Folic acid and CVD risk
Folic acid, widely touted as a heart-healthy supplement, neither increases nor decreases the risk of cardiovascular events or all-cause mortality in patients with a history of cardiovascular or end-stage renal disease. Twelve trials showed that supplements lowered blood homocysteine levels, but the reduction didn’t correlate with any specific clinical outcome (
JAMA. 2006;296:2720-2726).
Health food flunks
Black cohosh, soy, and other naturopathic products failed to relieve menopausal symptoms in a large, yearlong, double-blind trial. At the end of the study period, there were no statistically significant differences in the incidence or intensity of hot flushes or night sweats per day among any of the herbal-treatment groups and the placebo group (
Ann Intern Med. 2006;145:869-879).
Rubbing away knee pain
Massage reduces pain and improves function in patients with symptomatic osteoarthritis of the knee, according to a new trial. Eight weeks of massage resulted in substantial improvement in pain, stiffness, physical function, walking, and range of motion compared with conventional care. The improvements were sustained at 16 weeks (
Arch Intern Med. 2006;166:2533-2538).
Screening Down
The American College of Obstetricians and Gynecologists now calls for doctors to offer pregnant women of all ages screening for Down syndrome. Previous guidelines focused on women aged 35 years and older. Screening should occur before the 20th week of pregnancy (
Obstet Gynecol. 2007;109:217-228).
Brain bleeds up
As the use of warfarin (Coumadin) surged during the 1990s, so did the annual incidence of anticoagulant-associated intracerebral hemorrhage, which went from 0.8 cases per 100,000 population in 1988 to 4.4 in 1999. Among patients 80 years and older, the annual incidence increased from 2.5 in 1988 to 45.9 in 1999 (
Neurology. 2007;68:116-121). Per capita U.S. distribution of warfarin quadrupled from 1988-1999.