Long-Term Job Stress May Raise Blood Pressure

Men who worked for 25 years or more at a demanding job over which they felt little control had a large increase in blood pressure both when they were on the job and at home, according to the study published in the American Journal of Epidemiology.

A previous study, by the same researchers, showed that men who were currently in high stress jobs had an increase of 6 to 8 points in systolic blood pressure -- the upper number in the blood pressure reading -- compared to workers in low stress jobs.

One question the previous study hadn't answered was whether job stress over many years would have a cumulative effect, Dr. Paul Landsbergis, an assistant professor in the department of community and preventive medicine at the Mount Sinai School of Medicine in New York, said in an interview with Reuters Health.

"We wondered: what about all those years before they came to this study?" Landsbergis said. "The men were 30 to 60 years old when the study started so some had already had many years on the job."

When Landsbergis and his colleagues took a closer look at previous job experience, they found that 25 or more years in a highly demanding, low-control job led to an extra 4.8 point rise in systolic blood pressure when the men were at work and 7.9 point rise when the men were at home.

For the new study, Landsbergis and his colleagues interviewed 213 men about their job histories. The impact of current working conditions had already been studied in these men in a trial called the Work Site Blood Pressure Study.

The men were asked about characteristics of their jobs. For example, to determine how much control the men had over their work environment, men were asked about how much freedom they had to make decisions and whether they could choose how to perform their work. Researchers also tried to determine how demanding the job was and how pressured the men felt by their jobs.

Landsbergis says he hopes that studies like this will encourage employers to try to find ways to make jobs less stressful.

"There are lots of ways," he said. "Workers can be allowed to have a greater say in what goes on. They can be given more flexible schedules and a chance to develop more skills on the job. Overtime can be made voluntary rather than mandatory.

Changes in the work environment could lead to a much healthier work force, Landsbergis said.

"We've known for a while that the risk of high blood pressure goes up with age," he said. "The question has been why. We think work stress is one of the reasons. In more primitive societies blood pressure doesn't go up at all with age. People reach the age of 70 and they still have blood pressure readings of 100/60."

SOURCE: American Journal of Epidemiology 2003;157:998-1006.

Exercise May Reduce Risk of Pregnancy Complication

The results of the study suggest that current public health efforts to increase physical activity may help reduce the risk of high blood pressure during pregnancy, according to the study's authors.

Little is understood about pregnancy-induced high blood pressure, a condition known as preeclampsia. It poses a risk to both the mother and fetus. In severe cases, preeclampsia can lead to maternal seizures and, in rare cases, to death. Writing in the June issue of the journal Hypertension, Dr. Michelle A. Williams, of the Swedish Medical Center in Seattle, and colleagues note that previous research showed that recreational physical activity during the first 20 weeks of pregnancy reduces the risk of the complication. However, the effects of pre-conception exercise and of typical daily activities remain unstudied.

To investigate, Williams and her colleagues evaluated 201 women with preeclampsia who delivered between 1998 and 2001, and 383 women who did not develop high blood pressure during pregnancy. Women were asked about recreational activities, walking and stair climbing for the year prior to conception and the first 20 weeks of their pregnancies.

Risk was reduced by about a third in women who had participated in any recreational physical activity during early pregnancy or during the year before pregnancy, the researchers report.

The pace of walking was associated with reduced risk, with most benefit noted for those who walked at a rate of three miles an hour or faster, according to the report.

And even among women who did not exercise regularly, climbing one to four flights of stairs every day appeared to confer some protection.

SOURCE: Hypertension 2003;41:1273-1280.

Britain Warns Kids, Teens on Drug Paxil

The drug, which is called Seroxat outside the United States and is made by British-based GlaxoSmithKline, is not licensed for use in children and teenagers anywhere in the world. However, some doctors give it to treat depression, based on their own judgment.

The new research, provided to Britain's Medicines and Healthcare products Regulatory Agency by GlaxoSmithKline, does not apply to adults, the regulators said.

Britain's Department of Health said the evidence provided by the drug company, from nine studies based on more than 1,000 youngsters, shows there is an increase in the rate of self harm and potentially suicidal behavior in those under 18 taking Paxil.

GlaxoSmithKline spokesman David Mawdsley said the rate of a collection of emotional side-effects, ranging from mood swings and increased crying, to suicidal thoughts and self-harm, was twice as high in the Paxil group as in those taking a fake pill. A total of 3.2 percent of patients on Paxil had the emotional side-effects, compared with 1.5 percent of those taking the dummy pill.

"It has become clear that the benefits of Seroxat in children for the treatment of depressive illness do not outweigh these risks," the government said in a statement. "Young people under 18 years currently taking Seroxat for depression should consult their doctor."

Alasdair Breckenridge, chairman of the regulatory agency, said the benefits for adults of taking Seroxat for depression were well known.

"It is important that patients who are benefiting from Seroxat should not be alarmed by the announcement and should continue their treatment," he said.

An expert advisory panel was set up last month to look into the effects of Paxil and other medications in its class, known as selective serotonin reuptake inhibitors, or SSRIs.

"The expert group will be examining urgently what implications, if any, these new findings have for the use of Seroxat in adults," said the panel's chairman, Ian Weller. "At present the evidence is not sufficient to confirm a causal association between SSRIs and suicidal behavior in adults."

It is estimated that almost 17 million people worldwide have been treated with Paxil.

Smoking Speeds Up Memory Loss in Middle Age

UK researchers found that, from their 40s to their 50s, smokers showed a faster decline in their scores on tests of word memory, relative to non-smokers.

Furthermore, people who smoked in their 40s did worse on tests that measure how fast they could pick out certain letters from a page than non-smokers of the same age, the authors write in the American Journal of Public Health.

The relationship between smoking and memory loss appeared strongest in people who smoked more than 20 cigarettes each day, and persisted even when the authors controlled for the influence of socioeconomic status, gender and a range of medical conditions.

Just why smoking may speed up age-related memory loss is not yet clear, study author Dr. Marcus Richards of University College London told Reuters Health.

He said that he and his colleagues suspected that smoking may accelerate memory loss by increasing the risk of high blood pressure, which can damage the brain. However, the relationship between smoking and brain functioning may be slightly more complicated, Richards said.

"Our results for memory still held up after taking blood pressure into account, but smoking could have been causing changes in the brain's blood supply that we were not able to measure," he said.

Alternatively, chemicals in cigarette smoke could also damage the brain directly, Richards added.

Whatever the reasons for why smoking accelerates memory loss, the message from these results should be clear, Richards said.

"This is yet another reason to quit smoking," he said. "If you can't, then cut down as much as you can."

During the study, Richards and his team reviewed information collected from 5,362 people born in 1946. Study participants were contacted 21 times by the time they turned 53.

Researchers measured people's mental functioning via a series of tests. In one test, which looked at verbal memory, the investigators showed people 15 words for two seconds each, then asked them to write down as many as they could remember.

During tests of speed and concentration, people had to look for and cross out as many Ps and Ws they could find in a page of other letters within one minute.

Although smokers in their 40s performed just as well as non-smokers in the verbal memory tests, puffers' performance deteriorated much faster from their 40s to their 50s.

And people who said they smoked while in their 40s scored worse during speed tests conducted in their 40s than non-smokers.

But the findings also suggest that quitting may help, for the researchers discovered that people who stopped smoking before age 53, and especially those who stopped before age 43, tended to exhibit a slower decline in memory.

"Our results suggest that quitting may slow down the negative impact of smoking on cognitive function," Richards said.

SOURCE: American Journal of Public Health 2003;93.

Red Clover Can Help Hot Flashes

Sept. 13 (HealthDayNews) -- A dietary supplement made from red clover provides relief for women with hot flashes, claims a new study.

Promensil, a standardized red clover supplement, reduces the frequency and severity of hot flashes, say the research, which appears in the current issue of The Female Patient.

The study found that 40 milligrams a day of Promensil reduced hot flashes by 48.5 percent, while a placebo offered a 10.5 percent reduction.

The study included 30 healthy, non-vegetarian women who had been post-menopausal for more than a year. None of them had used hormone replacement therapy (HRT), soy or other estrogen-active plant products for at least 16 weeks.

Non-vegetarian women were used in the study to avoid potential biasing. Vegetarian women eat more soy and legumes, which contain isoflavones that help control hot flashes.

"This study demonstrates that dietary supplementation with red-clover derived isoflavones is an effective alternative for symptomatic relief of vasomotor symptoms in post-menopausal women, reducing both the average daily frequency and severity of hot flushes," says study author Dr. Arturo Jeri, director of the climacteric unit at the Institute of Gynaecology and Reproduction in Peru.

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