percent (207) had renal ultrasonography; and 50 percent (478) had EKGs, the results indicate.

"Our study describes for the first time, to our knowledge, equally low levels of obtaining echocardiograms and renal ultrasonography, which are recommended by national hypertension guidelines, by adolescents with essential hypertension," the authors note. "In contrast, we found that one-half of adolescents with essential hypertension had at least one EKG during the study period, a diagnostic test that is not recommended by pediatric hypertension guidelines but one that is recommended for adults with hypertension."

Boys, younger adolescents, those who had EKGs and those who had renal ultrasonography were more likely to receive echocardiograms compared with girls, older adolescents, and those who did not have EKGs or renal ultrasonography.

The authors suggest that the patterns of EKG and echocardiogram use in their study raises questions "about the level of familiarity, awareness or agreement with pediatric hypertension guideline recommendations and the rationale behind these recommendations."

"The decision and choice of diagnostic tests to evaluate for target organ damage in adolescents with essential hypertension warrant further study to understand the underlying rationale for those decisions and to determine treatment effectiveness," the researchers conclude.

(Arch Pediatr Adolesc Med. Published online July 23, 2012. doi:10.1001/archpediatrics.2012.1173. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: The study was funded by a grant from the National Heart, Lung and Blood Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: More Questions than Answers About Hypertension in Youths

In an editorial, Sarah D. de Ferranti, M.D., M.P.H., of Boston Children's Hospital, and Matthew W. Gillman, M.D., S.M., of Harvard Medical School, Boston, write: "The answers to the many questions raised here are unclear, pointing to the need for more information about the extent to which the BP [blood pressure] guidelines overall, and recommended diagnostic testing in particular, are implemented."

"It is important to get these answers," they continue.

"Future revision of the guidelines will require not only updating the evidence base for what should be done in ideal circumstances, but also what can be done in the real world given the range of possible health care provider, patient and payor facilitators and barriers to implementation," they conclude.

(Arch Pediatr Adolesc Med. Published online July 23, 2012. doi:10.1001/archpediatrics.2012.1503. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: The authors made financial disclosures. Also, de Ferranti's work is supported by grants from the National Institutes of Health and funding from the Boston Children's Heart Foundation. Gillman's work is funded in part by a grant from the National Heart, Lung and Blood Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

### To contact Esther Y. Yoon, M.D., M.P.H., call Mary Masson at 734-764-2220 or email mfmasson@med.umich.edu. To reach editorial author Sarah D. de Ferranti, M.D., M.P.H., call Keri Stedman at 617-919-3110 or email keri.stedman@childrens.harvard.edu.


ELSE PRESS RELEASES FROM THIS DATE:

Joslin researchers gain new understanding of diabetes and kidney disease

2012-07-24
BOSTON – July 23, 2012 – Scientists at Joslin Diabetes Center have identified biological mechanisms by which glucagon-like peptide-1 (GLP-1), a gut hormone, protects against kidney disease, and also mechanisms that inhibit its actions in diabetes. The findings, which are reported today online by Diabetes, may lead to the development of new therapeutic agents that harness the actions of GLP-1 to prevent the harmful effects of hyperglycemia on renal endothelial cells. Renal complications, also known as diabetic nephropathy, are one of the most life-threatening complications ...

ICAP study finds concerningly high HIV infection rates for young black gay and bisexual men in US

2012-07-24
Researchers at ICAP's Harlem Prevention Center (HPC) joined the HIV Prevention Trials Network (HPTN) today to announce study results that showed disturbing rates of new HIV infections occurring among black gay and bisexual men in the U.S. (also known as men who have sex with men, or MSM), particularly young black MSM. The HPTN 061 study showed that the overall rate of new HIV infection among black MSM in this study was 2.8% per year, a rate that is nearly 50% higher than in white MSM in the U.S. Even more alarming, HPTN 061 found that young black MSM—those 30 years of ...

UCSB researchers achieve world's first violet nonpolar vertical-cavity laser technology

2012-07-24
In a leap forward for laser technology, a team at University of California, Santa Barbara, has developed the first violet nonpolar vertical-cavity surface-emitting lasers (VCSELs) based on m-plane gallium nitride semiconductors. This recent discovery by LED pioneer Shuji Nakamura and his research team at UCSB is an achievement in VCSEL technology that opens doors for higher optical efficiency lasers at greatly reduced manufacturing costs for a variety of applications. "We have demonstrated working, electrically-injected nonpolar m-plane nitride VCSELs lasing at room ...

Making allowances for job seekers on Facebook

2012-07-24
Your inappropriate Facebook profile, posts and photos could lose you your next job, according to an in-depth study of employers from six different industries. The conclusion of a paper to be published in the International Journal of Work Innovation this month reveals that many employers are using the Facebook profiles of job candidates to filter out weaker applicants based on perception of lifestyle, attitudes and personal appearance. Vanessa A. de la Llama, Isabel Trueba, Carola Voges, Claudia Barreto and David J. Park of the School of Journalism and Mass Communication, ...

Fools' gold found to regulate oxygen

2012-07-24
As sulfur cycles through Earth's atmosphere, oceans and land, it undergoes chemical changes that are often coupled to changes in other such elements as carbon and oxygen. Although this affects the concentration of free oxygen, sulfur has traditionally been portrayed as a secondary factor in regulating atmospheric oxygen, with most of the heavy lifting done by carbon. However, new findings that appeared this week in Science suggest that sulfur's role may have been underestimated. Drs. Itay Halevy of the Weizmann Institute's Environmental Science and Energy Research Department ...

Judging DNA by its cover

2012-07-24
Stem cells hold great promise for the medicine of the future, but they can also be a cause of disease. When these self-renewing, unspecialized cells fail to differentiate into diverse cell types, they can start dividing uncontrollably, leading to cancer. Already several decades ago, Weizmann Institute scientists were among the first to demonstrate the link between cancer and the faulty differentiation of stem cells. Now a new Weizmann Institute-led study, published in Molecular Cell, reveals a potential molecular mechanism behind this link. The scientists managed to ...

32-country study shows that type 2 diabetes drug is clinically effective for long-term use

2012-07-24
An extended trial of a drug for people with type 2 diabetes has confirmed that the oral DPP-4 inhibitor linagliptin is a safe and effective means of lowering glucose levels for up to 102 weeks, either on its own or in combination with other selected oral anti-diabetic medication. The 32-country study, published in the August issue of IJCP, the International Journal of Clinical Practice, followed 2,121 individuals who had taken part in four previous 24-week randomised, double-blind, placebo controlled trials, in order to monitor them for a further 78 weeks. Those ...

Caught in the act: Bats use the sound of copulating flies as a cue for foraging

2012-07-24
Mating at night does not necessarily lead to offspring, at least in flies: males produce a buzzing sound with their wings that can be perceived by bats. Stefan Greif from the Max Planck Institute for Ornithology, and colleagues, observed this in a long-term study on wild Natterer's bats that eat the copulating flies in a double-sized meal. Flies that were just sitting or walking on the ceiling did not elicit a predatory response by the bats. This is the first experimental evidence how mating itself can be risky. Mating activities are a dangerous business because the attention ...

Snacking and BMI linked to double effect of brain activity and self-control

2012-07-24
Snack consumption and BMI are linked to both brain activity and self-control, new research has found. The research, carried out by academics from the Universities of Exeter, Cardiff, Bristol, and Bangor, discovered that an individual's brain 'reward centre' response to pictures of food predicted how much they subsequently ate. This had a greater effect on the amount they ate than their conscious feelings of hunger or how much they wanted the food, A strong brain response was also associated with increased weight (BMI), but only in individuals reporting low levels of ...

Public sightings suggest increase in basking sharks in British waters

2012-07-24
The number of basking sharks recorded in Britain's seas could be increasing, decades after being protected from commercial hunting in the late 20th century. The most comprehensive analysis ever undertaken of basking shark sightings in UK waters, by the University of Exeter, the Marine Conservation Society (MCS), Cornwall Wildlife Trust (CWT) and Wave Action, is published in the journal Marine Ecology Progress Series. The northeast Atlantic hosted an extensive commercial fishery for basking sharks, mainly in Norway, Ireland and Scotland, where more than 81,000 were killed ...

LAST 30 PRESS RELEASES:

Scientists reverse Alzheimer’s in mice using nanoparticles

‘Good’ gut bacteria boosts placenta for healthier pregnancy

USC team demonstrates first optical device based on “optical thermodynamics”

Microplastics found to change gut microbiome in first human-sample study

Artificially sweetened and sugary drinks are both associated with an increased risk of liver disease, study finds

Plastic in the soil, but not as we know it: Biodegradable microplastics rewire carbon storage in farm fields

Yeast proteins reveal the secrets of drought resistance

Psychiatry, primary care, and OB/GYN subspecialties hit hardest by physician attrition

New Canadian study reveals where HIV hides in different parts of the body

Lidocaine poisonings rise despite overall drop in local anesthetic toxicity

Politics follow you on the road

Scientists blaze new path to fighting viral diseases

The mouse eye as a window to spotting systemic disease

AI and the Future of Cancer Research and Cancer Care to headline October 24 gathering of global oncology leaders at the National Press Club: NFCR Global Summit to feature top scientists, entrepreneurs

FDA clears UCLA heart tissue regeneration drug AD-NP1 for clinical trials

Exploring the therapeutic potential of cannabidiol for Alzheimer's

We need a solar sail probe to detect space tornadoes earlier, more accurately, U-M researchers say

Acute myeloid leukemia (AML): Disease risk but not remission status determines transplant outcomes – new ASAP long-term results

Sperm microRNAs: Key regulators of the paternal transmission of exercise capacity

Seeing double: Clever images open doors for brain research

Inhaler-related greenhouse gas emissions in the US

UCLA Health study finds inhalers for asthma and COPD drive significant greenhouse gas emissions

A surgical handover system for patient physiology and safety

Cardiovascular health changes in young adults and risk of later-life cardiovascular disease

Nurse workload and missed nursing care in neonatal intensive care units

How to solve the remote work stalemate – dissertation offers tools for successful hybrid work

Chip-based phonon splitter brings hybrid quantum networks closer to reality

Texas Children’s researchers create groundbreaking tool to improve accuracy of genetic testing

Milken Institute, Ann Theodore Foundation announce more than $2.5 million in new funding for sarcoidosis research and launch new call for proposals

Boston University professor to receive 2025 Eugene Braunwald Academic Mentorship Award

[Press-News.org] Study examines use of diagnostic tests in adolescents with hypertension