Extra Stress Stresses Immune System, Too

Investigators found that older people under chronic stress had higher-than-normal elevations of interleukin-6 (IL-6), an immune-system protein in the blood that promotes inflammation. IL-6 has been linked with various age-related conditions such as heart disease, diabetes, osteoporosis, frailty and certain cancers.

"This is how chronic stress can really affect health," said study author Dr. Janice K. Kiecolt-Glaser, a professor of psychiatry at Ohio State University in Columbus.

"The take-home advice from this study is that it's really important to try to deal with stress," she told Reuters Health. "The older you are, the more it really matters."

Over the course of the six-year study, IL-6 levels increased an average of four times faster among men and women who were caring for spouses with dementia than among people who were not caring for ill spouses. The study participants ranged in age from 55 to 89 at the beginning of the study, with an average age of 71.

The 119 caregivers reported spending about 10 hours a day on average caring for a spouse when the study began, Kiecolt-Glaser and colleagues note in the online early edition of the Proceedings of the National Academy of Sciences.

Tests conducted periodically throughout the study period showed that the caregivers experienced consistently higher levels of stress and loneliness than the 106 non-caregivers.

In the cases where spouses died during the study, caregivers continued to have high IL-6 levels, even several years later.

All of the study participants were healthy at the outset of the study, and the caregiving and non-caregiving groups had similar levels of chronic health problems during the follow-up period.

However, it's likely that the caregivers would go on to develop a greater number of illnesses due to their higher IL-6 levels, Kiecolt-Glaser said.

"These data provide important evidence of a key mechanism through which chronic stressors may have potent health consequences for older adults, accelerating risk of a host of age-related diseases," the researchers conclude in their paper.

SOURCE: Proceedings of the National Academy of Sciences 2003/doi/10.1073/pnas.1531903100.

Serious Spousal Spats Spike Blood Pressure

Investigators at Miami University in Oxford, Ohio, found that, during discussions between couples with a somewhat turbulent relationship in which one partner wanted the other to make certain changes in their marriage, the change-desiring spouse often experienced a marked increase in blood pressure, which lasted as long as the conversation.

A sustained and repeated increase in blood pressure can affect a spouse's health, perhaps eventually leading to cardiovascular disease, the study's lead author told Reuters Health.

"There may be some type of physical toll that is taken on a person," said Dr. Tamara L. Newton.

During the study, Newton and her co-author monitored changes in heart rate and blood pressure in both members of married couples as they discussed topics of conflict.

In one discussion, the partners talked about changes the husband wished the wife would make, while the other talk focused on things the wife wished the husband would change about himself.

In an interview, Newton said that the changes sought by husbands and wives ranged in importance, and included wishing the partner would spend more or less time with in-laws, participate more in housework or childcare, spend less money or make changes in their sex life.

In general, people who experienced the highest increases in blood pressure during the tense discussions were those who also showed the most negative behaviors during the discussions, Newton said. Negative behaviors included being critical or antagonistic, or dominating partners by cutting them off and being dogmatic.

And among couples who adopted those negative behaviors, blood pressure tended to increase more while discussing points in which they wanted their partners to change than when talking about something their partner wanted to change about them.

The discussions lasted for 15 minutes, and this increase in blood pressure continued throughout the entire conversation, Newton noted.

These findings suggest that the person who desires change is more likely to feel the health effects of arguments, she added.

The other partner, who is representing the way things currently are, is "in a more secure position, I think," she said. "They have more control, more security, there's less effort involved."

Research has shown that women typically desire more changes from their partners than men do, Newton said.

Studies have also shown that women may experience increases in blood pressure during conflict not seen in men -- but, according to this newest research, Newton said this increase could stem from the fact that women are more likely to desire change, and not from gender itself.

SOURCE: Health Psychology 2003;22:270-278.

More Evidence Mediterranean Diet Cuts Deaths

After following more than 22,000 adults in Greece for almost four years, Dr. Dimitrios Trichopoulos and his colleagues found that people who closely followed the Mediterranean-type diet were less likely to die of any cause, including the major killers heart disease and cancer.

Previous studies have shown that people living in Mediterranean regions tend to live longer than North Americans and people from Northern Europe, and this latest research adds further evidence to the theory that Mediterranean peoples could be eating their way toward long life.

The current study, appearing in The New England Journal of Medicine (news - web sites), "goes a long way in documenting that, in the end, diet really matters," said Trichopoulos, who holds positions at Harvard University in Boston and the University of Athens in Greece.

Although some investigators are skeptical of the benefits of the Mediterranean-type diet, "when you face the data, you just have to believe it," Trichopoulos told Reuters Health.

He said that the current study was conducted in people who were apparently healthy, but previous research has shown that following a Mediterranean-type diet can also help people with illnesses, like heart disease.

"It seems to be a diet good for the healthy as well as the sick," Trichopoulos said.

The traditional Mediterranean diet contains many components, including a high intake of fruits and vegetables, nuts and cereals, and olive oil. Followers of the diet often have wine with their meals, regularly down fish and dairy products -- largely in the form of cheese and yogurt -- and only rarely eat meat and poultry.

During the study, Trichopoulos and his team surveyed 22,043 adults in Greece about their eating habits, noting how closely each person followed the traditional Mediterranean diet. The researchers then followed participants for 44 months, noting who died, and of what cause.

After almost four years, the researchers recorded 275 deaths. And the more closely a person followed the Mediterranean diet at the outset of the study, the less likely he was to die of any cause.

In addition, people who followed the Mediterranean diet more closely than others were also 33 percent less likely to die from heart disease, and 24 percent less likely to die from cancer.

Interestingly, after breaking down the individual components of the Mediterranean diet, Trichopoulos and his colleagues discovered that no single component appeared to reduce the risk of death. This finding suggests that each component has only a small effect, visible only when all are combined, or that the effects of the different components interact, causing benefits only when combined, the authors write.

In an accompanying editorial, Dr. Frank B. Hu of Harvard University and Brigham and Women's Hospital in Boston writes that in many countries near the Mediterranean, including Greece, dietary habits are changing, with more people embracing Western diets filled with saturated fat and refined carbohydrates.

As evidence of this shift, Hu notes that the prevalence of obesity in Greece has risen "dramatically" in recent years.

Trichopoulos said that this trend is indeed occurring, but noted that older generations and people living in rural areas in Greece continue to follow the Mediterranean style of eating. Furthermore, he said, some young, educated people are rediscovering the benefits of the diet, and changing their eating habits accordingly.

SOURCE: The New England Journal of Medicine 2003;348:2595-2596,2599-2608.

In Learning, Short Nap Is as Good as Night's Sleep

U.S. investigators found that people who took a 60- to 90-minute nap after practicing a task that tests visual perception skills improved their performance just as much as if they had gotten a full night's sleep.

And people who got both a nap and a full night's sleep showed similar improvements in test performance to what would appear after two full nights of sleep, the study's lead author told Reuters Health.

"People who had a nap and a full night of sleep actually looked like they had two nights of sleep," said Dr. Sara Mednick of the Salk Institute in La Jolla, California.

She noted that the test used in the study measures how well people can use their eyes to pick out certain objects from their surroundings, a skill that applies to many areas of life.

However, these results describe only improvements on a specific test of visual skills, and Mednick cautioned that they do not suggest that sleeping for only 90 minutes is generally as good as a full night's rest.

"I don't think you can replace a night of sleep with a nap," she said.

During the study, published in the advance online issue of Nature Neuroscience, Mednick and her team asked around 70 people to complete a basic visual test in which they had to spot a specific image on a screen filled with other images.

Tests occurred at 9 a.m. and 7 p.m. on the same day.

Some of the study participants were allowed to take a nap in the mid-afternoon, lasting either 60 or 90 minutes.

In an interview, Mednick explained that research has shown that any "improvement" in the test -- meaning, spotting the target image faster than in previous rounds -- occurred only after test takers had a good night's sleep.

In contrast, asking people to repeat the test many times on the same day, without giving them a break to sleep, tends to worsen their performance, Mednick said.

In this study, however, Mednick and her team found that people who took a nap that included both deep, slow-wave sleep and the lighter, dream-filled sleep stage known as REM showed improvements on their afternoon test that were similar to what would typically have been seen after a night's rest.

"That improvement was equal to the amount of improvement you would show if you'd had six hours of sleep," Mednick said.

"So the nap was actually as good as a night of sleep to show learning, in this specific task," she added.

And taking a nap and having a good night's sleep improved test performance even further, equivalent to what was seen from non-nappers after two nights' rest, Mednick said.

She noted that the time of day a person takes a nap is probably important. The naps that led to test improvements were those that featured both slow-wave and REM sleep, Mednick said, and naps that take place in the morning or evening -- as opposed to the afternoon -- typically contain either one or the other sleep stages.

SOURCE: Nature Neuroscience 2003;doi:10.1038/nn1078.

U.S. Rate of Hypertension Rises in 1990s

The prevalence of high blood pressure, which is a major risk factor for cardiovascular disease, rose to 29 percent among adults, up 4 percent since the last survey in 1988-1991 and halting the decline since 1960 in hypertension rates.

Of the estimated 58.4 million hypertensive U.S. adults in 1999-2000, nearly one-third were unaware of their illness, wrote study authors Ihab Hajjar of the University of South Carolina, Columbia, and Theodore Kotchen of the Medical College of Wisconsin, Milwaukee, based on their analysis of government data.

The study found two out of five hypertensive adults went untreated and more than two-thirds did not have their condition under control with antihypertensive drugs or other means.

The U.S. Department of Health and Human Services, which has similarly warned about the dangers of obesity, put off until 2010 from 2000 the goal of having half of hypertensive adults get the condition under control. Less than one in four controlled it at the time of the earlier survey.

Those with blood pressure of 140/90 or above or those who took antihypertensive medications qualified as hypertensive. Those who lowered their blood pressure to 130/85 or below were considered as exerting control.

"Women, older participants, and Mexican Americans tended to have the lowest rates of control," said the study published this week's issue of the Journal of the American Medical Association.

"Programs targeting hypertension prevention to achieve the 16 percent target for hypertension prevalence by 2010 and improving awareness and treatment are of utmost importance for the health of the U.S. population," the authors concluded.

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