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At the heart of general practice since 1960

Cholesterol seasonal misdiagnosis risk

Seasonal variations in serum cholesterol levels can cause people to be misdiagnosed with hypercholesterolaemia, new research suggests.

Researchers from the US measured cholesterol levels every three months in 517 healthy adult volunteers and found a cholesterol over 240mg/dl – the threshold for hypercholesterolaemia – in 22 per cent more patients in winter than in summer. The effect was significantly more pronounced in women than in men.

Archives of International Medicine 2004;164:863-870

COPD exacerbations' effect on life quality

Exacerbations have a greater impact on patients with moderate chronic obstructive pulmonary disease (COPD) than those with severe COPD, new Spanish research has found.

Researchers measured health-related quality of life of 336 patients over two years of follow-up. They found patients with moderate COPD who had more than three exacerbations a year had significantly reduced quality of life compared with those who had less than three exacerbations. For patients with severe COPD, exacerbations had no effect on quality of life.

Thorax 2004; 59:387-395

Identifying risks for severe asthma

Development of severe asthma is more likely in patients with house dust mite allergy, aspirin intolerance and those who have had the disease for more than a decade.

Researchers from Poland examined 1,006 patients' histories and symptoms and found that 7.45 per cent were classified as 'severe'.

In the severely asthmatic patients, odds ratios were 5.65 for house dust mite allergy, 5.44 for aspirin intolerance and 3.64 for disease duration of 10 years.

Annals of Allergy, Asthma & Immunology 2004;92:453-458

Lifestyle strategies do not cut BP

Non-pharmacological interventions such as lifestyle prompts, information booklets and the provision of low-sodium salt are no more effective than brief advice in reducing high blood pressure. Primary care researchers based in Southampton found patients who had blood pressures of 160/90 or more at baseline had no significant reduction in blood pressure at one month after interventions.

But the study showed important risk factors for stroke were significantly affected by the interventions at one month.

BMJ 2004; 328:1054-1057

Socioeconomic effects on asthma

Socioeconomic status has little impact on asthma, New Zealand researchers say.

Following a cohort of 1,000 patients from birth to the age of 26, researchers found no association between socioeconomic status as a child or adult and asthma prevalence, lung function and airway responsiveness.

Children from higher socioeconomic groups had a higher prevalence of atopy.

Thorax 2004; 59:376-380

Tax hikes reduce smoking rate

Public health measures to combat smoking are working, a study of US states claims. Researchers found that raising taxes on cigarettes significantly increased the number of young people who gave up smoking.

The average 'price elasticity' of cessation is 0.35, indicating that decisions on whether to smoke are affected by cost.

Researchers also found that stronger restrictions on smoking in public places and at work increased the cessation rate.

Health Policy 2004; 68:321-332

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