10 Ways You’re Using Condoms Wrong

Photo: Getty Images

It’s been a while since that awkward moment in health class when you learned how to put a condom on a banana. Whether you were actually paying attention or too preoccupied chatting with your friends (and avoiding saying the word “penis” at all costs), it’s possible you may have missed a thing or two about the proper way to wrap it up.

Now that you’re an adult, you may think you’ve mastered these simple sheaths. But believe it or not, the CDC estimates there’s a typical use failure rate of 18%. The takeaway: even as an adult, you’re not immune to teenage-status condom errors. However, when used correctly, condoms are 98% effective at preventing pregnancy, and they’re your best line of defense against STDs. To help you avoid joining that 18%, stop making these common mistakes.

RELATED: 9 Types of Condoms You Should Know About

Waiting too long

Your health teacher wasn’t lying to you, “There’s plenty of sperm in pre-ejaculation,” says Lauren Streicher, MD, Associate Clinical Professor of Obstetrics and Gynecology at Northwestern University, and author of Sex Rx: Hormones, Health and Your Best Sex Ever ($14; amazon.com). “So even if he doesn’t ejaculate, you’re still at risk of both pregnancy and a sexually transmitted infection.” In other words: quit procrastinating. As soon as you’re ready to get going, grab a condom.

Forgetting to check for damages

About 83% of women and 75% of men failed to check condoms before use in an Indiana University review of studies. We get it—in the heat of the moment, you aren’t thinking about much more than getting that condom on as quickly as possible. But before you assume that rubber is ready for action, take a beat to make sure the wrapper doesn’t look worn out and the condom isn’t sticky, brittle, discolored, or damaged. Also, if it expired back your college days, it’s time to trade up to a fresh box.

Faulty application

While it may seem pretty self-explanatory, there are plenty of ways to mess up the simple act of putting on a condom. So here’s a quick throwback to the banana lesson: After unwrapping the condom and checking that it’s not inside out, place the rolled tip on top of the penis. Then unroll it to completely cover the shaft. If you only bother going halfway down, you’ll be exposed to way more skin, putting you at risk of contracting (or transmitting) an STD. Also, while putting it on, pinch out excess air inside the condom and make sure you leave half an inch of space at the tip where semen can collect, reminds Dr. Streicher.

Doubling up

If one condom is great at preventing pregnancy and STDs, then two condoms should be even better, right? Definitely not. More is not merrier in this case. Layering two condoms can dramatically increase the chance of slipping off, especially if you’re using a lubricated type, explains Dr. Streicher. “If the first condom rolls off, then it usually takes the second one with it.”

RELATED: 13 Healthy Reasons to Have More Sex

Taking it off too soon

Just like waiting too long to put the condom on is problematic, so is taking it off too early. Yet, researchers from Indiana University found between 13.6% and 44.7% of individuals removed the condom before intercourse was over. Of course, pulling off protection puts you at risk of both STDs and pregnancy. So instead of giving up on a condom before you’ve reached the final act, consider trying out different kinds to figure out which one works best for you and your partner.

Buying the wrong size

Condoms aren’t a one-size-fits-all deal, and let’s face it, not every man is an XL (sorry, fellas). “There’s always that guy who buys the extra-gigantic condom, when he’s not,” says Dr. Streicher. When it comes to staying safe, it’s important to be realistic about size. If the condom is too small, it could break. If it’s too large, it could slip off during sex. The most important thing is not to focus on stroking your guy’s ego, but rather finding a condom that actually fits properly.

Forgetting about oral

You can’t get pregnant from oral sex, but you can still get an STD, says Dr. Streicher, which means you’ve still got to wrap it up. And here’s a trick they probably didn’t teach you in health class: women can use condoms when receiving oral as well. “Since no one ever uses dental dams, instead, take a condom and cut the tip off,” instructs Dr. Streicher. “This will give you a square to put over your vulva for protection.” If you decide to try out this tip (no pun intended), make sure you use an un-lubricated condom; otherwise the barrier will fly right off.

RELATED: Everything You Need to Know About the ‘New’ STD

Using the wrong lube

Speaking of which, lube can be a great addition to your condom experience. Not only can it make sex more enjoyable, but it also helps prevent the latex from tearing or ripping. However, if you choose the wrong lubricant, it could spell disaster. “Not all lubricants are condom-compatible,” says Dr. Streicher. “Any oil-based product can cause break-down of condoms. You always want to stick with water-based or silicone-based, or a mixture of both.”

Storing them improperly

You have have been told in high school health class not to store condoms in your wallet. Well, that wasn’t just a myth to scare you into celibacy. All the bending and friction can cause tiny holes, rendering the rubber totally useless, and if you keep your wallet in your pocket, your body heat can also degrade the sheath. Instead, make sure you keep condoms in a cool, dry place away from sunlight or heat.

Not using one at all

You already know you need to be using condoms, but the advice is worth repeating: “Any time there’s skin-to-skin contact, you should really use a condom,” says Dr. Streicher. Educate yourself on the nine types of condoms, and stock up.

RELATED: 8 Ways Sex Affects Your Brain

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Concussions Are Biggest Health Risk to Cheerleaders

By Maureen Salamon
HealthDay Reporter

THURSDAY, Dec. 10, 2015 (HealthDay News) — Concussion tops the list of injuries sustained by high school cheerleaders as the once-tame sideline activity becomes more daring and competitive, a new U.S. study finds.

But cheerleading still ranks near the bottom of high school sports in terms of overall injury rate, according to the research, published online Dec. 10 in the journal Pediatrics.

“Anecdotally, it’s pretty clear to most people over the past few decades that cheerleading has shifted from a sideline activity to a competitive sport itself. This may have resulted in an increase in injury,” said study author Dustin Currie, a doctoral student in epidemiology at Colorado School of Public Health at the University of Colorado Anschutz Medical Campus.

“We only have five years of data … but I don’t know whether to say it’s better for cheerleading to not become a more competitive sport,” he added. “If it’s getting more children to participate in athletics, it’s probably a net positive.”

About 400,000 students in the United States participate in high school cheerleading each year, including more than 123,000 involved in competitive “spirit squads” that incorporate stunts, pyramids, tosses and jumps, according to the U.S. National Federation of State High School Associations.

But states classify cheerleading in various ways, with some defining it as a sport and others lumping it with other nonathletic extracurricular activities, Currie said. The distinction is important because defining it as a sport requires stricter rules regarding practice location and other safety measures, as well as coaching certification requirements, he said.

The new study is the first to compare injury rates of high school-sanctioned cheerleading to other sports. Using a large national sports injury database, Currie and his colleagues found that while overall injury rates among cheerleaders were lower than most other high school sports, the injuries that do occur are more severe.

Cheerleading ranked behind only gymnastics in the percentage of injuries resulting in an athlete being benched for at least three weeks or even the entire season, according to the new research.

These dangers were also underscored in a 2012 policy statement by the American Academy of Pediatrics noting that cheerleading has accounted for about 66 percent of all catastrophic injuries in high school girl athletes over the past 25 years.

The new study shows that concussions were the most common cheerleading injury, comprising 31 percent of all injuries, but that concussion rates were significantly lower in cheerleading than all other sports combined as well as all other girls’ sports.

“There’s been a pretty strong rise in concussion rates over the last decade in pretty much all high school sports,” Currie said. “I think that’s partially due to the increased awareness and diagnosis of concussions occurring. So I wouldn’t say I’m surprised … and the more important thing to point out is that concussion rates are still lower in cheerleading than other sports.”

More than half of cheerleading injuries occurred during stunts, with pyramid formations constituting 16 percent and tumbling accounting for 9 percent. Most stunt- and pyramid-related concussions resulted from contact with another person, most commonly their elbow, the study said.

Cheerleaders at the base of formations for stunts and pyramids represented 46 percent of all injuries, followed by fliers (36 percent) and spotters (10 percent).

Dr. Cynthia LaBella, medical director of the Institute for Sports Medicine at Ann and Robert H. Lurie Children’s Hospital of Chicago, said more research is needed not only into what kinds of injuries occur among cheerleaders but whether certain safety measures are effective. These include using proper spotting techniques and making sure coaches are certified, she said.

“I don’t know that it’s a bad thing that cheerleading has changed,” said LaBella, also an associate professor of pediatrics at Northwestern University Feinberg School of Medicine in Chicago. “It has evolved, but we just need to make sure the procedures on how we monitor injuries and athletes’ skills … evolve with it. Now there are high-flying stunts, but we need to respect that and have all the safeguards in place that would be in place for other risky sports.”

Currie said one way to potentially reduce cheerleading injuries would be for all states to consider cheerleading a sport and recognize that the “vast majority of high school cheerleaders are athletes” requiring the support of athletic trainers and other appropriate medical staff.

“States need to think about it in terms of cheerleaders being athletes, as they are now, rather than some recreational activity on the sidelines,” he said.

More information

The American Association of Cheerleading Coaches and Administrators offers a glossary of cheerleading stunts and rules.

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Lumpectomy Plus Radiation May Beat Mastectomy for Early Breast Cancer

By Amy Norton
HealthDay Reporter

THURSDAY, Dec. 10, 2015 (HealthDay News) — Women with early stage breast cancer may survive longer if they opt for the less-extensive surgery called lumpectomy, followed by radiation, rather than a mastectomy, a new study suggests.

“I think these results offer women important information to discuss with their doctors when making a treatment decision for early stage breast cancer,” said lead researcher Sabine Seisling, of the Netherlands Comprehensive Cancer Organization, in Utrecht.

Mastectomy removes the entire the breast, while lumpectomy involves removing only the tumor with some surrounding tissue. Some studies have suggested that women with early stage breast cancer have a better five-year survival rate after lumpectomy.

The new study, which included 37,000 Dutch women, found that the advantage may also extend to the longer term. Of nearly 22,000 patients who underwent lumpectomy plus radiation, 77 percent were still alive 10 years later. That compared with only 60 percent of women who’d undergone a mastectomy — with no radiation, which is typical for early stage breast cancer.

There were key differences between the two groups, Seisling noted.

Women who chose lumpectomy and radiation were younger, and more likely to receive hormonal therapy. But even with those differences considered, women in the lumpectomy group were 21 percent more likely to be alive 10 years after treatment, the study showed.

Seisling was scheduled to present the findings Thursday at the annual San Antonio Breast Cancer Symposium. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

But at least one expert cautioned that the study doesn’t prove that lumpectomy and radiation give women a better chance than mastectomy does.

“We do need to take the results with a grain of salt,” said Dr. David Euhus, chief of breast surgery at Johns Hopkins Hospital, in Baltimore.

That’s because the findings are based on a review of patient records. And, Euhus said, the study couldn’t account for all of the factors that could have swayed each woman’s treatment decision.

There have been clinical trials looking at the question, Euhus pointed out. Several trials that started back in the 1980s found that for women with early stage breast cancer, the outlook was similar whether they had a mastectomy or lumpectomy plus radiation.

So, Euhus said, the less-extensive surgery is at least comparable to a mastectomy. “This new study reaffirms that lumpectomy plus radiation is a good treatment,” he said.

That’s important, according to Euhus, because the number of women wanting a mastectomy, including double mastectomy, has gone up in the past decade. And recent research suggests that fear of a cancer recurrence is a big driver of that trend.

Yet in the current study, lumpectomy patients not only lived longer, but were also less likely to have a cancer recurrence in the lymph nodes near the breast, or at other sites in the body.

“Our hypothesis,” Seisling said, “is that the radiotherapy kills any remaining cancer cells left after surgery.”

Lumpectomy plus radiation may also carry fewer complications and lower costs, according to another study presented at the same meeting.

That’s true, at least, when women opt for breast reconstruction after their mastectomy. Researchers led by Dr. Benjamin Smith of the University of Texas MD Anderson Cancer Center in Houston found that those women had nearly double the risk of complications — such as infection and bleeding — compared with women who underwent lumpectomy and radiation.

That study also found the average cost of mastectomy and reconstruction hovered around $89,000 for women with private insurance. That compared with just under $66,000 for women who underwent lumpectomy and radiation, the study revealed.

Ultimately, Euhus said, the treatment choice depends on more than statistics. Each woman’s cancer is different, and every woman’s comfort level with a particular treatment will be different.

“A cancer diagnosis takes away your sense of well-being,” Euhus said. “Some women will feel that their well-being and peace of mind can only be restored with a mastectomy.”

More information

The Susan G. Komen Foundation has more on early stage breast cancer treatment.

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One in Five U.S. Kids Over Age 5 Has Unhealthy Cholesterol: CDC

THURSDAY, Dec. 10, 2015 (HealthDay News) — Twenty-one percent of American children and teens have some form of “abnormal” blood cholesterol reading that leaves them at heightened risk for heart disease and stroke as they reach adulthood.

That’s the conclusion of a review of 2011-2014 federal health data compiled by researchers at the U.S. Centers for Disease Control and Prevention.

Overall, slightly more than 13 percent of kids had unhealthily low levels of HDL (“good”) cholesterol — the kind that actually might help clear out arteries. The CDC says just over 8 percent had too-high levels of other forms of cholesterol that are bad for arteries, and more than 7 percent had unhealthily high levels of “total” cholesterol.

Obesity helped drive these trends, the CDC said. For example, more than 43 percent of children who were obese had some form of abnormal cholesterol reading, compared to less than 14 percent of normal-weight children.

Not surprisingly, rates of abnormal cholesterol readings rose as kids aged. For example, while slightly more than 6 percent of children aged 6 to 8 had high levels of bad cholesterol, that number nearly doubled — to 12 percent — by the time kids were 16 to 19 years of age, the CDC said.

The CDC report noted that while there were slight differences in cholesterol rates between boys and girls, race did not seem to matter.

Cardiologists weren’t surprised by the findings.

“When one looks at the data it is clear that the obesity epidemic is responsible for a substantial portion of these abnormal cholesterol values,” said Dr. Michael Pettei, who co-directs preventive cardiology at Cohen Children’s Medical Center in New Hyde Park, N.Y. “Approximately one-third of U.S. children and adolescents are either overweight or obese.

“Clearly, the American Academy of Pediatrics’ recommendations to screen all children for cholesterol status, and to take measures to prevent and manage obesity, are more appropriate than ever,” he said.

Dr. Kevin Marzo, chief of cardiology at Winthrop-University Hospital in Mineola, N.Y., agreed.

“Abnormal cholesterol is a key modifiable risk factor for developing cardiovascular disease, including heart attack and stroke, in adulthood,” he said. “This study confirms that preventive strategies must start in childhood, including healthy eating habits, regular exercise, and maintaining ideal body weight.”

The findings were published Dec. 10 as a Data Brief from the CDC’s National Center for Health Statistics.

More information

There’s more on keeping kids’ hearts healthy at the American Heart Association.

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How to Keep Whitening Toothpastes From Hurting Your Teeth

Photo: Getty Images

I use whitening toothpaste morning and night. Is this safe for my teeth and gums?

Whitening toothpastes are generally safe for daily use but should not be used more often than the label indicates or your dentist advises. They contain both special chemicals and polishing agents to remove stains, which can lead to teeth and gum sensitivity and damage the tooth enamel over time if relied on too much.

Like any good toothpaste, most whitening blends have fluoride as the active ingredient, which fights cavities and gum disease but doesn’t whiten. The actual brightening effect is mostly due to the mechanical abrasives (common ones are silica and baking soda) that scrub away stains. Some brands also include a dose of peroxide, a bleaching chemical, but in such small amounts that it’s unlikely to cause sensitivity or irritation.

You should know that whitening toothpastes—even if they contain peroxide—act only on surface stains, like those caused by drinking tea or coffee. If you’re unhappy with the color of your teeth, ask your dentist about professionally applied or over-the-counter peroxide products, typically in the form of special gel trays or strips; they have higher peroxide concentrations and are designed to reach deeper stains in the tooth enamel. (Over-the-counter options usually contain 5 to 15 percent peroxide, while dentist-administered products tend to have 25 to 40 percent.)

Keep in mind that the American Dental Association recommends that you talk to your dentist before using any teeth-whitening products so you can determine the best option for you.

Health‘s medical editor, Roshini Rajapaksa, MD, is associate professor of medicine at the NYU School of Medicine and co-founder of Tula Skincare.

RELATED:

20 Things That Can Ruin Your Smile

How to Brighten Up Your Smile

Can Brushing Your Teeth Fight a Cancer-Causing Virus?

 

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Unhappiness Won’t Kill You

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, Dec. 9, 2015 (HealthDay News) — Here’s some good news for the grim and the grumpy: A new study claims that unhappiness itself has no direct effect on whether people will die before their time.

Women in poor health are more likely to be unhappy, but their unhappiness does not in and of itself increase their overall risk of early death, researchers concluded after evaluating data on more than 700,000 women from the United Kingdom.

Earlier research on happiness and health put the cart before the horse, confusing cause and effect, said study co-author Sir Richard Peto, a professor of medical statistics and epidemiology at the University of Oxford in England.

“Illness makes you unhappy and causes stress,” Peto said. “Illness is the thing causing unhappiness, not unhappiness causing illness.”

The study was published Dec. 9 in The Lancet.

The new findings stem from the UK Million Woman Study, which continues to track the health records of 1.3 million women recruited between 1996 and 2001. Three years after enrollment, the women filled out a questionnaire that asked them to rate their health, happiness, stress, relaxation and feelings of control.

The researchers focused on a group of 719,671 women who answered all the questions regarding happiness, including 31,531 who died during the subsequent decade. About one out of six in the group said they were generally unhappy.

The overall death rate among the unhappy wound up the same as the death rate among the generally happy, after researchers accounted for differences in health and lifestyle. This was true for overall mortality, and it also held true for deaths from cancer or heart disease, they said.

Therefore, the investigators concluded that unhappiness itself was not associated with increased mortality among the unhappy contingent of women.

Previous studies that linked reduced mortality with happiness, relaxation or a sense of well-being have not allowed for the strong psychological effect of ill health, the researchers said.

In the new study, women who were already in poor health tended to say that they were unhappy, stressed, not in control and not relaxed.

“If you want to be happy, then the main thing you need to do to be happy is to remain healthy, because illness is most likely to make you unhappy,” Peto said.

Peto said the findings show that people need to focus on problems that directly affect their health, like smoking or obesity, rather than assuming that keeping their chin up also will keep them free from illness.

“There are these claims that if you have a positive attitude, you’ll be healthy, but your health depends on what you do in your daily life,” Peto said. “Going around with a positive attitude but still smoking, that’s no good for your health. We need to concentrate on the few important causes of premature death.”

However, this study does not completely shut the door on the potential health effects of happiness, because the researchers only looked at how happiness affected a person’s risk of dying, said Philipe de Souto Barreto, a researcher with the Institute of Aging at the University Hospital of Toulouse in France.

“Health is a broader concept,” said Barreto, who wrote an accompanying editorial in The Lancet. “If we think about diseases, studies have found, for example, that happiness was associated with a reduced risk of onset of coronary heart disease.”

Barreto also noted that the sample only included women who, on average, were in late middle age. Other studies have shown that happiness may be more beneficial to men than women when it comes to overall risk of death, he said.

“Therefore, in my opinion, the debate is not yet closed,” Barreto said. “Further research is still needed in the field of happiness and medical outcomes.”

More information

For more on well-being, visit the U.S. Centers for Disease Control and Prevention.

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Unhappiness Won’t Kill You

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, Dec. 9, 2015 (HealthDay News) — Here’s some good news for the grim and the grumpy: A new study claims that unhappiness itself has no direct effect on whether people will die before their time.

Women in poor health are more likely to be unhappy, but their unhappiness does not in and of itself increase their overall risk of early death, researchers concluded after evaluating data on more than 700,000 women from the United Kingdom.

Earlier research on happiness and health put the cart before the horse, confusing cause and effect, said study co-author Sir Richard Peto, a professor of medical statistics and epidemiology at the University of Oxford in England.

“Illness makes you unhappy and causes stress,” Peto said. “Illness is the thing causing unhappiness, not unhappiness causing illness.”

The study was published Dec. 9 in The Lancet.

The new findings stem from the UK Million Woman Study, which continues to track the health records of 1.3 million women recruited between 1996 and 2001. Three years after enrollment, the women filled out a questionnaire that asked them to rate their health, happiness, stress, relaxation and feelings of control.

The researchers focused on a group of 719,671 women who answered all the questions regarding happiness, including 31,531 who died during the subsequent decade. About one out of six in the group said they were generally unhappy.

The overall death rate among the unhappy wound up the same as the death rate among the generally happy, after researchers accounted for differences in health and lifestyle. This was true for overall mortality, and it also held true for deaths from cancer or heart disease, they said.

Therefore, the investigators concluded that unhappiness itself was not associated with increased mortality among the unhappy contingent of women.

Previous studies that linked reduced mortality with happiness, relaxation or a sense of well-being have not allowed for the strong psychological effect of ill health, the researchers said.

In the new study, women who were already in poor health tended to say that they were unhappy, stressed, not in control and not relaxed.

“If you want to be happy, then the main thing you need to do to be happy is to remain healthy, because illness is most likely to make you unhappy,” Peto said.

Peto said the findings show that people need to focus on problems that directly affect their health, like smoking or obesity, rather than assuming that keeping their chin up also will keep them free from illness.

“There are these claims that if you have a positive attitude, you’ll be healthy, but your health depends on what you do in your daily life,” Peto said. “Going around with a positive attitude but still smoking, that’s no good for your health. We need to concentrate on the few important causes of premature death.”

However, this study does not completely shut the door on the potential health effects of happiness, because the researchers only looked at how happiness affected a person’s risk of dying, said Philipe de Souto Barreto, a researcher with the Institute of Aging at the University Hospital of Toulouse in France.

“Health is a broader concept,” said Barreto, who wrote an accompanying editorial in The Lancet. “If we think about diseases, studies have found, for example, that happiness was associated with a reduced risk of onset of coronary heart disease.”

Barreto also noted that the sample only included women who, on average, were in late middle age. Other studies have shown that happiness may be more beneficial to men than women when it comes to overall risk of death, he said.

“Therefore, in my opinion, the debate is not yet closed,” Barreto said. “Further research is still needed in the field of happiness and medical outcomes.”

More information

For more on well-being, visit the U.S. Centers for Disease Control and Prevention.

---

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More Support for Lower Blood Pressure Goals

WEDNESDAY, Dec. 9, 2015 (HealthDay News) — Intensive treatment to lower blood pressure below currently recommended levels reduces the risk of heart attack and stroke in patients with high blood pressure, heart disease, diabetes and kidney disease, a new study shows.

Effective blood pressure goals have been the subject of much recent scientific debate, with another recent study also supporting lower targets.

For this study, researchers analyzed data from 19 clinical trials that included nearly 45,000 people. They wanted to assess the potential benefits and safety of pushing systolic blood pressure in high-risk patients below the current target of 140. Systolic is the top number in a blood pressure reading.

Compared to those who received standard treatment, average systolic pressure was 6.8 lower and diastolic blood pressure was 4.5 lower in patients who received more intensive treatment — 133.2/76.4 versus 140.4/80.9.

Intensive treatment patients were about 14 percent less likely to suffer a heart attack, about 25 percent less likely to suffer a stroke, and about 20 percent less likely to have progressive retinopathy (damage to the eye’s retina), the study found.

The greatest benefits of intensive treatment were seen in patients with heart disease, kidney disease or diabetes, according to the study recently published in The Lancet.

Intensive treatment did not appear to reduce the risk of heart failure, heart-related death, kidney failure or premature death, however, the researchers said.

The findings show the need to revise current blood pressure target guidelines for high risk patients, the study authors said.

“Our robust evidence clearly shows that treating blood pressure to a lower level than currently recommended targets results in better health outcomes for patients,” lead author Anthony Rodgers, professor of global health at the George Institute of Global Health in Sydney, Australia, said in a journal news release.

Rates of serious side effects were similar in the standard and intensive treatment groups, but intensive treatment nearly tripled the risk of abnormally low blood pressure, the study found.

“These adverse effects are important but do not outweigh the benefits of lowering blood pressure using intensive treatment in high-risk patients,” Rodgers said. But much more research is needed to determine how to easily and safely achieve and maintain greater blood pressure reductions, he said.

“Patients are also likely to benefit from non-drug approaches such as weight loss and restricting salt intake,” he added.

The study “provides strong evidence that intensive blood pressure reduction is more beneficial than less intensive blood pressure reduction,” Mattias Brunstrom and Bo Carlberg of Umea University, Sweden, wrote in an accompanying editorial.

Another study, published last month in the New England Journal of Medicine, also concluded that lower is better when it comes to blood pressure.

The SPRINT trial revealed that a target systolic blood pressure of 120 reduces by about one-quarter the rate of death, heart attack, heart failure and stroke, compared with the currently recommended target pressures of 140 for people under age 60 and 150 for seniors.

More than 9,300 participants aged 50 and older were recruited for SPRINT from about 100 medical centers and clinical practices throughout the United States and Puerto Rico. The U.S. National Institutes of Health-funded trial ended early so that the agency could share “potentially lifesaving information” with the public.

More information

The U.S. National Heart, Lung, and Blood Institute has more about high blood pressure treatment.

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Implanted Lung Valves Show Promise in Some Emphysema Patients

By Randy Dotinga
HealthDay Reporter

WEDNESDAY, Dec. 9, 2015 (HealthDay News) — New research suggests that more careful selection of patients could help improve the success rate of valves implanted into the lungs of people with emphysema.

The valves aim to improve breathing, allowing patients with the chronic lung disease to be more active and to perhaps survive longer. Previous research into the valves has been mixed, but the new Dutch study found that they work more effectively if physicians are more selective about which patients get them.

“The results are relatively impressive,” said lung physician Dr. Gary Hunninghake, an assistant professor at Harvard Medical School in Boston. “These are benefits that physicians would want to get, and patients might feel better. This could result in people being more enthusiastic about this technique.”

However, the valves come with a risk of serious side effects, the study authors noted, and the treatment appears to be expensive. It’s also not clear whether the valves actually extend lives.

Emphysema is a type of chronic obstructive pulmonary disease (COPD) that damages the airways and makes it difficult for people to breathe. Smoking is the main cause.

Treatment may help patients. But the prognosis can be grim for some people, with death expected within a few years.

In patients with emphysema, pockets filled with air can develop in the lungs and disrupt breathing, said Hunninghake, who was not involved in the new study. The pockets may push on other areas of the lung, causing it to expand in an unhealthy way.

Scientists have developed one-way “endobronchial valves,” which are implanted in the lung and allow air to get out of the pockets but not get back into them, Hunninghake said. “It’s a way of reducing the volume of these areas without doing surgery on them,” he added, and patients may have several valves implanted.

Some physicians have wondered if they don’t work as well in certain patients because air finds other ways to re-enter the pockets. In those patients, it appears that “the valve doesn’t shut down the problem,” Hunninghake said.

The new study aimed to eliminate these kinds of patients from the research. The study authors recruited 68 patients with severe emphysema, average age 59, to get valves implanted or regular treatment.

In general, those who received the valve treatment were able to breathe better and walk 243 feet farther in six minutes. Seventy-five percent of the patients who got the devices responded to the treatment, said study co-author Dr. Dirk-Jan Slebos, an associate professor with the department of pulmonary diseases at the University of Groningen, in the Netherlands.

According to Slebos, the surgery and follow-up treatment for a year in the Netherlands would cost the equivalent of about $22,000 to $33,000. The treatment is available in the United States, Hunninghake said, although he doesn’t know its cost.

Will more doctors embrace this treatment? Maybe, Hunninghake said, if the findings can be confirmed. More research is underway, said study author Karin Klooster, a graduate student at the University of Groningen.

But doctors will have to consider the side effects, Hunninghake said, including those that occurred in this study — an 18 percent chance of a collapsed lung and a 15 percent chance that the valve would have to be removed. It’s possible, however, that the side effect rate will improve as surgeons get better at implanting the valves, he said.

Another lung specialist said the study raises hope for the treatment.

“Although the majority of people with chronic obstructive pulmonary disease will not be suitable for this, it could still benefit a sizable minority and is a significant step forward,” said Dr. Nicholas Hopkinson, a consultant chest physician with the Royal Brompton and Harefield NHS Foundation Trust in London. He said his own recent research with colleagues found similar results for the treatment over a three-month period.

The study was published Dec. 10 in the New England Journal of Medicine.

More information

For more about emphysema and related illnesses, try the American Lung Association.

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Common Heart Failure Drugs May Harm More Than Help

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Dec. 9, 2015 (HealthDay News) — Nitrates are commonly prescribed for heart failure patients, but a new study finds they don’t improve quality of life or everyday activity levels as intended.

The drugs are prescribed to relieve chest pain so patients whose hearts still contract normally might feel comfortable enough to increase their daily activities. Now, new research suggests the opposite is true.

“Nitrates tended to reduce daily activity and significantly reduce active hours per day,” said lead researcher Dr. Margaret Redfield, a professor of medicine at the Mayo Clinic in Rochester, Minn.

Moreover, nitrates did not improve exercise capacity or symptoms of heart failure, such as shortness of breath and weakness when walking. She said symptoms tended to be worse among those taking the drugs.

“This study should change practice,” Redfield said. “Long-acting nitrates should not be used for symptom relief in heart failure.”

The report was published Dec. 10 in the New England Journal of Medicine.

For the study, Redfield’s team randomly assigned 110 heart failure patients to six weeks of daily treatment with an increasing dose of isosorbide mononitrate — from 30 milligrams (mg) to 120 mg — or to take a placebo.

The patients suffered from heart failure with so-called preserved ejection fraction, which affects about half of heart failure patients.

According to the American Heart Association, this condition means that the heart muscle contracts normally but the lower chambers of the heart — the ventricles — don’t relax as they should when being filled with blood or when they pump blood out.

This reduces the amount of blood entering the ventricles. Although the heart pumps out all the blood in the ventricles, it isn’t enough blood to meet the body’s needs.

Six weeks into the study, the groups switched medication regimens, and the trial continued for another six weeks, according to the report.

Patients wore accelerometers to measure daily activity levels. The researchers found that patients receiving the 120-mg dose of isosorbide mononitrate tended to have reduced daily activity and a significant decrease in the hours of daily activity, compared with those receiving the dummy drug.

Moreover, daily activity was reduced among patients receiving the nitrate regardless of dose, compared with the placebo. And as the dose of isosorbide mononitrate increased, activity levels decreased while remaining steady among those taking the placebo, the investigators found.

Also, no significant difference between the groups was seen in distance walked within six minutes or in quality-of-life scores. And there was no difference in blood levels of a biological indicator that is used to diagnose the extent of heart failure.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said this study highlights the critical need to identify new therapies that can improve outcomes for this common, costly and deadly condition.

“Despite close to 3 million men and women having heart failure, there have not been any medications that have been demonstrated to reduce the risk of hospitalization or death,” Fonarow said.

“Use of nitrates as a treatment for heart failure in this patient population does not appear to provide a benefit,” he said.

More information

For more on heart failure, visit the American Heart Association.

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