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Anchor lead: Does keeping blood pressure in control reduce your risk of dementia? Elizabeth Tracey reports

Keeping blood pressure in check didn’t reduce the development of dementia in older people, a recent study found, although the condition known as ‘mild cognitive impairment’ did decrease in those whose blood pressure was controlled. Constantine Lyketsos, an Alzheimer’s disease expert at Johns Hopkins, comments.

Lyketsos: I don’t think this is disappointing. I think this is a step in the process of understanding the relationship between blood pressure and cognitive outcomes. My bet would be that if they did this aggressive blood pressure control in fifty to sixty five year olds that it would be impactful.  :18

Lyketsos notes that blood pressures that are too low can be harmful.

Lyketsos: What’s the right blood pressure for an older person? Over 75, in that age group aggressive blood pressure management is probably harmful, because people need a higher blood pressure to perfuse their brain.  :11

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can you avoid developing heart disease? Elizabeth Tracey reports

One in two adults in the US have some form of heart disease, federal statistics reveal. Coupled with the fact that heart disease remains the number one cause of death, adopting behaviors to reduce your risk is likely a good idea. Seth Martin, a cardiologist at Johns Hopkins, says such a strategy should start in childhood.

Martin: Especially if there’s a family history of heart disease then that would be a particular reason to do a cholesterol in the children to see where you’re at. I think that its also a time just to check basic things like where a child’s weight is and is it a healthy weight? And is it something that’s above average or even placing them in an obese category where that should be a focus of attention because the earlier you get on the right trajectory the better.  :30

Martin encourages people to make heart disease prevention a family affair, implementing healthy diets and exercise for all. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Heart disease is very, very common, Elizabeth Tracey reports

Almost half of all adult Americans have some form of heart disease, a recent look at federal statistics reveals. Seth Martin, a cardiologist at Johns Hopkins, reacts to the statistics.

Martin: Yikes. 48% we knew it was high but I think this is a call to action, again a reminder that heart disease is such a prevalent disease amongst our US population.  :12

Martin notes that women in particular should be aware.

Martin: Heart disease is still the number one killer among women. It’s not breast cancer its actually heart disease. So this is a reminder that we should be looking at what are the steps we can take to really live the healthiest lifestyle to mitigate the risk of heart disease.  :18

The best advice remains preventing heart disease before it happens by not smoking, watching both weight and diet, remaining physically active, and controlling cholesterol and blood pressure, Martin says, and these should be lifelong practices. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Are statins useful even as we age? Elizabeth Tracey reports

Statins are used to lower cholesterol and reduce the risk of heart disease. Now a new study shows that even as people get older there are still good reasons to take a statin. That’s according to Seth Martin, a cardiologist at Johns Hopkins.

Martin: Overall the main message from this meta analysis is that it reinforces that across the age spectrum there’s benefits of statin therapy through LDL lowering.  :10

Martin notes that if you’ve never had a heart problem and you’re over 80, the jury is still out.

Martin: Does it really make sense now, at age 80, to start a statin when you’ve made it that far without a cardiovascular event, they acknowledge that its an open question in that primary prevention context. There is still some uncertainty around the evidence. :15

Martin says that studies are currently underway looking at this very question, so for now, talk with your doctor about whether a statin makes sense for you. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new technology may help doctors identify resistant organisms more quickly, Elizabeth Tracey reports

When a critically ill person has an infection, determining the right antibiotic and starting it right away is crucial. Yet culturing organisms and determining their sensitivity takes time, sometimes a couple of days. Now a new method developed by Pranita Tamma, an infectious disease expert, and colleagues at Johns Hopkins may be able to reduce that time period significantly.

Tamma: We used a technology called nanopore sequencing. Basically what it does is it measures the electrical current of the strand of DNA as it goes through these tiny pores called nanopores. In real time you can identify certain antibiotic resistance genes. By 14 hours we were able to detect accurately 92% of the time if resistance to specific antibiotics was present.  :26

Tamma says right now only one organism has been tested this way but predicts that as the technology is improved, the method will be expanded to test many more organisms for antibiotic resistance. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can a simple decision tool help reduce unnecessary antibiotic prescriptions? Elizabeth Tracey reports

Antibiotics are overused. That’s clear. Can a new decision tool calling for four points of decision developed by Pranita Tamma, an infectious disease expert at Johns Hopkins, and colleagues, help?

Tamma: It’s a very simple construct. It seems like common sense. But the hope would be that these four moments would become ingrained in medical practice as a way to make sure that we’re prescribing antibiotics when needed as best as we can, and avoiding them or stopping them when they’re no longer needed.  :16

Tamma says she hopes some version of the tool might help in the outpatient setting as well.

Tamma: Unfortunately I do think for several reasons, sometimes it’s not having that close follow up with patients or patients are traveling from far away, people sometimes feel more secure starting an antibiotic than not so we’re trying to figure out how to make this same simple message for the outpatient setting that makes more sense for the way the outpatient clinicians practice.  :20

Tamma notes that for now, patients can help by not insisting on an antibiotic prescription when it may not be needed. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What’s behind the recent measles outbreak? Elizabeth Tracey reports

In Washington state, a confirmed measles outbreak is underway. The reason an infectious disease that can be serious is once again gaining a foothold is because parents are opting to not immunize their children. Maria Trent, an adolescent medicine expert at Johns Hopkins, says that compromises the 90% rule that allows herd immunity, whereby the majority who are vaccinated protect those who can’t receive the vaccine.

Trent: If a lot of parents start to say I’m not going to immunize my child, then you lose the herd immunity effect. So unless you are allergic to a component of the vaccine, you should take your role in society, the public health component of it, very seriously. Because it protects those who can’t be vaccinated. We see measles in a lot of places like California where people are not willing to be immunized and then you see an outbreak, and that’s the kind of thing we experience when people don’t take their role in vaccinating their own child, for their own individual benefit, or their place in society very seriously.  :33

At Johns Hopkins, I’m Elizabeth Tracey.

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