Checking blood pressure at home pays off

Posted July 03, 2013, 2:57 pm

Do-it-yourselfers, take heart. Here’s something else to do at home that can have a substantial benefit on your health: measure your blood pressure. It’s easy, inexpensive, and helps control blood pressure better than visits to the doctor.

The latest evidence for the benefits of home blood pressure monitoring comes from researchers in Minnesota. They studied 450 people with hypertension, more commonly known as high blood pressure. All had blood pressures higher than deemed healthy—above 140/90, or above 130/80mmHg if they had diabetes or kidney disease.

About half of the volunteers were given home blood pressure monitors capable of electronically sending readings to a secure website. After being shown how to use their monitors, the volunteers were asked to send six readings each week. That information was assessed by pharmacists, who could adjust medications if needed and offer advice on lifestyle changes that could improve blood pressure. The other volunteers received usual care from their primary care providers.

At every step of the way, people in the home monitoring group had more success getting their blood pressure under control than people who had received only usual care. At the end of the trial, 72% of those doing home monitoring had their blood pressure under control, compared to 57% of the usual care group. The benefits persisted six months after the program had ended.

The results, published today in JAMA, are similar to the findings of previous studies on home blood pressure monitoring. But, according to the researchers, this is the first time people with both uncontrolled blood pressure and other conditions (such as diabetes) have been studied in such a program, and the first time results were measured after the formal monitoring program had ended.

“More frequent blood pressure monitoring allows more opportunities to detect blood pressure that is higher than the desired range. That may trigger more intensive treatment of elevated blood pressure,” says cardiologist Dr. Deepak Bhatt, a professor at Harvard Medical School. In other words, if you stay on top of it, you’ll do a better job of treating it.

An editorial accompanying the report said that the study “demonstrates how to improve blood pressure control by making hypertension management more like modern banking: accessible, easy, and convenient.”

The Centers for Disease Control and Prevention reports that 1 in 3 adults in the United States has high blood pressure, and half of them don’t have it under control. High blood pressure increases the risk for heart disease and stroke, the leading causes of death in the United States.

Even though the American Heart Association and other organizations have called for greater use of home blood pressure monitoring, it isn’t yet widespread. One reason is that insurance coverage for such programs still lags. Another is that full-fledged efforts like the one in Minnesota could cost $1,350 per person.

But you don’t need a special program. You can buy a good home blood pressure monitor at a pharmacy or online merchant for anywhere from $50 to $100. (Ask if your insurance company will cover the cost.) A few things to look for:

an automatic monitor that doesn’t require a stethoscope (it’s easier to use)a monitor that takes the blood pressure reading using a cuff that fits around the upper arm;a read-out large enough for you to see the numbers;a seal from an organization such as the British Hypertension Society, International Protocol for the Validation of Automated BP Measuring Devices, or Association for the Advancement of Medical Instrumentation (AAMI).

Ask your doctor, nurse, or pharmacist for help calibrating your monitor and learning how to use it.

How often should you check? At first, take your blood pressure twice a day for a week. The best times are early in the morning (before you have taken any blood pressure medications) and again in the evening. After you’ve done this for a week, once or twice a month—or whatever your doctor recommends—is fine.

“It can be a very effective way to see if blood pressure medications are doing the trick. It can also be useful to monitor for the side effect of blood pressure that is too low. Just remember that home monitoring should not be used as a substitute for regular physician check-ups, especially for patients with poorly controlled blood pressure,” says Dr. Bhatt.

Check out the video below to see the right, and wrong, ways to check blood pressure at home. And you can see more tips here.

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Pharmacist-Guided Home Blood Pressure Monitoring May Help Patients

Study found combination led to better control of hypertension

By Serena Gordon

HealthDay Reporter

TUESDAY, July 2 (HealthDay News) -- Using home blood pressure monitoring and partnering with a pharmacist for lifestyle advice and medication changes led to better control of hypertension, a new study shows.

After six months of the intervention, nearly 72 percent of the study volunteers had their high blood pressure under control compared to 45 percent in the group that received usual care. Also, the effects of the intervention persisted even after the intervention ended. Six months later, about 72 percent of the intervention group had their high blood pressure under control compared to 57 percent in the usual care group.

"The reason that only about half of people with [high] blood pressure have it under control is that usual care isn't working. We combined two interventions that we thought would be very powerful together -- home monitoring and pharmacist managements -- and this is one system that we've shown works very well for blood pressure control," said senior investigator Dr. Karen Margolis, from the HealthPartners Institute for Education and Research in Minneapolis.

The findings appear in the July 3 issue of the Journal of the American Medical Association.

High blood pressure affects about 30 percent of U.S. adults, according to background information in the study. Treating and controlling high blood pressure can help prevent cardiovascular events, such as heart attacks. However, only about half of the adults in the United States with high blood pressure have it under control.

Home blood pressure monitoring has shown some success in helping people lower their blood pressure, so the researchers took that a step further and used telemonitoring devices that could send blood pressure readings to a pharmacist who could then adjust that person's blood pressure medication accordingly.

The study included 450 people receiving care at one of eight different clinics. All of the people recruited for the study had high blood pressure that wasn't well controlled.

The patients were randomized to receive either usual care (222 people) or the study intervention, which included blood pressure telemonitoring with pharmacist management.

In the study intervention group, each person received a home blood pressure monitor capable of sending readings to a secure website that a pharmacist monitored. At the start of the study, patients met with the pharmacist for an hour and were taught how to use the machines. They were also given lifestyle advice on lowering their blood pressure.

People in the study intervention group were asked to send at least six blood pressure readings from different times of the day to the pharmacist each week. During the first six months of the study, patients and pharmacists talked by phone every two weeks, until blood pressure was under control for at least six weeks, and then they talked monthly. During months seven to 12 of the study, the calls were reduced to every two months. During the calls, pharmacists reviewed lifestyle changes and emphasized adherence to medications.

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Pain Reliever Lowers Blood Sugar in Type 2 Diabetics, Study Says

But side effects of aspirin-like drug warrant further study

By Serena Gordon

HealthDay Reporter

MONDAY, July 1 (HealthDay News) -- An aspirin-like drug appears to lower blood sugar in people with type 2 diabetes, according to new research.

A study of the drug -- the prescription pain reliever salsalate -- also found it reduced inflammation associated with type 2 diabetes. But it produced unwelcome side effects that could limit its potential as a diabetes treatment.

"This trial is a test of possibly the oldest drug in Western use, and, because it's so old, there are no clinical trials on it," said study senior author Dr. Steven Shoelson, a professor of medicine at Harvard Medical School in Boston.

"This trial was for a full year and showed that salsalate does lower blood glucose," said Shoelson, who is also the associate research director at the Joslin Diabetes Center in Boston.

The study, published in the July 2 issue of the Annals of Internal Medicine, included 286 people between 18 and 75 years old with type 2 diabetes. Type 2 diabetes occurs when the body no longer produces enough of the hormone insulin to convert carbohydrates from food into fuel for the body.

At the start of the study, the participants' average A1C levels -- a measure of blood sugar levels over several months -- were between 7 and 9.5 percent. The American Diabetes Association generally recommends a level of below 7 percent for adults.

The study volunteers were randomly assigned to 48 weeks of salsalate at a dose of 3.5 grams per day, or to an inactive placebo pill. No other changes were made to current diabetes, blood pressure or cholesterol medications during the first six months of the trial, the researchers noted.

Over 48 weeks, people taking the medication saw their A1C levels drop by 0.37 percent compared to placebo.

Shoelson said that people who have metabolic syndrome -- a group of risk factors (including type 2 diabetes) for cardiovascular disease -- often have higher than normal white blood cell counts, suggesting inflammation. In this study, people on salsalate saw a drop in their white blood cell counts, but Shoelson noted that they were "always well within the normal range."

Improvements were seen in several areas among those taking the drug, including: fasting blood sugar; uric acid, which is a chemical associated with gout; and levels of triglyceride, a type of blood fat. Levels of adiponectin -- a substance related to decreased insulin resistance -- and hematocrit, a measure of red blood cells, also improved for people taking salsalate.

Not all of the changes linked to the drug were beneficial, however. The medication appeared to cause a slight weight gain -- less than 3 pounds compared to those taking the placebo. Many type 2 diabetes medications have weight gain as a side effect, Shoelson said.

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Pricey New Blood Thinner Might Be Safer for Leg Clots

In trial, Eliquis worked as well as warfarin but with less risk of bleeding

By Brenda Goodman

HealthDay Reporter

MONDAY, July 1 (HealthDay News) -- The new pill Eliquis prevents dangerous blood clots in the legs and lungs as well as standard therapy, though with less risk of serious bleeding, a new study shows.

The research, published online July 1 in the New England Journal of Medicine, may point doctors toward a simpler, if more costly, way to prevent repeat blood clots in patients at risk for venous thromboembolism.

Venous thromboembolism includes two related conditions: deep vein thrombosis (DVT) and pulmonary embolism. Together, these conditions hospitalize more than 500,000 adults each year in the United States, according to the government's National Hospital Discharge Survey.

In DVT, a blood clot forms in the deep veins of the leg, causing swelling, redness, warmth and pain. If the blood clot breaks free, it can travel and lodge near the brain, heart or another vital organ, causing severe damage. If a clot blocks a blood vessel in the lungs, it's a life-threatening emergency called pulmonary embolism (PE). PEs are the third leading cause of cardiovascular death after heart attacks and strokes.

Blood clots in veins can happen without warning, but certain factors increase a person's risk including obesity, high blood pressure, long-distance travel, air pollution, cigarette smoking, pregnancy or recent surgery or injury.

Once a person has had one venous clot, they're more likely to get another, so doctors will often prescribe medication to lower the risk.

For years, the medication doctors relied on to prevent blood clots was a drug called warfarin, which is also sold under the brand name Coumadin.

Warfarin works well, but it's also tricky to take. Patients on the drug need regular blood tests -- these can be weekly at the start of treatment -- to make sure they're taking the right dose. And the dose can change from day to day or week to week. There are also a number of foods and drugs that can interact with warfarin, interfering with its effectiveness.

"It's really challenging for elderly patients to get it all right," said senior study author Dr. Jeffrey Weitz, a professor of medicine at McMaster University in Ontario, Canada.

In December, the U.S. Food and Drug Administration approved the drug Eliquis. Like warfarin, Eliquis prevents blood clots, but it works in a slightly different way than the older medication. It also doesn't require regular blood tests or changing dosages, making it much easier to manage.

One drawback of Eliquis is its price. Mail-order pharmacies charge between $250 and $275 for a 30-day supply of the medication in the United States, according to the website pharmacychecker.com. Warfarin, on the other hand, is $4 for a 30-day supply at stores like Target and Walmart. That means that one Eliquis pill costs about as much as an entire month's supply of warfarin.

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Cellphone Calls During Blood Pressure Readings May Skew Results

Interruption can cause spike in systolic pressure, study found

By Alan Mozes

HealthDay Reporter

WEDNESDAY, May 15 (HealthDay News) -- New Italian research offers some cautionary advice for patients with high blood pressure: The next time you take a blood pressure reading, turn off your cellphone.

The reason: Answering a cellphone call during a reading may cause a temporary but significant spike in blood pressure, rendering the results inaccurate and misleading.

"The cellular phone has burst into our everyday life, and is often an indispensable communication tool for business and social relations," said study author Dr. Giuseppe Crippa, head of the hypertension unit at Guglielmo da Saliceto Hospital in Piacenza, Italy. "[Now] we know that the radio-frequency field generated by mobile phones does not affect blood pressure, and should not increase blood pressure in subjects suffering from hypertension.

"But what is the effect of the noise generated by the phone ringing and of the intrusion into our life of an unscheduled phone conversation?" Crippa asked. "In our study, we have shown that blood pressure, particularly systolic blood pressure, increases quickly and significantly in this situation."

The study authors said one in three Americans (and 1 billion people worldwide) currently struggles with high blood pressure.

Those grappling with keeping their high blood pressure under control often are instructed to either come in for routine readings taken by a health care professional, or to use one of many at-home monitoring kits that give patients the option of taking their own readings on a regular basis.

To explore the question of how cellphones might affect such readings, the authors focused on 49 Italian women with an average age of 53, all of whom were taking medication to control high blood pressure.

After discussing their general cellphone usage habits, all underwent two sets of multiple blood pressure readings, each set registering six readings at one-minute intervals. All the readings took place in a physician's office, where patients were left alone (in what the researchers described as a "comfortable" setting) after the first reading.

During one of the two readings, an investigator disabled caller ID and anonymously called each patient's cellphone three times, with a patient's response to at least one of the calls being deemed sufficient for testing purposes.

The result: By comparing readings taken with and without incoming calls, the team found that patients' systolic numbers (the top figure in a blood pressure reading, indicating blood pressure as the heart contracts) went up "significantly" whenever the patients answered their phones.

Patients who had indicated relatively heavy routine cellphone usage (30 or more calls per day), however, experienced a less steep rise in their systolic numbers during incoming calls. Since heavy users tended to be younger, the team theorized that a greater cellphone comfort level among younger patients may protect them from the cellphone dynamic.

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Cellphone Calls During Blood Pressure Readings May Skew Results

By Alan Mozes
HealthDay Reporter

WEDNESDAY, May 15 (HealthDay News) -- New Italian research offers some cautionary advice for patients with high blood pressure: The next time you take a blood pressure reading, turn off your cellphone.

The reason: Answering a cellphone call during a reading may cause a temporary but significant spike in blood pressure, rendering the results inaccurate and misleading.

"The cellular phone has burst into our everyday life, and is often an indispensable communication tool for business and social relations," said study author Dr. Giuseppe Crippa, head of the hypertension unit at Guglielmo da Saliceto Hospital in Piacenza, Italy. "[Now] we know that the radio-frequency field generated by mobile phones does not affect blood pressure, and should not increase blood pressure in subjects suffering from hypertension.

"But what is the effect of the noise generated by the phone ringing and of the intrusion into our life of an unscheduled phone conversation?" Crippa asked. "In our study, we have shown that blood pressure, particularly systolic blood pressure, increases quickly and significantly in this situation."

The study authors said one in three Americans (and 1 billion people worldwide) currently struggles with high blood pressure.

Those grappling with keeping their high blood pressure under control often are instructed to either come in for routine readings taken by a health care professional, or to use one of many at-home monitoring kits that give patients the option of taking their own readings on a regular basis.

To explore the question of how cellphones might affect such readings, the authors focused on 49 Italian women with an average age of 53, all of whom were taking medication to control high blood pressure.

After discussing their general cellphone usage habits, all underwent two sets of multiple blood pressure readings, each set registering six readings at one-minute intervals. All the readings took place in a physician's office, where patients were left alone (in what the researchers described as a "comfortable" setting) after the first reading.

During one of the two readings, an investigator disabled caller ID and anonymously called each patient's cellphone three times, with a patient's response to at least one of the calls being deemed sufficient for testing purposes.

The result: By comparing readings taken with and without incoming calls, the team found that patients' systolic numbers (the top figure in a blood pressure reading, indicating blood pressure as the heart contracts) went up "significantly" whenever the patients answered their phones.

Patients who had indicated relatively heavy routine cellphone usage (30 or more calls per day), however, experienced a less steep rise in their systolic numbers during incoming calls. Since heavy users tended to be younger, the team theorized that a greater cellphone comfort level among younger patients may protect them from the cellphone dynamic.

Incoming calls had no impact on patients' diastolic numbers (the bottom figure in a reading, indicating blood pressure while the heart is at rest), nor did patients' overall heart rates shift when the cellphone rang.

The team concluded that patients should be advised to turn off their cellphones whenever and wherever they have a blood pressure reading, to ensure accuracy.

"It is noteworthy that the great majority of the patients recruited for this survey were not used to turning off the mobile phone, even during a medical examination, and easily answered the calls even when an automated device was measuring blood pressure," Crippa said.

"Therefore, we believe that it is important to advise patients that the unnecessary and exaggerated use of cellphones can increase, at least temporarily, their blood pressure," he said.

Dr. Gary Schwartz, a professor of medicine at the Mayo Clinic College of Medicine in Rochester, Minn., said the issue is not the disturbance of a cellphone call, but rather any disturbance in general.

"I wouldn't look at this study and say cellphones are bad for you," Schwartz said. "But American Heart Association standards call for the need to be quiet, whether you're getting your blood pressure measured at a doctor's office or at home.

"Just engaging in conversation, whether or not it's on the phone, can raise the numbers and give an inaccurate reading," he said. "It's the same principle behind why we don't measure a person's blood pressure while they're playing tennis. What we want is for patients to be quiet and at rest."

Crippa and his colleagues are scheduled to present their findings Wednesday at the American Society of Hypertension annual meeting in San Francisco. Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Giuseppe Crippa, M.D., head, hypertension unit, Guglielmo da Saliceto Hospital, Piacenza, Italy; Gary Schwartz, M.D., professor, medicine, Mayo Clinic College of Medicine, Rochester, Minn.; May 15, 2013, presentation, American Society of Hypertension annual meeting, San Francisco

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Yoga May Help Ease High Blood Pressure, Study Finds

Numbers were lowered when people engaged in a few sessions per week

By Robert Preidt

HealthDay Reporter

WEDNESDAY, May 15 (HealthDay News) -- People who follow the ancient practice of yoga may be getting an added health boost, with a new study suggesting it can fight high blood pressure -- also known as hypertension.

"This study confirms many people's feelings that exercise may be useful in the control of hypertension," said Dr. Howard Weintraub, a cardiologist and associate professor of medicine at NYU Langone Medical Center in New York City. Weintraub was not connected to the new study.

Based on the new findings, "yoga would be a useful adjunct in the lowering of blood pressure in certain populations," he said.

In the study, researchers led by Dr. Debbie Cohen of the University of Pennsylvania tracked 58 women and men, aged 38 to 62, for six months.

Although the study couldn't prove a cause-and-effect relationship, doing yoga two to three times a week was associated with an average drop in blood pressure readings from 133/80 to 130/77, the researchers said.

In comparison, the average decrease in blood pressure was smaller (134/83 to 132/82) among people who ate a special diet but did not do yoga.

In a bit of a surprise, doing yoga in tandem with a special diet did not outperform doing yoga alone -- blood pressure numbers fell only slightly (135/83 to 134/81) among people who ate a special diet and also did yoga, the researchers said.

The small decline in blood pressure among people who ate a special diet and did yoga may be because doing both required a greater amount of time, making it more difficult for participants to stick with their regimens, the authors said.

Weintraub said the study shows that "yoga can have a favorable effect" on hypertension. Although the amount of change was small, he said, "some large population studies have suggested that changes of this magnitude could have very significant long-term benefits."

The study did have some limitations, including its relatively short length and the fact that most participants were young and had milder forms of high blood pressure, Weintraub said.

Another expert agreed that the ancient Indian practice of yoga might ease hypertension.

"Yoga, along with deep breathing exercises, meditation and inner reflection, is a good adjunctive and integrative cardiovascular approach to better health, including lowering blood pressure, as this data suggests," said Dr. David Friedman, chief of Heart Failure Services at the North Shore-LIJ Plainview Hospital, in Plainview, N.Y.

"In addition to proper diet and aerobic physical fitness most days of the week, I recommend that my patients take time each day for the above measures of finding disciplined inner peace, for improved health and well-being," he said.

The findings were presented Wednesday at the annual scientific meeting of the American Society of Hypertension, in San Francisco. Findings presented at medical meetings typically are considered preliminary until published in a peer-reviewed journal.

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Can I lower my blood pressure without taking medication?

Posted June 28, 2013, 2:00 am

My blood pressure medication has side effects that are difficult to tolerate. What else can I do to lower my BP?

If you’re a regular reader of this column, you’ve heard me say more than once that diet and exercise sometimes can eliminate the need for medications for a variety of conditions. That’s true — and it surely is true for high blood pressure.

However, sometimes diet, exercise and stress management lower blood pressure only part of the way. Medications may still be necessary. Every medicine ever invented can cause side effects in some people. But the other side of that coin is that medicines often do not cause side effects. And just because one medicine causes side effects does not mean that another will.

Fortunately, there are many different medicines to treat high blood pressure. In my experience, you can usually find a blood pressure medication that is both effective and free of side effects. But even when that’s true, it’s still important to get back to basics: a healthy lifestyle.

A healthy lifestyle is the cornerstone for preventing and treating hypertension. It may allow you to lower your medication dose or stop taking medication altogether. At the very least, you’ll feel better:

First and foremost, if you smoke, quit. Your blood pressure will start to decrease within hours after your last cigarette. Your doctor can recommend resources to help you quit.Another important step is to reach and maintain a healthy body weight. Being overweight or obese itself raises your blood pressure.Even if you don’t need to lose weight, eating the right foods can make a difference. The key features of a blood-pressure-friendly diet include plenty of fruits, vegetables and whole grains; several servings daily of low-fat dairy products; some fish, poultry, dried beans, nuts and seeds; and minimal red meat, sweets and sugar-laden beverages. Also try to limit your sodium intake to less than 1.5 grams of sodium per day. You can find the sodium content of prepared foods on the Nutrition Facts label.Limiting alcohol can help. Have no more than two drinks per day if you’re male, or one drink per day if you’re female. That’s drinking in moderation. Drinking in moderation may even help lower blood pressure, while drinking more can definitely raise blood pressure.Regular exercise lowers high blood pressure. Aim for at least 30 minutes of moderate-intensity exercise on all or most days of the week. Examples include walking or riding a stationary bike. Regular exercise is a potent tonic for lowering your blood pressure — even if you don’t lose weight.Finally, relax. Ongoing stress raises your blood pressure. Learn relaxation techniques, such as meditation, progressive muscle relaxation, deep breathing or yoga. I have a patient who took up tai chi several years ago and does it daily. I can’t prove there’s a connection, but I can tell you that her blood pressure has never been so low, and she says she feels great. window.fbAsyncInit = function() { FB.init({appId: "199616670120169", status: true, cookie: true, xfbml: true});}; (function() { var e = document.createElement("script"); e.async = true; e.src = document.location.protocol + "//connect.facebook.net/en_US/all.js"; document.getElementById("fb-root").appendChild(e);}());

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Gene-Based Blood Test for Colon Cancer Shows Promise

Early trial supports accuracy of the screening, which could be a boon in preventing the disease

By Robert Preidt

HealthDay Reporter

WEDNESDAY, June 19 (HealthDay News) -- Could screening for colon cancer someday be as easy as having a blood test? Researchers say just such a test is showing early promise in trials.

The screening checks for levels of miR-21 -- a piece of DNA known as microRNA. Researchers in the gastrointestinal cancer research lab at the Baylor Research Institute in Dallas studied several hundred patients with either colorectal polyps (noncancerous growths that often precede cancer) or full-blown cancer.

They found that measuring levels of miR-21 in the blood accurately spotted up to 92 percent of patients with colorectal cancer.

The test also accurately identified up to 82 percent of patients with advanced colorectal polyps -- growths that put people at high risk of developing colorectal cancer.

The study was published June 19 in the Journal of the National Cancer Institute.

"This blood-based test could be transformative in how we screen patients for colorectal cancer; it would save lives and could result in major savings of health care dollars," Dr. Michael Ramsay, president of Baylor Research Institute, said in an institute news release.

Other experts were cautiously optimistic.

"These results are very promising for the future of cancer screening and treatment," said Dr. Jerald Wishner, director of colorectal surgery at Northern Westchester Hospital in Mount Kisco, N.Y.

"Colonoscopy screening is the current gold standard to detect colon cancer. However, less than 50 percent of Americans who should be screened get screened," Wishner said. "The blood test is a less invasive screening method that will eliminate barriers to colonoscopies, including embarrassment and possible discomfort in preparation for the test."

Dr. David Robbins, associate chief of endoscopy at Lenox Hill Hospital in New York City, agreed that it is "only a matter of time before we can screen for the most common, and most lethal, cancers using a simple blood test."

"This well-designed study brings us one step closer to the holy grail of colon cancer eradication by identifying those at high risk for developing colon cancer by measuring a pretty straightforward genetic signature," Robbins said.

According to the American Cancer Society, colon cancer is the second leading cancer killer, after lung cancer. More than 102,000 new cases of the disease will be diagnosed among Americans this year, and almost 51,000 people will die from the disease in 2013.

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Health Tip: Lower Your Blood Pressure

(HealthDay News) -- High blood pressure increases a person's risk for heart attack, stroke, kidney disease and congestive heart failure.

The U.S. Centers for Disease Control and Prevention offers this advice for people whose pressure is too high:

Cut back on salt in your diet, and increase consumption of fruits and vegetables.Get plenty of regular exercise.Lose weight if you're overweight or obese.Don't smoke, and limit alcohol intake.Take any prescribed blood pressure medication as directed. Talk to your doctor if you have side effects from any medication.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

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Blood Test Might Predict Type 1 Diabetes in Children, Study Finds

Evidence of two autoantibodies signaled a 70 percent risk, researchers say

By Serena Gordon

HealthDay Reporter

TUESDAY, June 18 (HealthDay News) -- A diagnosis of type 1 diabetes often seems to come out of the blue. But German researchers say they can predict who will likely develop the chronic disease.

Blood samples taken from children at increased genetic risk of type 1 diabetes reveal significant "preclinical" clues, the researchers found. The strongest predictor is the presence of two diabetes-related autoantibodies, they reported in the June 18 issue of the Journal of the American Medical Association.

"If you have two or more autoantibodies, it's nearly inevitable that you will develop the disease. Most people -- even physicians -- don't appreciate this risk," said Dr. Jay Skyler, deputy director for clinical research at the Diabetes Research Institute and a professor at the University of Miami Miller School of Medicine. Skyler was not involved in the research.

Nearly 70 percent of youngsters with two diabetes-related autoantibodies developed type 1 diabetes over a 10-year period compared to less than 15 percent of kids with just one autoantibody, the researchers found.

Skyler, co-author of an accompanying journal editorial, said this study highlights the need for effective prevention strategies for type 1 diabetes.

Type 1 diabetes is believed to be an autoimmune disease in which the body's immune system mistakenly destroys the insulin-producing beta cells in the pancreas. Insulin is a hormone needed to turn the carbohydrates from food into fuel for the body.

To survive, people with type 1 diabetes must monitor their food intake and replace the lost insulin through injections or an insulin pump.

Type 1 diabetes can occur at any age, and there's currently no known way to prevent or cure it, according to the JDRF (formerly the Juvenile Diabetes Research Association). And unlike its more common counterpart, type 2 diabetes, the development of type 1 diabetes isn't linked to lifestyle choices.

The current study included children from Colorado, Finland and Germany who were followed from birth for as long as 15 years. Children in the Colorado and Finland study groups were included in the study if they had a specific genotype that indicated a genetic predisposition to developing type 1 diabetes. Children in the German study had to have a parent with type 1 diabetes to be included in the study.

More than 13,000 youngsters were recruited in all. During the study follow-up, the researchers found that nearly 1,100 children -- or about 8 percent of the total group -- developed one or more autoantibodies, which are markers for the destruction of the insulin-producing beta cells in the pancreas.

The vast majority of the children, despite their higher risk, remained free of type 1 diabetes and free of signs that the disease might develop.

"Autoantibodies are a marker for the risk of diabetes. [But] they are just markers; they are not causing the disease," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

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Blood Tests May Predict COPD Flare-Ups

Signs of chronic inflammation in the blood linked to faster deterioration of lung function

By Brenda Goodman

HealthDay Reporter

TUESDAY, June 11 (HealthDay News) -- People with chronic obstructive pulmonary disease (COPD) who have signs of chronic inflammation in their blood are more likely to have flare-ups of the lung disease than those who do not, a large new study shows.

In addition to the slow, steady deterioration in lung function caused by COPD, patients can have sudden, distressing flare-ups. These so-called "exacerbations" are periods of worsening breathing problems that are typically triggered by infections or air pollution.

Patients who experience frequent flare-ups decline more quickly than those who do not; they also tend to have worse quality of life and poorer survival rates than those whose conditions are more stable, according to background information in the study.

Preventing flare-ups is a major goal of COPD treatment, but these episodes can be difficult to predict.

In a study of more than 61,000 people in Denmark, researchers found that COPD patients who had increased levels of certain proteins and cells in their blood were at greater risk for frequent flare-ups.

These particular proteins and cells -- C-reactive protein, fibrinogen and leukocytes -- increase in response to infections, tissue damage and inflammation.

People with higher levels of all three of these "markers" were more likely to experience frequent flare-ups than those with normal levels. That was true regardless of the stage or severity of their COPD.

But the risk was especially pronounced for patients in the study with the worst breathing problems. Among patients who had the highest grade of COPD symptoms, 24 percent with no elevated markers had frequent flare-ups compared to 62 percent of those who had high levels of all three markers.

Patients with frequent exacerbations had two or more flare-ups each year they were followed for the study.

The study is published in the June 12 issue of the Journal of the American Medical Association.

According to Dr. Elizabeth Regan, who is studying the genetics of COPD at National Jewish Health in Denver, the researchers "give compelling evidence that those are useful tests." Regan was not involved with the study.

"These are tests that are readily available. The practicing physician kind of has them at their fingertips. They're not unusual, they're not high-risk," said Regan. "If I were seeing patients, I'd be strongly attracted to doing it."

The price of each test varies, but in general, they're inexpensive, ranging between $10 and $40. Insurance often covers the cost. The only trouble with doing the tests now, Regan said, is that doctors still don't know exactly how to use the information.

"While these tests look like they're strong predictors, we don't have the next piece of this clearly in place," she noted.

The study wasn't able to prove that inflammation causes COPD exacerbations, or that lowering inflammation with medications could head off future flare-ups, Regan explained.

Other studies currently underway are testing whether antibiotics or newer medications can prevent such attacks, she noted.

Until more is known, the researchers say there is still one good reason for COPD patients to get the blood tests.

"Many patients with COPD aren't very adherent to their inhalation medication. Patients don't like to be sick, so they think 'it's doing well now, so let me stop,'" said study author Dr. Borge Nordestgaard, a clinical professor in the department of diagnostic sciences at the University of Copenhagen in Denmark.

"But if you're one of these patients with high biomarkers, then you should be even better at taking your daily inhalation medication," he said. "That's the best advice at present."

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Study: Low Blood Pressure May Weaken Brains of Some Heart Patients

Pressure that's too low -- or too high -- might damage brain cells, new research suggests

By Steven Reinberg

HealthDay Reporter

MONDAY, June 10 (HealthDay News) -- People suffering from cardiovascular disease who have lower-than-normal blood pressure may face a higher risk of brain atrophy -- the death of brain cells or connections between brain cells, Dutch researchers report.

Such brain atrophy can lead to Alzheimer's disease or dementia in these patients. In contrast, similar patients with high blood pressure can slow brain atrophy by lowering their blood pressure, the researchers added.

Blood pressure is measured using two readings. The top number, called systolic pressure, gauges the pressure of blood moving through arteries. The bottom number, called diastolic pressure, measures the pressure in the arteries between heartbeats. Normal blood pressure for adults is less than 120/80, according to the U.S. National Heart, Lung, and Blood Institute.

For the study, 70 to 90 was considered normal diastolic blood pressure, while under 70 was considered low.

"Our data might suggest that patients with cardiovascular disease represent a subgroup within the general population in whom low diastolic blood pressure might be harmful," said researcher Dr. Majon Muller, an epidemiologist and geriatrician at VU University Medical Center in Amsterdam.

On the other hand, lowering blood pressure in people with high blood pressure might slow brain atrophy, she said.

"Our findings could imply that blood pressure lowering is beneficial in patients with higher blood pressure levels, but one should be cautious with further blood pressure lowering in patients who already have low diastolic blood pressure," Muller added.

The report was published in the June 10 online edition of JAMA Neurology.

A U.S. expert noted the complex effects of blood pressure levels on the brain.

"High blood pressure has been shown to increase the risk of vascular brain lesions and brain atrophy. Trials of blood pressure lowering in patients with hypertension have shown reduced risk of brain lesions," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, and a spokesman for the American Heart Association.

However, in patients with hypertension, the relationship between the levels of systolic and diastolic blood pressure and brain atrophy has been less clear, he said.

This new study suggests that low diastolic blood pressure levels were associated with brain atrophy regardless of blood pressure levels after patients developed dementia, Fonarow said.

"These findings suggest that while treatment and control of high blood pressure is very important for brain and cardiovascular health, caution is needed in patients who have low diastolic blood pressure levels," he said.

To see what changes blood pressure would make in the progression of brain atrophy, Muller's group studied 663 patients who suffered from heart disease, cardiovascular disease, peripheral artery disease or abdominal aortic aneurysm. The average age of participants was 57 and most were men.

People whose diastolic blood pressure was below 70 had more brain atrophy over time, the study found. For people with higher-than-normal blood pressure, brain atrophy decreased when their blood pressure did. When blood pressure rose, however, atrophy increased.

Another expert, Dr. Sam Gandy, associate director of the Mount Sinai Alzheimer's Disease Research Center in New York City, said that the finding "is an important cautionary tale."

"This implies that one must adapt the approach to the individual patient. Correction of hypertension is helpful, but reducing blood pressure in patients with normal blood pressure is risky and complicated," Gandy said.

Although the study found an association between low diastolic blood pressure and the risk of developing brain atrophy for people with artery disease, it did not establish a cause-and-effect relationship.

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Low Blood Sugar May Raise Dementia Risk in Diabetics: Study

Overly aggressive glucose control might backfire in older patients, findings suggest

By Steven Reinberg

HealthDay Reporter

MONDAY, June 10 (HealthDay News) -- Low blood sugar in older adults with type 2 diabetes may increase their risk of dementia, a new study suggests.

While it's important for diabetics to control blood sugar levels, that control "shouldn't be so aggressive that you get hypoglycemia," said study author Dr. Kristine Yaffe, a professor of psychiatry, neurology and epidemiology at the University of California, San Francisco.

The study of nearly 800 people, published online June 10 in JAMA Internal Medicine, found that people with episodes of significant hypoglycemia -- low blood sugar -- had twice the chance of developing dementia, Yaffe said. Conversely, "if you had dementia you were also at a greater risk of getting hypoglycemic, compared with people with diabetes who didn't have dementia," she said.

People with type 2 diabetes, by far the most common form of the disease, either don't make or don't properly use the hormone insulin. Without insulin, which the body needs to convert food into fuel, blood sugar rises to dangerously high levels. Over time, this leads to serious health problems, which is why diabetes treatment focuses on lowering blood sugar. But sometimes blood sugar drops to abnormally low levels, which is known as hypoglycemia.

Exactly why hypoglycemia may increase the risk for dementia isn't known, Yaffe said. Hypoglycemia may reduce the brain's supply of sugar to a point that causes some brain damage, Yaffe said. "That's the most likely explanation," she added.

Moreover, someone with diabetes who has thinking and memory problems is at particularly high risk of developing hypoglycemia, she said, possibly because they can't manage their medications well or perhaps because the brain isn't able to monitor sugar levels.

Whether preventing diabetes in the first place reduces the risk for dementia isn't clear, although it's a "very hot area" of research, Yaffe said.

But the findings do suggest that patients' mental status needs to be considered in the management of diabetes, Yaffe said.

Other experts agreed.

"This does raise concern about low blood sugar causing future problems with dementia and dementia causing problems with low blood sugar," said Dr. Stuart Weinerman, an endocrinologist at North Shore-LIJ in Great Neck, N.Y.

Weinerman isn't convinced that the association between hypoglycemia and dementia is cause-and-effect, however. "This is not a definitive study. It raises questions, but it doesn't answer them," he added.

But hypoglycemia is a serious problem for diabetics, Weinerman said. "Sooner or later, everyone is going to have some hypoglycemia," he said.

Episodes of hypoglycemia increase with age, perhaps because of changes in kidney function and drug metabolism, according to an accompanying journal commentary.

Anyone taking drugs that lower blood sugar should be aware of the signs of hypoglycemia, and be prepared to deal with it, Weinerman said. Symptoms can include confusion, jitteriness, fainting, heart palpitations and blurred vision.

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How do blood pressure drugs work and how can I find the one that’s right for me?

Posted June 10, 2013, 2:00 am

How do blood pressure drugs work? And how will my doctor know which one is right for me?

There are many different drugs for blood pressure and they work in different ways. Finding which one will work best for you may involve a process of trial-and-error. But in the end, you’ll be rewarded with a medication that offers the best blood pressure control with the fewest side effects.

If you have other health conditions — diabetes and heart disease often accompany hypertension, for instance — certain drugs can lower blood pressure while also helping to treat these conditions.

I’ll briefly summarize the different classes of blood pressure drugs and how they work. I won’t go into the potential side effects of these drugs here, but you should discuss them with your doctor. (I’ve put tables with examples of the different types of drugs at the end of this post.)

Diuretics, or “water pills,” help the kidneys eliminate sodium and water from the body. This decreases blood volume, so the heart has less to pump with each beat. Of all the blood pressure drugs used today, diuretics have been around the longest and their beneficial effects are solidly proven.ACE inhibitors decrease blood volume by preventing the kidneys from retaining sodium and water. They do this by deactivating angiotensin-converting enzyme (ACE). ACE is a natural chemical (an enzyme) that converts another natural chemical, angiotensin I, to the chemical called angiotensin II. Angiotensin I is inactive, but angiotensin II raises blood pressure. So reducing the amount of angiotensin II by reducing ACE, the enzyme that makes angiotensin II, helps lower blood pressure.Angiotensin-receptor blockers (ARBs) block the blood pressure-raising effects of angiotensin II. So, the ACE inhibitors reduce the amount of angiotensin II the body makes, and the ARBs reduce the blood pressure-raising effect of angiotensin II.Calcium-channel blockers slow the movement of calcium into the smooth-muscle cells that are in the heart and the walls of the blood vessels. This makes heart muscle pump less forcefully (but still forcefully enough), which reduces blood pressure. Calcium-channel blockers also relax the muscle in the blood vessel walls, which makes blood vessels open wider, lowering blood pressure.Anti-adrenergics limit the action of the hormones epinephrine and norepinephrine. This relaxes the blood vessels and reduces the speed and force of the heart’s contractions.Direct-acting vasodilators relax the arteries. They act quickly and are often used in emergencies.Direct renin inhibitors inhibit the activity of renin, the enzyme largely responsible for angiotensin II levels. Aliskiren (Tekturna) is a renin inhibitor.

There really is no “best” blood pressure medication. The goal is to find the right medication for you. Often, more than one type of medicine used in combination proves the best. That means finding the medicine or medicine combo that effectively lowers your blood pressure while not causing side effects — and not costing more than you can afford.

Weakness, confusion, potassium depletion, gout, fatigue, thirst, frequent urination, lightheadedness, muscle cramps, diarrhea or constipation, increased sensitivity to sunlight, allergic reaction in people allergic to sulfa drugs, impotence.Esidrix, HydroDiuril, MicrozideWeakness, confusion, potassium depletion, gout, fatigue, thirst, diarrhea or constipation, increased sensitivity to sunlight, allergic reaction in people allergic to sulfa drugs, impotence.Potassium-sparing diuretics/aldosterone-receptor blockers*Excessive potassium levels, especially in patients with kidney disease; breast enlargement and erectile dysfunction in men; menstrual irregularities in women.Headache, dizziness, diarrhea, fatigue, upset stomach, and breast enlargement or tenderness.*Note: Potassium-sparing diuretics also directly or indirectly block aldosterone, a hormone that raises blood pressure by causing the kidneys to conserve sodium and water. As a result, these four medications are sometimes also known as aldosterone-receptor blockers. Amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium) also affect other hormones and thus carry some unwanted side effects, such as breast enlargement and impotence in men and menstrual irregularities in women.Beta blockers (cardioselective)acebutolol (Sectral)atenolol (Tenormin)betaxolol (Kerlone)bisoprolol (Zebeta)metoprolol (Lopressor)metoprolol extended release (Toprol-XL)nebivolol (Bystolic)penbutolol (Levatol)Wheezing, dizziness, depression, impotence, fatigue, insomnia, decreased HDL cholesterol levels, lower exercise tolerance. Can worsen peripheral vascular disease and heart failure. Abrupt withdrawal may trigger angina or a heart attack in patients with heart disease.nadolol (Corgard)pindolol (Visken)propranolol (Inderal, Inderal LA)sotalol (Betapace)timolol (Blocadren)doxazosin (Cardura)prazosin (Minipress)terazosin (Hytrin)A drop in blood pressure upon standing up, fainting, weakness, heart palpitations, headache, nasal congestion, dry mouth.carvedilol (Coreg)labetalol (Normodyne, Trandate)Wheezing, depression, insomnia, diarrhea, lightheadedness, dizziness, unusual tiredness or weakness, drying of the eyes, erectile dysfunction, headache, dry mouth, nasal congestion, decreased HDL cholesterol levels, lower exercise tolerance, a drop in blood pressure upon standing up, fainting, heart palpitations. Can worsen peripheral vascular disease and heart failure. Abrupt withdrawal may trigger angina or a heart attack in patients with heart disease.clonidine (Catapres, Catapres-TTS)methyldopa (Aldomet)A drop in blood pressure upon standing up, drowsiness, sedation, dry mouth, fatigue, erectile dysfunction, depression, dizziness. Catapres-TTS (a patch) may cause a rash.Peripheral nerve–acting agentsguanethidine (Ismelin)reserpine (Serpalan)A drop in blood pressure upon standing up, depression, nasal stuffiness, nightmares. Guanethidine may slow heart rate, and reserpine may cause indigestion. Headaches, palpitations, weakness, flushing, nausea. Minoxidil may cause hair growth, fluid retention, and increased blood sugar.Headache, dizziness, edema, and heartburn. Nifedipine can cause palpitations. Diltiazem and verapamil can cause constipation and a slowed heartbeat.Cough, rash, fluid retention, high potassium levels, and loss of taste. May cause low blood pressure and fainting. Can worsen kidney impairment if narrowed arteries feed both kidneys. May cause spontaneous abortion. window.fbAsyncInit = function() { FB.init({appId: "199616670120169", status: true, cookie: true, xfbml: true});}; (function() { var e = document.createElement("script"); e.async = true; e.src = document.location.protocol + "//connect.facebook.net/en_US/all.js"; document.getElementById("fb-root").appendChild(e);}());

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Despite Big Progress, Many Kids Have High Lead Levels in Blood

Title: Despite Big Progress, Many Kids Have High Lead Levels in Blood
Category: Health News
Created: 4/4/2013 2:35:00 PM
Last Editorial Review: 4/5/2013 12:00:00 AM

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Study Pinpoints Women at Risk for Blood Clots From Pregnancy

Factors include age, disease history and weight

By Robert Preidt

HealthDay Reporter

TUESDAY, April 2 (HealthDay News) -- Several factors that increase the risk of blood clots in women during or after pregnancy are outlined in a large new study.

Women who were older than 35, who were overweight or obese, or who smoked were at somewhat higher risk of developing blood clots during pregnancy. Medical complications such as pre-existing diabetes, varicose veins and inflammatory bowel disease were also associated with increased risk.

The findings could help doctors identify at-risk women and take measures to prevent them from developing blood clots, which can be dangerous and potentially deadly if they break free and travel to areas such as the heart, brain or lungs.

For the study, researchers analyzed data from nearly 400,000 pregnancies that occurred between 1995 and 2009.

Among new mothers, being obese was associated with a fourfold increased risk of developing a blood clot. The risk was two times higher than normal among those who had a cesarean delivery, a premature birth, bleeding in pregnancy or had given birth three or more times, according to the study, which appeared April 2 in the journal Blood.

Women who had a stillbirth were six times more likely to develop a blood clot, formally known as venous thromboembolism (VTE).

"We believe the strong association between stillbirths and premature births and [blood clots] in particular is a finding of real importance that has received only limited attention to date," study leader Dr. Matthew Grainge, of the School of Community Health Sciences at the University of Nottingham, in England, said in a university news release. "[Stillbirths and premature births] are not currently incorporated in the guidelines for risk assessment for [blood clots] and, if they were, then many cases associated with those risk factors could potentially be prevented."

Blood clots affect about one or two pregnancies per 1,000, according to the news release. Despite being rare, blood clots are a leading cause of death in expectant and new mothers in developing countries.

"Preventative measures for [blood clots], such as a daily dose of the blood thinner heparin, may not be cost effective or safe and are therefore only recommended for women who are considered high risk," Grainge said. "However, there is currently inconsistency and disagreement over the factors that put women in that high-risk category, and we hope this research will provide clinicians with valuable new information."

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Aspirin Equals Pricier Blood Thinner for Preventing Clots: Study

After hip replacement, no disadvantage found for the low-cost treatment

By Serena Gordon

HealthDay Reporter

TUESDAY, June 4 (HealthDay News) -- Aspirin appears to be just as good as more expensive, more potent blood-thinning medication for preventing blood clots after hip replacement surgery, according to new research.

People who get artificial hips are at risk of serious blood clots, such as deep vein thrombosis and pulmonary embolism, after the surgery. To prevent them, doctors usually prescribe blood-thinning (anticoagulant) medications, such as low-molecular-weight heparin, which is given by injection, or the newer drug, rivaroxaban (brand name Xarelto), a pill.

But that old medicine-cabinet standby, aspirin, also has blood-thinning properties. And the Canadian researchers wondered if this simple, inexpensive drug could also prevent blood clots after a major surgery.

They compared the drugs for four weeks, following 10 days of treatment with heparin immediately post-surgery.

The investigators found the two medications were similarly effective and safe. Where the medicines differ significantly is in cost.

"Low-molecular-weight heparin and the newer blood thinner, Xarelto, are similarly priced; they're several hundred-fold more expensive than aspirin," said the study's lead author, Dr. David Anderson, a professor and head of the department of medicine at Dalhousie University in Halifax, Nova Scotia.

"Given the low cost of aspirin and its convenience, it's a reasonable alternative to low-molecular-weight heparin when used in the manner designed in this trial," said Anderson.

Another expert said the study results, published in the June 4 issue of the Annals of Internal Medicine, support previous observations. "After initial treatment with an anticoagulant, then giving aspirin to these patients for the prevention of [serious blood clots] is as good," said Jawed Fareed, professor of pharmacology and pathology and director of the hemostasis and thrombosis research unit at Loyola University Medical Center in Maywood, Ill.

For the study, Anderson and his colleagues recruited 778 patients undergoing elective hip replacement surgery between 2007 and 2010. All received 10 days of heparin (dalteparin) following surgery. After that, they were randomized into one of two groups for four more weeks of blood-thinning therapy. Half continued receiving heparin injections, while the other half took low-dose (81 milligrams) aspirin daily.

Five people on dalteparin and one on aspirin developed a blood clot. The absolute difference between the two therapies was 1 percent. Bleeding events serious enough to require treatment occurred in five people on dalteparin, and two on aspirin.

Anderson said the difference in bleeding events wasn't statistically significant, but there was a trend toward aspirin being the safer alternative. However, it's too soon to tell definitively whether aspirin might cause less bleeding, he said.

Anderson said the researchers had to stop the study early because they weren't able to recruit the desired number of patients. While the study was under way, Xarelto was approved, and because it's a pill instead of an injectable like dalteparin (brand name Fragmin), it became difficult to find volunteers for the multiple injection part of the trial.

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Blood Test Might Spot Pancreatic Cancer Early, Study Finds

Title: Blood Test Might Spot Pancreatic Cancer Early, Study Finds
Category: Health News
Created: 3/29/2013 10:35:00 AM
Last Editorial Review: 3/29/2013 12:00:00 AM

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Blood Test Might Spot Pancreatic Cancer Early, Study Finds

But not early enough to make a big difference in survival rates, an expert says

By Steven Reinberg

HealthDay Reporter

FRIDAY, March 29 (HealthDay News) -- A new blood test that detects deadly pancreatic cancer earlier than usual might slightly improve patients' odds for survival, a small Japanese study suggests.

"This new diagnostic test may be a safe and easy screening method that could improve the prognosis of patients with pancreatic cancer through earlier detection," said lead researcher Dr. Masaru Yoshida, an associate professor in the division of metabolomics research at Kobe University Graduate School of Medicine. "A drop of blood contains a lot of information."

Currently, the 5-year survival rate for pancreatic cancer is less than 5 percent, largely because the cancer usually has spread by the time it is detected.

The new approach relies on metabolomics technology, an emerging science that focuses on small molecules. The blood test measures byproducts of metabolism, called metabolites, found in the blood.

By looking for differences between the levels of metabolites in patients with and without pancreatic cancer, the researchers are able to identify those with cancer.

Finding pancreatic cancer earlier means more patients can have the tumor removed and live longer than most patients do now, Yoshida noted.

"Conventional tests using blood or imaging are not appropriate for pancreatic cancer screening and early detection, so new screening and diagnostic methods for pancreatic cancer are urgently required," Yoshida said.

Currently, in more than 80 percent of cases of pancreatic cancer, the cancer has metastasized, or spread, making it inoperable, he explained.

One expert doesn't think this test is a breakthrough.

"It's an improvement, but not a breakthrough," said Dr. James D'Olimpio, director of supportive oncology at North Shore-LIJ Cancer Institute in Lake Success, N.Y.

"The problem is it's not early enough," he said.

Even if the cancerous tumor can be removed, it's usually too late, he said. By the time the cancer is detected, even in the early stage suggested by their test, the cancer has most likely spread beyond the pancreas, D'Olimpio pointed out.

"The test is able to detect cancer when it is at stage 1, but it's a fatal disease once it gets past stage 0," D'Olimpio said. (Staging, which refers to the severity of a person's cancer, usually runs from 0 to 4.)

"The cure rates of these patients is still going to be less than 20 percent," he said.

For the study, published online March 29 in Cancer Epidemiology, Biomarkers & Prevention, the researchers used a technology called gas chromatography mass spectrometry to analyze the blood from study participants.

The researchers randomly assigned 43 pancreatic cancer patients and 42 healthy participants to what they called a training set, where they made their initial findings. To validate their findings, they also tried the test on 42 patients with pancreatic cancer, 41 healthy people and 23 people with chronic pancreatitis (inflammation of the pancreas).

The researchers found 18 metabolites that were significantly different in patients with pancreatic cancer, compared with the healthy patients.

They refined their test using four metabolites to identify patients with pancreatic cancer.

The test had a sensitivity of 71.4 percent and a specificity of 78.1 percent when it was used with patients with pancreatic cancer and patients with chronic pancreatitis, the researchers reported. Sensitivity measures the accuracy of the test in identifying people with pancreatic cancer and specificity measures the accuracy of the test in weeding out those who didn't have the disease. Chronic pancreatitis is sometimes mistaken for cancer, so cutting down false positives is important.

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