FYI from the NHLBI Index
May 2001: Vol. 2, Issue 1 In the News
News from Capitol Hill
Recent Advances from the NHLBI
- Inhaled Corticosteroids Do Not Slow Progression of COPD
- Reduced Fat Intake To Lower Cholesterol Is Safe and Beneficial for Children
- Study Reveals Link Between Salt Sensitivity
and Risk of Death in People without Hypertension
FY 2002 House Appropriations Hearings
This year, the House Appropriations Subcommittee for Labor,
Health and Human Services, and Education hearings addressed broad
NIH topics instead of discussing individual NIH institutes.
During the theme hearings, each NIH institute director participated
in one of three panels. An NIH overview hearing is scheduled for mid-May
with Dr. Ruth Kirschstein, Acting Director, NIH, as the principal witness.
On March 28, NHLBI Director Dr. Claude Lenfant served on the
chronic
diseases panel. In
oral testimony, he emphasized the importance of
focusing on disease prevention and treatment, reminding those in attendance
that nearly all of the diseases studied by the NHLBI are chronic. Members of
the subcommittee expressed interest in the application of research results to
the treatment of patients, differences in how physicians diagnose cardiovascular
disease in men and women, asthma in children, and research on sickle cell
disease. In addition to institute-specific questions, members asked questions
about broader NIH issues including stem cell research and funding for young
scientists entering biomedical research.
The
remaining two panels met on April 4. The first, titled "Life Span,"
addressed research to enable people of all ages to live productive lives
and to get necessary health care. Life span research encompasses all NIH
areas of interest and covers all ages, from prenatal development and infancy through
old age. The second panel, "Special Populations," addressed issues of particular
significance to minorities and other groups that have not benefitted from
biomedical research to the extent that others have. Special populations
experience a wide range of health disparities, which are attributable to
race, ethnicity, gender or lack of access to health care.
New Legislation
Two new bills have been introduced that include provisions relevant
to the NHLBI. The Pulmonary Hypertension Research Act of 2001 (H.R. 1297)
would provide for expansion of NHLBI pulmonary hypertension research and
coordination of that research with similar activities of other NIH institutes
and centers. Provisions in the
Comprehensive Tuberculosis Elimination Act of 2001
(H.R. 1167) would require the NHLBI to expand, intensify, and coordinate
basic and clinical research and related activities with respect to
TB. It also recognizes the NHLBI's current Tuberculosis Academic
Awards program and would authorize a new career development program for
clinically trained professionals who are committed to research in pulmonary
infections and TB. The full text of these bills can be found by searching
the Library of Congress' Thomas database.
Recent Advances from the NHLBI
Inhaled Corticosteroids Do Not Slow Progression of COPD
A recent New England Journal of Medicine paper ended
controversy about effects of corticosteroids
in people with chronic obstructive pulmonary disease (COPD).
The study showed that patients treated with inhaled corticosteroids
experienced no significant slowing of the decline in lung function
that makes COPD ultimately fatal. However, they had fewer symptoms,
lower health care utilization, and some improvement in the sensitivity
of the lungs to external stimuli than members of the placebo group.
They also experienced more bruising and
a small amount of bone loss. Dr. Robert Wise of Johns Hopkins
University noted "The bone loss was not clinically important.
However, we don't know whether it would progress with prolonged use of the drug. Physicians treating patients with COPD should weigh the
benefits of inhaled corticosteroids against the potential risks."
Reduced Fat Intake To Lower Cholesterol Is
Safe and Beneficial for Children
Children with high blood cholesterol levels can benefit from reducing the amounts of fat and cholesterol in their diets without adversely affecting their development, according to results
published in the journal Pediatrics. The Dietary Intervention Study in
Children (DISC) revealed that a low-fat, low-cholesterol diet does not
affect children's growth, nutritional status, or sexual maturation.
Furthermore, the diet helps children decrease their low-density lipoprotein,
or "bad" cholesterol, levels. "This is the first study of this size to examine
long-term effects of reduced dietary saturated fat and cholesterol intake among
children," said NHLBI director Dr. Claude Lenfant. "DISC confirms that dietary
changes in children with high levels of LDL
cholesterol may thwart development of atherosclerosis without adverse effects."
Study Reveals Link Between Salt Sensitivity and Risk of Death in People without Hypertension
Results from an NHLBI-supported study, published in a recent issue of
Hypertension: Journal of the American Heart Association, show that
sensitivity to salt increases the risk of death even for people with
normal blood pressure. Although salt has been associated with hypertension
for years, new research reveals that salt sensitivity (a measure of how blood
pressure responds to salt intake) increases risks of developing
other conditions such kidney problems.
According to Dr. Myron Weinberger, Director of the Hypertension Research
Center at the Indiana University School of Medicine and the study's principal
investigator, about 26 percent of Americans with normal blood pressure
and about 58 percent of those with hypertension are salt sensitive. Because
there is no easy way to test for salt sensitivity, Dr. Weinberger advises
all Americans with normal blood pressure to follow the federal
recommendation of having no more than 2,400 milligrams of sodium a day.
Because only 10 percent of dietary sodium is
added by salting food at the table, Americans
interested in reducing their sodium consumption
should be careful about the sodium content of
processed foods.
But how to interpret food-
labels? "Sodium free" and "salt free" both mean
the product contains 5 milligrams or less of
sodium per serving. A serving of a "low sodium"
product has 140 milligrams or less of sodium. "Reduced sodium" or
"light in sodium" means the product contains at least 25% or 50% less
sodium than the regular version, respectively.
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