Tag: hypertension

Bioethics Blogs

Creative Minds: Exploring the Role of Immunity in Hypertension

Meena Madhur / Credit: John Russell

If Meena Madhur is correct, people with hypertension will one day pay as much attention to their immune cell profiles as their blood pressure readings. A physician-researcher at Vanderbilt University School of Medicine, Nashville, Madhur is one of a growing number of scientists who thinks the immune system contributes to—or perhaps even triggers—hypertension, which increases the risk of stroke, heart disease, kidney disease, and other serious health problems.

About one of every three adult Americans currently have hypertension, yet a surprising number don’t know they have it and less than half have their high blood pressure under control—leading many health experts to refer to the condition as a “silent killer”[1,2]. For many folks, blood pressure control can be achieved through lifestyle changes, such as losing weight, exercising, limiting salt intake, and taking blood pressure medicines prescribed by their health-care provider. Unfortunately, such measures don’t work for everyone, and some people continue to suffer damage to their kidneys and blood vessels from poorly controlled hypertension.

Madhur wants to know whether the immune system might be playing a role, and whether this might hold some clues for developing new, more targeted ways of treating high blood pressure. To get such answers, this practicing cardiologist will use her 2016 NIH Director’s New Innovator Award to conduct sophisticated, single-cell analyses of the immune systems of people with and without hypertension. Her goal is to produce the most comprehensive catalog to date of which human immune cells might be involved in hypertension.

Back in the 1960s, animal studies provided the first indication that the immune system might play a role in hypertension.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

How you’ll grow up, and how you’ll grow old

By Nathan Ahlgrim
Nathan Ahlgrim is a third year Ph.D. candidate in the Neuroscience Program at Emory. In his research, he studies how different brain regions interact to make certain memories stronger than others. In his own life, he strengthens his own brain power by hiking through the north Georgia mountains and reading highly technical science…fiction.

An ounce of prevention can only be worth a pound of cure if you know what to prevent in the first place. The solution to modifying disease onset can be fairly straightforward if the prevention techniques are rooted in lifestyle, such as maintaining a healthy diet and weight to prevent hypertension and type-II diabetes. However, disorders of the brain are more complicated – both to treat and to predict. The emerging science of preclinical detection of brain disorders was on display at Emory University during the April 28th symposium entitled, “The Use of Preclinical Biomarkers for Brain Diseases: A Neuroethical Dilemma.” Perspectives from ethicists, researchers conducting preclinical research, and participants or family members of those involved in clinical research were brought together over the course of the symposium. The diversity of panelists provided a holistic view of where preclinical research stands, and what must be considered as the field progresses.
Throughout the day, panelists discussed different ethical challenges of preclinical detection in the lens of three diseases: preclinical research and communicating risk in the context of Autism Spectrum Disorder (ASD), interventions and treatment of preclinical patients in the context of schizophrenia, and the delivery of a preclinical diagnosis and stigma in the context of Alzheimer’s disease.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Intersectionality and the Dangers of White Empathy when Treating Black Patients

by Keisha Ray, Ph.D.

(Originally presented at the 7th International Health Humanities Consortium meeting in Houston, Texas)

I’ve had many odd, seemingly racially motivated experiences with racially uneducated and racially insensitive doctors and nurses. From being told by one of my white physicians that I sound white when I speak, to another physician calling me “sista girl” for what seemed like 100 times during our brief 15-minute interaction, or another physician who in disbelief kept asking me “Are you sure you’ve never been pregnant? It’s very rare for a black woman your age to not have had any pregnancies. Maybe you think I mean births, when I mean pregnancies?” At the time, I was only 25 years old. Although these stories made for good laughs between my friends and I, there is one experience that I have had with the medical profession that was less comical because my doctor’s attitudes about race could have had serious effects on my health.

When I was a senior in college I discovered I had hypertension. I went to see a doctor at a family medicine facility and was prescribed a common hypertension drug. While meeting with the doctor in her office, she was very reassuring and told me not to worry that this drug has been known to work very well for black people.

But this drug did not work for me at all. Consistently my blood pressure readings were 140/120 (what is considered “normal” varies but typically 120/80 is the standard). So after taking the drug for a month as instructed, I went back to see my doctor.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Pregnancy risks in older women

Older women preganacy risks. As obstetric complications in these women remain high American Society of Reproductive Medicine made an ethical evaluation

Advanced reproductive age is a risk factor for women’s fertility, pregnancy loss, foetal abnormalities, stillbirth and obstetric complications. The American Society of Reproductive Medicine Ethics Committee recently evaluated the ethics of assisted reproduction practices in older women. Difficulties linked to older women preganacy can be avoided by using donor eggs. However, obstetric complications in older women remain high, especially those related with the delivery and risks of hypertension and cardiovascular problems. Physicians should therefore be obliged to perform a thorough medical evaluation of candidates for these procedures whenever the woman is aged over 45 years. In any case, these procedures should be advised against for women aged over 55 years (see more HERE).

La entrada Pregnancy risks in older women aparece primero en Observatorio de Bioética, UCV.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Pregnancy risks in older women

Older women preganacy risks. As obstetric complications in these women remain high American Society of Reproductive Medicine made an ethical evaluation

Advanced reproductive age is a risk factor for women’s fertility, pregnancy loss, foetal abnormalities, stillbirth and obstetric complications. The American Society of Reproductive Medicine Ethics Committee recently evaluated the ethics of assisted reproduction practices in older women. Difficulties linked to older women preganacy can be avoided by using donor eggs. However, obstetric complications in older women remain high, especially those related with the delivery and risks of hypertension and cardiovascular problems. Physicians should therefore be obliged to perform a thorough medical evaluation of candidates for these procedures whenever the woman is aged over 45 years. In any case, these procedures should be advised against for women aged over 55 years (see more HERE).

La entrada Pregnancy risks in older women aparece primero en Observatorio de Bioética, UCV.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Physician’s Near-Death Experience Inspires Campaign to Boost More Effective Patient Communication

January 5, 2017

(Science Daily) – In an article to be published in the Jan. 5 edition of the New England Journal of Medicine, a Henry Ford Hospital critical care medicine physician describes in candid detail about how her own near-death experience inspired an organizational campaign to help health professionals communicate more effectively and demonstrate more empathy to their patients. Rana Awdish, M.D., director of the hospital’s Pulmonary Hypertension Program, writes in “A View from the Edge: Creating a Culture of Caring” that as a patient “I learned that though we do many difficult, technical things so perfectly right, we fail our patients in many ways.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Gun Violence Should Be Treated As A Public Health Crisis, Study Says

Every year in the U.S., more than 30,000 people die from things related to guns. That puts guns ahead of HIV, Parkinson’s disease, malnutrition, hypertension, intestinal infection, peptic ulcer, anemia, viral hepatitis, biliary tract disease, atherosclerosis and fires. Yet, the funding for research on gun violence lags far behind other leading causes of death, according to a study published Tuesday in JAMA

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

A Call to Action: Improve Indigenous Health

Alain Beaudet shares an excerpt of his speech, given at last week’s annual Forum of the Canadian Academy of Health Sciences, which outlines research priorities for indigenous health.

__________________________________________

. . . [K]udos to the Canadian Academy of Health Sciences for devoting a full day of its annual meeting to a major forum on solutions to inequities in indigenous health. The topic is a critical one. Indeed, as you all know, many Canadian indigenous communities are living in a real state of crisis.

Some indigenous communities have tuberculosis rates that are four hundred times the rates of non-indigenous communities and some Inuit communities have forty times the suicide rates of non-Inuit communities.

Obesity, diabetes and hypertension are on the rise, with rates akin to those of low and middle income countries. For example, obesity rates exceed 26% among First Nations people, 22% for Métis, and 26% for Inuit, compared with 16% for non-indigenous Canadians. Smoking rates are also over two times higher among indigenous groups than the non-indigenous population, leading to increased incidences of lung cancer and chronic lung diseases.

Photo Credit: Françoise Baylis

And all this in a developed country, a member of the select group of G7 countries and a country particularly proud of its universal healthcare system.

. . .

The Canadian Institutes of Health Research (CIHR) has made indigenous health one of its top research priorities in its last two 5-year strategic plans and its investments in this field have increased accordingly, growing from $2.14 million in 2001-02 to $30.8 million in 2014-15, in the face of a stagnating CIHR budget.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Cardiometabolic Disease: Big Data Tackles a Big Health Problem

More and more studies are popping up that demonstrate the power of Big Data analyses to get at the underlying molecular pathology of some of our most common diseases. A great example, which may have flown a bit under the radar during the summer holidays, involves cardiometabolic disease. It’s an umbrella term for common vascular and metabolic conditions, including hypertension, impaired glucose and lipid metabolism, excess belly fat, and inflammation. All of these components of cardiometabolic disease can increase a person’s risk for a heart attack or stroke.

In the study, an international research team tapped into the power of genomic data to develop clearer pictures of the complex biocircuitry in seven types of vascular and metabolic tissue known to be affected by cardiometabolic disease: the liver, the heart’s aortic root, visceral abdominal fat, subcutaneous fat, internal mammary artery, skeletal muscle, and blood. The researchers found that while some circuits might regulate the level of gene expression in just one tissue, that’s often not the case. In fact, the researchers’ computational models show that such genetic circuitry can be organized into super networks that work together to influence how multiple tissues carry out fundamental life processes, such as metabolizing glucose or regulating lipid levels. When these networks are perturbed, perhaps by things like inherited variants that affect gene expression, or environmental influences such as a high-carb diet, sedentary lifestyle, the aging process, or infectious disease, the researchers’ modeling work suggests that multiple tissues can be affected, resulting in chronic, systemic disorders including cardiometabolic disease.

The work, published in the journal Science and partially supported by NIH, was initiated by Johan L.M.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

What’s in the IVF Petri dish?

Starving Dutch children looking for food during the Dutch Hunger Winter    

With as many as one in 25 children being born through IVF in some countries, you would think that doctors understand the health risks perfectly.

Not so.

A clutch of papers in the leading journal Human Reproduction points out that the Petri dishes in which IVF embryos spend the first days of their lives are filled with mysterious fluids made up of unknown ingredients. And the composition of these laboratory cultures affects the birthweight of the resulting babies – and possibly their long-term health.

In a blistering editorial, Hans Evers, the journal’s editor, writes that he knows far more about the ingredients in his favourite peanut butter, from the ingredients to the production record, than he does about embryo culture media.

“It’s not possible to sell a single drug on the market if you do not give the total composition of the drug, but for such an important thing as culture media, that envelopes the whole embryo, you can sell it without revealing its contents. For me, that’s unacceptable,” Evers told New Scientist. “Compared to the rest of medicine, this is such a backward area. We can’t accept it any longer.”

In one paper, Dutch scientists conducted a random controlled trial of two types of IVF culture media. They found a clear correlation between the media and low birthweight. “This means that we should be careful and we should no longer blindly accept new culture media, or other alterations in laboratory or clinical procedures, without first rigorously studying effectiveness and safety,” the scientists wrote.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.