Low Testosterone Might Shorten Men's Lives

(HealthDay News) -- Men aged 40 or over with low levels of testosterone may be at increased risk of fatal heart attacks or death from any cause, a British study suggests.

In fact, "The magnitude of the effect was very similar to that of [high] cholesterol or blood pressure," said lead researcher Dr. Kay-Tee Khaw, professor of clinical gerontology at the University of Cambridge School of Clinical Medicine.

However, more work is needed to see whether testosterone supplements should be recommended for men with naturally low levels of the hormone, she said.

"We need to replicate these findings," Khaw said. "We hope we can entice other investigators to look at testosterone levels and see if these findings are confirmed."

Her team published the findings in the Nov. 27 issue of Circulation.

The study included more than 11,600 men ages 40 to 79 who were free of known cardiovascular disease and cancer at the start of the trial. It was done because "there have been lots of studies suggesting that low testosterone may not be good for health," Khaw said. "So, we wanted to see if this could be demonstrated in a large population. Testosterone is hard to measure, the test can be expensive."

The men were divided into four groups based on their blood testosterone levels.

Those men in the highest quarter of testosterone readings -- with at least 19.6 nanomoles of the hormone per liter of blood -- had a 41 percent lower risk of dying over 10 years than those in the lowest quarter of testosterone readings -- less than 12.5 nanomoles of testosterone per liter of blood.

One major question is whether low testosterone is a risk factor itself or just a marker for other risk factors, said Dr. Victor Montori, associate professor of medicine at the Mayo Clinic in Rochester, Minn. He has done his own studies on testosterone replacement therapy.

"It does not mean that replacing or normalizing levels of testosterone would reverse the outcome," he said. "There are other hormones in the blood that are related to other risk factors, such as diabetes and hypertension."

In any case, a testosterone replacement regimen "would not be a walk in the park," Montori said. "It would be a major intervention."

According to Dr. Jorge Plutzky, director of the Vascular Disease Prevention Program at Brigham and Women's Hospital in Boston, the experience of women taking hormone replacement therapy (HRT) shows that hormonal regimens can have their dangers.

Beginning in the 1990s, millions of older American women took HRT, which replaced two female hormones, estrogen and progestin. Early trials had indicated that the therapy might reduce the risk of cardiovascular diseases such as heart attack and stroke in older women.

Instead, the Women's Health Initiative, a major study released in 2002, found that women taking HRT were at increased incidence of stroke, blood clots and breast cancer, noted Plutzky, who is also a spokesman for the American Cancer Society. HRT prescriptions dropped off precipitously after the study's release.

So, much more research is needed on the link between testosterone levels and mortality before doctors can recommend the regimen to men, Khaw said. Such studies might provide "insights and better understanding of disease mechanisms, such as how and why testosterone might be related to poorer health through, for example, insulin metabolism, lipid metabolism or inflammation," she said.

More information
There's more on testosterone at the U.S. National Library of Medicine.

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Back Pain Prevention Should Start With a Plan

(HealthDay News) -- A 10-step plan to help you reduce body stress and prevent back pain, especially during the demanding holiday season, is outlined by the U.S. National Athletic Trainers' Association.

"The human body is an incredible machine that adapts to the stresses we give it every day. Stresses such as poor posture, unusual movement or activities, or even a sedentary lifestyle can lead to poor mechanics and pain. Disability from back pain is second only to the common cold as a cause of lost work time," certified athletic trainer Darrell Barnes of the St. Vincent Sports Performance Center in Indianapolis, Ind., said in a prepared statement.

Back pain affects 80 percent of adults at some point in their lives, according to the Arthritis Foundation. Each year, Americans pay about $24 billion for treatment of back pain, limited mobility and stiffness.

Here are 10 things you can do to prevent and reduce back pain:

• Identify and correct body stresses such as poor posture, improper lifting techniques, or weak or tight muscles. Strengthen your back, learn proper lifting methods, carry lighter loads, and use luggage carts for heavy packages and suitcases.
• Increase your muscle mobility by stretching or doing activities -- such as yoga, tai chi, swimming or pilates -- that help keep you limber.
• Boost your strength by doing exercises that involve the whole body, especially the core muscles of the stomach, back, hips and pelvis. In addition, strengthening your legs and shoulders can help improve your ability to squat, lift and carry items without overworking or injuring your back.
• Do aerobic exercise, like walking, swimming and running, for at least 20 minutes three times a week. This kind of exercise increases muscular endurance and cardiovascular fitness, improves blood flow to the spine, and helps reduce stress.
• Practice good posture. If possible, don't sit for long periods of time. Get up every 15 to 30 minutes and move around or stretch. When you're seated, keep your hips and knees at right angles to one another and use a chair with adequate lumbar (lower back) support.
• When standing, keep your head up, shoulders straight, chest forward and stomach tight.
• Don't stand in the same position for too long. Use your legs, not your back, when pushing or pulling heavy items.
• Use proper lifting techniques. When lifting objects from a position below your waist, stand with a wide stance and a slight bend at your hips and knees. Tighten your stomach as you lift and keep your back as flat as possible -- don't arch or bend it. When carrying heavy items, keep them as close as possible to your body. Don't carry items on only one side of your body.
• Sleep on a firm mattress and box spring that doesn't sag. Sleep in a position that allows you to maintain the natural curve in your back.
• Warm up before exercise or sports. Increasing muscle temperature and mobility beforehand will reduce the risk of injury.
• Maintain/adopt a healthy lifestyle. Obesity and smoking increase the incidence of back pain.

More information
The U.S. National Institutes of Health offers back pain prevention advice.

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Health Tip: Managing Menopause

(HealthDay News) - If hot flashes and other symptoms of menopause are cramping your style, the U.S. Department of Health and Human Services offers these suggestions:

• Eat a healthy, balanced diet rich in fruits, vegetables, whole grains and lean meats.


• Get plenty of regular exercise.


• Hormone replacement therapy (HRT) may help certain women, but it carries medical risks. Discuss HRT with your doctor.


• Foods rich in soy may help some side effects, such as hot flashes.


• Get plenty of sleep, and maintain a regular sleep schedule.


• Avoid caffeine and alcohol.

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Simple Tips Keep the Flu at Bay

(HealthDay News) -- Between 5 percent and 20 percent of Americans will get hit by the flu bug this year, but some simple precautions can keep you from becoming one of that number, an expert said.

The flu shot is the most effective method of preventing the flu, said Dr. Robert C. Goldszer, associate chief medical officer at Brigham and Women's Hospital in Boston. It's important to get your shot early in the flu season -- October and November -- and to get a shot every year, Goldszer said. Everyone is eligible for a flu shot, and many places offer it for little or no cost.

If you do start to feel symptoms of the flu (tired, nauseous, congested, achy), get extra rest and drink plenty of fluids -- at least a quart of water every day. Proper hydration and nutrition can help lessen flu symptoms.

If you have the flu, try not to spread it to people around you. Flu viruses are spread by coughing and sneezing. Most people can spread the flu beginning one day before symptoms develop to up to five days after they become ill.

If you do have symptoms, stay home from work or school and avoid public places. Cover your mouth and nose when coughing or sneezing.

Take steps to protect yourself from getting the flu. If you use public transit or work in a crowded place, disinfect your hands regularly and avoid close contact with people who appear to have flu symptoms.

More information
The U.S. Centers for Disease Control and Prevention has more about seasonal influenza.

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Nicotine-Reduced Cigarettes Could Boost Quitting

(HealthDay News) -- Providing smokers with cigarettes of gradually decreasing levels of nicotine over a number of weeks can help cut their nicotine addiction, a U.S. study finds.

The study, conducted by researchers at the University of California, San Francisco, and San Francisco General Hospital Medical Center, included 20 adult smokers. They puffed on their usual brand for the first week of the study and then began a six-week program where they smoked cigarettes with steadily decreasing amounts of nicotine.
At the end of the six weeks, the smokers were free to start using their regular cigarette brands again, which most did. However, when checked a month later, they were smoking about 40 percent fewer cigarettes a day compared to when the study began.

The researchers also noted that about 25 percent of the smokers quit smoking entirely during the study.

The findings are published in the Nov. 14 issue of the journal Cancer Epidemiology, Biomarkers & Prevention.

"This study supports the idea that if tobacco companies were required to reduce the levels of nicotine in cigarette tobacco, young people who start smoking could avoid becoming addicted, and long-time smokers could reduce or end their smoking. This could spare millions of people from the severe health effects of long-term smoking," study team leader Dr. Neal Benowitz, professor of medicine, psychiatry and biopharmaceutical sciences, and chief, division of clinical pharmacology and experimental therapeutics at SFGH, said in a prepared statement.

Currently, the U.S. Congress is considering proposals to give the U.S. Food and Drug Administration authority to regulate tobacco products, including the reduction of nicotine levels in cigarettes.

More information
The U.S. Centers for Disease Control and Prevention has more about quitting smoking.

New Test Criteria Spots Rheumatoid Arthritis Sooner

(HealthDay News) -- More patients with early rheumatoid arthritis could be identified and enrolled in clinical studies if the process of diagnosis included one new type of assessment and excluded two traditional assessments, according to a new study.

Researchers looked at 292 people, average age 54, seen at the Arthritis Center of Brigham and Women's Hospital in Boston. The average duration of the patients' symptoms was four years.

Their findings showed that by including anti-CCP (cyclic citrullinated peptide) testing and excluding rheumatoid nodules and radiographic changes, the number of patients correctly classified as having rheumatoid arthritis increased from 51 percent to 74 percent.

When this approach was used in patients who had rheumatoid arthritis symptoms for less than six months (when signs such as nodules and radiographic changes may not yet be apparent), the percentage of patients correctly classified as having rheumatoid arthritis increased from 25 percent to 63 percent.

The study was to be presented Saturday at the American College of Rheumatology (ACR) meeting in Boston.

"Anti-CCP testing is now widely used in clinical practice to aid in the diagnosis of rheumatoid arthritis but is not included in the current ACR criteria for the classification of rheumatoid arthritis. Additionally, rheumatoid arthritis therapies available today are able to slow or halt disease progression. It is important that new therapies are tested early in the disease course before significant damage has occurred," lead investigator Dr. Katherine P. Liao said in a prepared statement.

"The current criteria for rheumatoid arthritis diagnosis include elements that may not become apparent until later in the disease. Minor modifications in these criteria may allow us to correctly identify rheumatoid arthritis patients earlier, when intervention may be more effective," she added.

More information
The American Academy of Family Physicians has more about rheumatoid arthritis.

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Many Patients Stop Taking Cholesterol-Lowering Drugs

(HealthDay News) -- Even though cholesterol-lowering statin drugs are known to be effective, many patients stop taking them, and researchers say a number of factors may be to blame.
In their study, researchers in Chicago analyzed a large pharmacy's database.

They found that statin discontinuation rates among more than 768,000 patients were 28 percent after three months, 41 percent after six months, and 59 percent after one year.

"We found that subjects who were on high-dose statins, paid high co-payments, or spoke Spanish were significantly more likely to discontinue," said the investigators at Radiant Research Inc.

Patients who used the Internet, had heart disease or high blood pressure were significantly less likely to stop taking statins.

Taking steps to address problems such as side effects associated with high doses of statins, high co-payments, and language issues may help improve patients' long-term statin therapy compliance, the researchers suggested.

The study was to be presented Thursday at the American Heart Association's annual meeting, in Orlando, Fla.

A second study to be presented at the same meeting found that, among American hypertension patients with increased risk of coronary artery disease, the time it took to bring "bad" low density lipoprotein (LDL) cholesterol under control was much longer for all women and black men than for non-black men.

These disparities in risk reduction can likely be attributed to patient differences in access/adherence to lipid-lowering medication therapy, said the University of Pennsylvania researchers.

More information
The American Academy of Family Physicians has more about cholesterol-lowering medications.

Chocolate Has Sweet Effect on Blood Flow

(HealthDay News) -- Chocolate lovers, take heart: A Japanese study finds that flavonoid-rich dark chocolate can improve coronary blood flow.

The study looked at what's known as coronary flow velocity reserve (CFVR), an indicator of the ability of the coronary arteries to dilate and allow more blood flow in response to medications.
The two-week trial included 39 healthy adults, average age 29, who ate either 550 milligrams per day of dark chocolate versus white chocolate with no flavonoids.

The researchers used Doppler echocardiography to assess CFVR at the start and end of the study. They also measured the participants' blood pressure, blood lipids and two markers of oxidative stress.

Participants who ate dark chocolate showed significantly improved CFVR after two weeks, while those who ate white chocolate showed no change, the study found.

"Flavonoid-rich dark chocolate intake had acute effects in improving coronary function in healthy adults, as compared to non-flavonoid white chocolate, independent of changes in oxidative stress parameters, blood pressure and lipid profile," wrote the researchers from Chiba University.

However, they noted that difficulties in blinding (preventing participants from knowing which kind of chocolate they were eating) may have affected the results.

The study was to be presented Sunday at the American Heart Association annual meeting in Orlando, Fla.

More information
The Linus Pauling Institute at Oregon State University has more about flavonoids.