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HRT may raise risk of dementia

Hormone replacement therapy may increase the risk of dementia, according to new results from the US Women's Health Initiative memory study.

In a randomised, double-blind trial, researchers compared oestrogen only and combination HRT with placebo in 7,500 women aged 65 to 79.

In the oestrogen-only arm, women were at slightly increased risk of developing dementia or mild cognitive impairment (hazard ratio 1.25), with a stronger effect found when data from the two HRT arms of the trial were combined.

JAMA 2004:291:2947-56

Grapefruit juice ups blood statins

Drinking grapefruit juice may increase the effectiveness of statins, but could also raise the risk of side-effects, a new study suggests.

Researchers conducted a randomised crossover study in which 10 healthy volunteers drank 200ml of grapefruit or water on three successive days and then received a 40mg dose of simvastatin.

Peak blood concentration of simvastatin was 3.9 times higher in people who received grapefruit juice than in controls, indicating that it may increase absorption of the drug into the bloodstream.

British Journal of Clinical Pharmacology 2004;58:56-60

Non-atopic wheeze 'undertreated'

Children with non-atopic wheeze less often receive treatment than those with atopic wheeze, even though morbidity differs little between the two groups, a new study finds.

Researchers conducted a whole population birth cohort study in 1,456 children on the Isle of Wight.

At 10 years of age, the frequency of atopic and non-atopic wheezing was 10.9 and 9.7 per cent respectively. Morbidity at 10 years was similar, although bronchial hyper-responsiveness and airways obstruction were more common in children with atopic wheeze.

Thorax 2004;59:563-8

Aspirin risk for heart failure patients

Patients with heart failure who receive aspirin may be at increased risk of hospitalisation.

In a US trial, researchers assigned 279 patients with heart failure to receive either 300mg/day aspirin, warfarin to a target international normalised ratio of 2.5, or no anti-thrombotic therapy.

The risk of death, non-fatal myocardial infarction or non-fatal stroke was 32 per cent, 26 per cent and 26 per cent respectively and trends for secondary outcomes, including hospitalisation, were significantly worse for patients in the aspirin group.

American Heart Journal 2004;148:157-64

Checklist spots development disorder

A motor performance checklist could help to identify children who should be referred to community occupational therapy services, according to new research.

The Australian study assessed the effectiveness of the checklist at identifying children with developmental

co-ordination disorder in 141 five-year-olds.

The approach had a positive predictive validity of 72 per cent and a negative predictive validity of 99 per cent, indicating its potential to be useful.

Journal of Paediatrics and Child Health 2004;40:369-73

Stress ups later risk of hypertension

Young adults who are prone to stress are at increased risk of hypertension later in life, according to a new study.

Researchers began the study in 1985, enrolling 5,115 men and women aged 18 to 30 and subjecting them to a range of psychological tests.

During 13 years of follow-up, 352 individuals developed hypertension. People who had large increases in blood pressure in response to the earlier tests – indicating larger stress responses – were at increased risk of developing hypertension.

Circulation 2004; June rapid access publication

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