By Dennis Thompson – HealthDay News – Jan. 18, 2023

Television ads for drugs are filled with glowing images of people living their best lives, all thanks to that new med they’ve been prescribed.  But drugs being touted on TV often have little to no benefit compared to other treatments, a new study published online Jan. 13 in JAMA Network Open finds.

Fewer than one-third of drugs commonly advertised in the United States are highly rated first-line therapies, based on regulatory reviews from three different health agencies, the researchers said. Further, medications categorized as “low benefit” accounted for nearly $16 billion of the $22 billion in TV ad spending during the six-year study period, the results showed.

“Proponents of direct-to-consumer pharmaceutical advertising often argue that these ads have high public health value by encouraging uptake of the most therapeutically beneficial therapies. Our study pushes back against this argument,” said lead researcher Neeraj Patel, a medical student at the Yale School of Medicine in New Haven, Conn.

“Taken together with other research, our findings suggest that pharmaceutical companies focus their advertising campaigns on expensive, brand-name drugs that have low or no comparative benefit versus existing alternatives,” Patel added.

Those billions spent on advertising do pay off for drug makers. TV drug ads reach a wide swath of Americans, and they influence a significant number to ask their doctor about one med or another, the nonprofit Kaiser Family Foundation (KFF) has found.

Nearly three out of four Americans (72%) say they’ve seen or heard an advertisement for prescription drugs, a 2018 KFF survey found. What’s more, the ads translate into action. One in seven people said they talked to their doctor as a result of seeing a drug advertisement, and more than half of those (55%) wound up with a prescription for the medication.

“These advertisements are hitting most U.S. households, and it’s resulting in people going and talking to their doctor about the prescription drug,” said Ashley Kirzinger, director of survey methodology for the Kaiser Family Foundation. “And among that group, a large share of them say that the doctor did, in fact, give them a prescription for the drug that they asked about.”

“It’s a lot of money [spent on drugs], and it results in a lot of people getting prescriptions to medications that the JAMA authors are saying maybe aren’t that beneficial,” Kirzinger added.

For the new study, Patel and his colleagues collected monthly lists of the top-advertised drugs in the United States from an industry publication called FiercePharma. The data ran from September 2015 to August 2021.  Of the top-advertised drugs, about 32% affect the immune system to treat a wide range of ailments – everything from arthritis, psoriasis and ulcerative colitis to severe autoimmune diseases and cancer. Another 16% of the drugs affected the digestive system and metabolism to treat conditions like diabetes, and about 14% were drugs to treat mental conditions and mood disorders.

The researchers then obtained therapeutic value ratings for each drug from health agencies in Canada, France and Germany. “We classified a drug as ‘high benefit’ if at least one of the three agencies rated the drug as having at least moderate therapeutic value compared to available alternatives,” Patel said.  On the other hand, a “low-benefit” drug would be one mainly used as a back-up option if better therapies don’t work for a particular patient, he added.

The researchers identified 73 drugs that at least one of the three agencies had rated for therapeutic value rating. But only 20 (27%) of the 73 were rated by any agency as having high therapeutic value, the researchers found.

More oversight needed

Those high-rated drugs represented only about one-quarter ($6 billion) of advertising spending for the period, while the rest of the ad dollars were spent touting drugs of more questionable benefit, the researchers said. This doesn’t mean that the advertised drugs are necessarily bad or should be avoided, Patel said.

“What our study does show is that drug companies tend to focus their advertising on drugs that are not necessarily the highest benefit drugs,” Patel said. “One explanation for that might be that drugs with high clinical value probably don’t need much advertising because they’re probably already likely to be recognized and prescribed without the additional promotion,” Patel continued. “So, the drugs you’re seeing advertised on TV aren’t necessarily the biggest breakthroughs in medicine, like you might assume.”

The Pharmaceutical Research and Manufacturers of America (PhRMA), an industry trade group, took issue with the findings.

“The study is predicated on the assumption that the ‘level of benefit’ the authors assign to each prescription medicine is a fair and complete representation of the value of that medicine to patients,” said PhRMA spokesperson Sarah Ryan. “But there is a large and growing body of research showing that standard one-size-fits-all value assessments, which often ignore dimensions of value patients find important and fail to take key patient differences into account, fall far short of capturing a medicine’s true value.”

According to Ryan, “Consumer advertising has shown to help patients by raising disease awareness, removing stigma from certain conditions, promoting adherence to medicine and encouraging important conversations between patients and their doctors.”

Regardless, the U.S. Food and Drug Administration could help the situation by being more proactive in regulating drug ads, Patel said. “The FDA does not review and approve all advertisements before they air, and often has to play ‘catch-up’ and regulate advertisements after they are already public,” Patel said. “I think we should invest more in the regulatory process to catch misleading advertisements earlier. This could help improve informational quality by weeding out advertisements that have misleading content.” The United States might also want to rethink whether these drug ads should be permitted at all, Patel stressed.

“The U.S. is one of only two high-income countries in the world that widely permits direct-to-consumer advertising of prescription drugs,” Patel said. “And there’s been a ton of empirical research over the past two decades that has suggested that this type of advertising can be misleading, lead to inappropriate prescribing, and inflate health care costs.”

In the meantime, people should have frank discussions with their doctor about any drug that’s caught their eye on TV, focusing on the real risks and benefits, Patel said. “Doctors and clinicians can draw on their experience, clinical knowledge, existing data and the particular circumstances of an individual patient to help guide the decision-making process,” Patel said. “That’s something that a 60-second drug advertisement is not able to do.”

‘Greg Says agrees with the view that drug advertising should be subject to more oversight.  A large part of the reason for ever-escalating healthcare costs is the cost of Rx drugs.  If less expensive alternatives to the highly advertised medications are just as effective, their use will have a positive impact on rising healthcare costs.’

Brush up on your knowledge of cardiac arrest and you may be able to help save someone’s life.

By Quinn Phillips – HEART HEALTH – Medically Reviewed by Michael Cutler, DO, PhD

November 7, 2022

Hands-only CPR is a lifesaving technique that doesn’t require mouth-to-mouth resuscitation.

Cardiac arrest means an absence of cardiac activity — in essence, a person’s heart stops beating. While certain health conditions and other factors increase the risk of cardiac arrest, it can happen to anyone.

When someone has cardiac arrest, immediate medical attention – starting with cardiopulmonary resuscitation (CPR) – can be the difference between life and death. Here’s what you should know about cardiac arrest, including what to do if someone near you appears to be experiencing it.

1. Cardiac Arrest Is Highly Fatal

About 90 percent of people who have cardiac arrest outside a hospital setting don’t survive it, according to the Centers for Disease Control and Prevention (CDC). Since about 350,000 people have cardiac arrest in non-hospital locations each year, that translates to hundreds of thousands of people dying from the condition in the United States annually.

“It’s thought that out of deaths in the United States, 13 to 15 percent are due to cardiac arrest,” says Eugene DePasquale, MD, a cardiologist at Keck Medicine of the University of Southern California in Los Angeles. That makes cardiac arrest one of the leading causes of death in the country.

2. Cardiac Arrest Survivors Can Face Lasting Health Problems

Mild to severe brain injury caused by lack of oxygen to the brain is common in cardiac arrest survivors, who often need intensive rehabilitation once they’re discharged from the hospital, as noted in an article published in the Lancet in October 2021.

Between 30 and 50 percent of cardiac arrest survivors experience cognitive deficits as a result, according to an article published in Dialogues in Clinical Neuroscience in March 2018. Survivors are also disproportionately burdened by mental illness – about 40 percent have anxiety, 30 percent have depression, and 25 percent have post-traumatic stress disorder (PTSD) in the aftermath of cardiac arrest.

3. Cardiac Arrest Is Not a Heart Attack

When someone collapses because of a heart condition, many people think it’s a “heart attack.” But that’s not what cardiac arrest is at all.

Cardiac arrest and a heart attack are “completely different,” says Anezi Uzendu, MD, an interventional cardiologist and an American Heart Association volunteer. “With cardiac arrest, the heart stops beating, and you can’t wait for emergency services.” A person will be completely unresponsive, and you need to start CPR right away.

In contrast, when someone has a heart attack – which happens when blood flow to the heart is blocked – they tend to experience symptoms like chest pain and shortness of breath, but they’re still conscious and responsive. It’s important to get immediate medical attention, but unlike with cardiac arrest, no treatment is required prior to arrival of emergency medical services for a heart attack.

4. Cardiac Arrest Can Happen to Anyone Without Warning

Not only has Dr. Uzendu studied and treated cardiac arrest, he experienced it himself at age 25, while playing basketball with friends at a gym.

“Halfway through a game, I collapsed and didn’t have a pulse,” he says. “The great thing was that people there were trained – they knew CPR, and there was an AED [automated external defibrillator] available. They used the training they had to help save my life.”

Uzendu was healthy, considered himself an athlete, and had no medical history that suggested an elevated risk of cardiac arrest. Yet on that day, he would have died without the immediate attention he got first from his fellow basketball players and then from emergency services.

In many cases, though, cardiac arrest happens in people with known risk factors. A leading cause of cardiac arrest is coronary artery disease (CAD), according to Dr. DePasquale – a condition that can be treated and controlled.

Other health conditions that increase the risk of cardiac arrest include certain arrhythmias (heart rhythm disorders), as well as cardiomyopathies – heart disorders that make it difficult to pump blood throughout the body.

5. Cardiac Arrest Doesn’t Only Happen During Physical Activity

In fictional portrayals of cardiac arrest, a character often collapses while performing some kind of physically demanding task. In real life, a person may or may not be doing something physically taxing when cardiac arrest happens.

“There has certainly been attention to cardiac arrest among athletes,” says DePasquale. “When that does happen, it gets attention because it’s typically at a venue with a lot of people.” But cardiac arrest “can easily happen when you’re not doing anything or taking it easy,” he adds.

While cardiac arrest that happens in public places tends to get more attention, about 7 in 10 cases occur when a person is at home, according to the CDC.

6. CPR Is Critical to Survival in Cardiac Arrest

CPR performed within the first few minutes of cardiac arrest can double or triple a person’s chances of survival, according to the CDC. Unfortunately, fewer than half of all people receive CPR from a bystander, according to Uzendu – and the numbers are barely different for people who have cardiac arrest at home versus in public.

It’s important for everyone in your household to know how to perform CPR if possible, Uzendu says. “Most of the time cardiac arrest is happening, it’s going to be someone in a household,” so you’re more likely to encounter a loved one who needs CPR than a stranger.

Before starting CPR, Uzendu says, you should check to see if the person is responsive by asking if they’re okay and tapping or shaking them. If they’re not responsive, check to see if they’re breathing normally. If not, immediately call 911 and start chest compressions.

Hands-only CPR consists of only two steps, according to the American Heart Association:

1. Call 911 and put your phone on speaker (or get someone else to call).
2. Push hard repeatedly, at a moderately fast pace, on the center of the person’s chest.

Uzendu laments that many people hesitate to perform CPR because either they don’t know how or when to do it, or they don’t feel comfortable doing it. “If someone doesn’t have a pulse or a heartbeat, you can’t make them worse,” he says. “You need to act.”

7. Anyone Can Use a Defibrillator (AED) 

In addition to administering CPR, you should use an automated external defibrillator (AED) if one is available. AEDs are available in many public places, including schools and universities, airports and other transit hubs, large offices, malls, grocery stores, and gyms.

To use an AED, all you have to do at first is turn the device on. Almost all modern devices are equipped with an audio system to guide you through all the necessary steps, according to Uzendu.

Based on the instructions given by the AED, you’ll need to expose the person’s chest and put the device’s pads on it. The device will analyze the person’s heart rhythm and advise to give an electric shock if needed, as many times as needed. Many devices also tell you when to perform or pause CPR.

8. Hospital Care for Cardiac Arrest Is Important, but May Come Too Late

The American Heart Association emphasizes that a “chain of survival” is needed for a person to have the best chance of surviving cardiac arrest. The steps in this chain are calling 911, performing high-quality CPR, defibrillation, advanced CPR by medical professionals, hospital care, and recovery.

Many different hospital treatments may be promising for cardiac arrest patients, according to Uzendu – including use of an external device to pump blood, inserting a stent to treat any heart blockages, and cooling the person to protect their brain once normal heart rhythm is restored. But doctors are still figuring out how to maximize survival with the tools they have.

“A lot of these therapies might not be beneficial in everyone,” says Uzendu. “I think the next phase of research is going to be trying to figure out which patients benefit from which therapies.”

9. Awareness and Prevention Are Key to Reducing Cardiac Arrest Deaths

Since coronary artery disease (CAD) is a leading cause of cardiac arrest, one of the best ways to reduce cardiac arrest deaths is to make sure people get screened and treated for CAD, according to DePasquale.

“Coronary artery disease is something that there are excellent treatments for,” says DePasquale. “There are also risk factors associated with it, such as high cholesterol or hypertension. If you’re seeing your physician regularly, that’s something that could potentially be controlled.”

But as much as prevention matters, Uzendu emphasizes the importance of recognizing and responding quickly to cardiac arrest.

“Everyone who is able to should learn CPR, how to save a life,” Uzendu urges. “Early defibrillation and bystander CPR can change the trajectory of cardiac arrest.”

Part of a successful and happy retirement is making the most of your fixed income. In addition to Social Security, which retirees start to draw on between ages 62-67, you may also expect to receive income from retirement savings and investment accounts. Many individuals want to avoid drawing on these resources as long as possible, especially as we expect to live longer than generations in the past. This is why the concept of required minimum distributions is important for those approaching or entering retirement to understand.

What is a Required Minimum Distribution?

A required minimum distribution is the amount you are required by law to withdraw from a retirement account each year. This requirement exists because many deposits to retirement accounts are made pre-tax, and eventually, the IRS wants to be able to tax those dollars. This is why a required minimum distribution will be added to your taxable income. Talk with a financial professional about what that means for your taxes and social security. You can withdraw more than this amount, but you can’t withdraw less.

What Retirement Accounts Have Required Minimum Distribution?

Almost every type of retirement account has a required minimum distribution. The only exception is a Roth IRA, which does not require a withdrawal until after the death of the owner. That is because those contributions are made post-tax, so the IRS isn’t worried about taxing them. Otherwise, all these accounts are subject to required minimum distributions:

401(k) Plan

403(b) Plan

457(b) Plan

Traditional IRA

SIMPLE IRA

SEP IRA

Defined Benefit Plan

If you have one or more of these accounts, you will eventually be required to withdraw a certain amount from savings each year and pay taxes on that withdrawal.

What is the Age for Required Minimum Distribution?

The Setting Every Community Up for Retirement Enhancement (SECURE) Act passed in 2019 affected the age that individuals are required to take minimum distributions. If you were born after June 30, 1949, you are required to take required minimum distributions on April 1 during the calendar year after you turn 72. If you were born before July 1, 1949, you are already taking required minimum distributions, or you will start as of April 1, 2020.

What Amount is the Minimum Required Distribution for Retirees?

The required minimum distribution you are required to withdraw depends on the account balance(s) at the end of the immediately preceding year. Remember that each account will have its own minimum distribution. Your retirement plan administrator, plan sponsor, or financial adviser should help you with this calculation. Figuring out the exact dollar amount required to be withdrawn relies on the IRS’ Uniform Life Table, which factors in your age, your marital status, and even how far apart in age you and a spouse might be. It’s important to get a professional’s help because if you do not take enough of a distribution, you may be charged as much as a 50% penalty on the amount that was not withdrawn.

Do I Have to Spend my Minimum Required Distribution?

If you have to take more than one required minimum distribution in a year, this could impact your tax status and your Social Security eligibility. While many choose to take these distributions in cash, the option of a qualified charitable distribution allows you to transfer as much as $100,000 directly from the account to a charity, thereby satisfying the IRS requirements without increasing your tax liability. Otherwise, once the distribution is taken as cash, you can spend or save it however you wish.

Understanding required minimum distributions is just one of the pieces of knowledge seniors need to successfully plan and prepare for retirement.

Better to ask for broccoli or spinach on the side, gentlemen. New research shows men can reduce the risk of bowel cancer by eating a diet rich in vegetables, whole grains, nuts and legumes.
The study, published in the journal BMC Medicine, involved 79,952 U.S. men and found those eating the highest level of healthy plant-based foods could cut their risk by up to 22% compared with those who ate the least.

But researchers found no such link among 93,475 U.S. women in the study.
According to researchers, the study suggests the link is clearer for men, who have a higher risk of bowel cancer.

On average, the men were 60 years old at the start of the study; the women were about 59.
The study’s participants were asked how often they consumed particular foods and drinks from a list of 180 options. Researchers also queried them about portion size.
Options were divided into food groups including animal foods (meat, dairy, eggs, fish or seafood), less healthy plant foods (food including potatoes and refined grains among others), and healthy plant foods like vegetables and legumes.

Participants told researchers whether they ate each item “never or hardly ever” or “two or more times a day.” For drinks, responses ranged from “never or hardly ever” to “four or more times a day.”
Bowel (also known as colorectal) cancer is the 3rd most common cancer worldwide, according to the World Cancer Research Fund International. The risk of developing it over a lifetime is one in 23 for men and one in 25 for women, said one of the study’s authors, Jihye Kim of Kyung Hee University in South Korea.

“Although previous research has suggested that plant-based diets may play a role in preventing colorectal cancer, the impact of plant foods’ nutritional quality on this association has been unclear,” Kim said in a news release describing the findings. “Our findings suggest that eating a healthy plant-based diet is associated with a reduced risk of colorectal cancer.”
Antioxidants found foods such fruits, vegetables, and whole grains “could contribute to lowering colorectal cancer risk by suppressing chronic inflammation, which can lead to cancer,” she said.

by Cara Murez – HealthDay News

Dec. 30, 2022

It’s that time of year again, when people gather up their best intentions for living a healthier life and make New Year’s resolutions.

Luckily, the American Medical Association (AMA) has some suggestions on which pledges pack the most punch.

Start by being more physically active. Adults should do at least 150 min. a week of moderate-intensity activity or 75 min. a week of vigorous-intensity activity, the AMA recommends.

“Many people kick off the start of each new year with big-picture health resolutions — ambitious, immediate lifestyle changes that are very difficult to maintain,” AMA president Dr. Jack Resneck Jr. said in an association news release. “The good news is that small, positive health choices made right now can have long-lasting effects.”

Here are 10 more tips from the AMA:

• Manage your stress with a good diet, at least 7.5 hours of nightly sleep, daily exercise and wellness activities, such as yoga and meditation. Ask for help from a mental health professional when you need it.
• Eat fewer processed foods and sugar-sweetened beverages, especially those with added sodium and sugar. Eat less red meat and processed meats, replacing these with more plant-based foods, such as olive oil, nuts and seeds.
• Drink water in place of sugar-sweetened beverages. Even 100% fruit juices are associated with a higher all-cause mortality risk.
• Alcohol should be consumed only in moderation, with up to one drink per day for women and two for men.
• If you use tobacco or e-cigarettes, talk to your doctor about how to quit. Keep your home and car smoke-free to eliminate secondhand exposure.
• Get your vaccines. The whole family should be up to date on all of their vaccines, including the flu shot and COVID-19 vaccine.
• Stay up to date on screening. Millions of cases of breast, colon and prostate cancers may have been missed because of pandemic-related care disruptions.
• Know your blood pressure numbers. You can better understand what’s right for you by visiting ManageYourBP.org. Controlling high blood pressure will reduce your risk of heart attack or stroke.
• Also learn your risk for type 2 diabetes. You can do this with a two-minute online self-screening test at DoIHavePrediabetes.org. Lifestyle changes made now can help prevent or delay the onset of type 2 diabetes.
• If taking prescription opioids or other medications, follow your doctor’s instructions, store them safely to prevent diversion or misuse, and properly dispose of any leftover medication. Always take antibiotics exactly as prescribed.

More information

The U.S. Centers for Disease Control and Prevention has tips for living a heart healthy lifestyle.