In the News |
Recent Advances from the NHLBI |
Earlier in 2004, President Bush signed the Asthmatic Schoolchildren's Treatment and Health Management Act of 2004 (H.R. 2023) into law as Public Law 108-377. It requires the Secretary, DHHS, when making grants to states for asthma-related activities, to give preference to those that require schools to allow students to self-administer medications for asthma or anaphylaxis.
Results from a study funded primarily by the NHLBI show that 5-year-old children who had symptoms of sleep disordered breathing (SDB) scored lower on standard tests measuring executive function (attention and planning), memory, and general intelligence than other children of the same age without SBD symptoms. Additionally, the children with symptoms of SDB, including frequent snoring, loud or noisy breathing during sleep, or sleep apneas observed by parents, were more likely to have behavioral problems.
The researchers found that the neurocognititve effects were significant even among children who had mild symptoms of SBD, but no actual sleep apneas. Results from this study emphasize the need for parents and pediatricians to watch for breathing problems in young children when they sleep, so that they can be treated to reduce any negative effects on their mental development.
Researchers in the Asthma Clinical Research Network (ACRN), sponsored by the NHLBI, found that over time, participants with mild asthma responded differently to daily doses of inhaled albuterol depending on which form of a specific gene they had inherited. A few weeks of regular use of albuterol improved overall asthma control in individuals with one form of the gene, but stopping all use of albuterol eventually improved asthma control in those with another form of the gene. Albuterol is the most commonly used drug for relief of acute asthma symptoms, or “attacks.”
This is the first study of an asthma drug in patients who were selected according to their genotype. Its findings could lead to better ways to individualize asthma therapy based on a patient’s genetic patterns.
A trial examining whether children with sickle cell anemia could safely discontinue their periodic blood transfusions, which reduce their risk of strokes, was stopped by the NHLBI. The Stroke Prevention Trial II (STOP II) began in 2000 with an expected recruitment of 100 patients age 2 to 18. It was stopped two years early with 79 patients enrolled.
At the time the study was halted, 14 of the 41 patients who had been randomly assigned to stop transfusions reverted to high risk of stroke as measured by a special ultrasound technique and 2 patients had suffered a stroke. No strokes or reversions to high stroke risk occurred in the group that continued with transfusions.
In a clinical alert to physicians who treat children with sickle cell anemia, the NHLBI advised that stopping transfusions cannot be recommended. It also urged physicians to discuss with patients and their families the stroke prevention benefits of continuing periodic transfusions and the risks associated with them.
The Institute’s Framingham Heart Study identified an apparent association between obesity and the risk of developing atrial fibrillation, a heart rhythm disorder. The investigators divided 5,282 Framingham participants who did not have atrial fibrillation when the study began into three categories of body mass index (BMI): normal, overweight, and obese. Over a period of almost 14 years, the incidence of atrial fibrillation increased as a function of increasing BMI for both men and women.
If confirmed by other observational studies, these results indicate that weight control, in addition to reducing risks for hypertension, diabetes, and other obesity-related complications, may also lower risk of atrial fibrillation.