FYI from the NHLBI Index
February 2005: Vol. 5, Issue 3 In the News
News from Capitol Hill
Recent Advances from the NHLBI
- Breathing Problems During Sleep May Affect Mental Development in
Young Children
- Genetics Play Role in Response to Most Common Asthma Drug
- Children with Sickle Cell Anemia Revert to High Risk for Stroke
if Transfusions Stopped
- Framingham Heart Study Finds Link Between Obesity and Atrial Fibrillation
The fiscal year (FY) 2005 appropriations process was completed on December 8,
2004, when the President signed the Consolidated Appropriations Act, 2005 (H.R.
4818), into law as Public Law 108-477. The law, which has been referred to as
an "omnibus" appropriations act because it includes several appropriations bills
that typically are discussed and voted on separately, increased the NIH budget
by 2 percent over its FY 2004 appropriation. Of the $28.364 billion budgeted for
the NIH, $2.941 billion was appropriated for the NHLBI, an increase of 2.1 percent
over the NHLBI budget for FY 2004.
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.
Recent Advances from the NHLBI
Breathing Problems During Sleep May Affect Mental Development
in Young Children
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.
Genetics Play Role in Response to Most Common Asthma
Drug
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.
Children with Sickle Cell Anemia Revert to High Risk
for Stroke if Transfusions Stopped
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.
Framingham Heart Study Finds Link Between Obesity and
Atrial Fibrillation
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.
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