Coronavirus patients with high blood pressure twice as likely to die: study

PARIS, France - Patients with high blood pressure admitted to hospital with coronavirus infections are twice as likely to die as those without the condition, researchers said on Friday.

For in-patients with the virus who had stopped taking medication for high blood pressure, the risk of dying doubled again, they reported in the European Heart Journal.

"It is important that patients with high blood pressure realize that they are at increased risk of dying from COVID-19," said senior author Fei Li, a cardiologist at Xijing Hospital in Xian, China.

For the study, researchers in China and Ireland retroactively examined cases admitted to Huoshenshan Hospital in Wuhan between February 5 and March 15.

Nearly 30 percent -- 850 patients -- had a history of hypertension, another term for high blood pressure.

Four percent of those patients died, compared with just over one percent of the 2,027 patients without hypertension.

After adjusting for age, sex and other medical conditions, the researchers calculated that having high blood pressure increased the risk of dying two-fold.

In a separate meta-analysis of three other studies covering 2,300 COVID-19 patients from the same hospital, the researchers investigated the impact of different blood pressure drugs on death rates.

Contrary to their expectations, they found that a class of drugs known as RAAS inhibitors -- which include angiotensin-converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARB) -- were not linked to higher COVID-19 mortality.

Indeed, the risk appeared to be somewhat diminished.

"We suggest that patients should not discontinue or change their usual anti-hypertensive treatment unless instructed by a physician," said co-author Ling Tao, a professor at Xijing Hospital.

The authors noted that their study was observational and not based on clinical trials, meaning further research was needed before they could make firm clinical recommendations.

Agence France-Presse

US 'medical tourists' seek cheap health care abroad

When Veronica Merrill decided to undergo stomach surgery for weight loss, she found two options: pay $12,000 at home in the United States, or have it done in Mexico for $4,000. 

She packed her suitcase.

Her insurance would only cover the operation if she was morbidly obese and suffering from diabetes and hypertension.

This was not the case for the 50-year-old, who weighs 210 pounds (95 kilos) but aspires to slim down to 160 -- precisely because she wants to avoid ending up with those medical conditions.

"It's sad that I have to come to another country" for the procedure, said Merrill, who drives a school bus in rural Arizona and is highly critical of the US health system -- the most expensive in the world.

"We shouldn't have to do that. That's crazy. And we're the only ones (with this system), and that is depressing."

After researching medical tourism options, she saved up the money and contacted a specialist agency to organize her trip over the border to Tijuana, where weight-loss operations and dental treatments are popular.

Others travel to the Mexican city for treatment of cardiovascular conditions or cancer, orthopedic work and fertility care, as well as to buy medications.

"If I only could have done it in the US... (but) I can't pay that much money," she told AFP. "I just want to be healthy."

No price regulation

Each year, an estimated 20 million "medical tourists" seek treatment around the world, according to Patients Beyond Borders. 

About 1.9 million of those people are Americans.

Mexico and Colombia -- which many Americans associate more with drug trafficking than health care -- are among the most popular destinations, along with Costa Rica and the Dominican Republic.

They all offer lower costs and high-quality infrastructure.

Bernie Sanders and Elizabeth Warren, two prominent Democratic candidates for the 2020 presidential election, have proposed universal health coverage -- an idea that Merrill considers "logical."

For now, Merrill turned to a company called Medical Tourism Corporation to organize every detail of her trip -- including her flight from Phoenix to San Diego, the driver who took her across the border and a luxury hotel.

Altogether, the tickets, hotel and surgery -- at the Oasis of Hope hospital, right by the border -- cost her $3,880. She paid in cash.

"We do the coordination... (we) have a destination manager in those cities who would help a patient with the language, the local logistics and things like that," said Deepak Datta, who founded Medical Tourism Corporation 13 years ago.

The company sends 60-70 people abroad each month to countries around the world, mainly Mexico.

"I operate on two or more foreigners every day," said surgeon Luis Cazares, who removed 80 percent of Merrill's stomach.

He said his greatest flow of patients is during the tax refund season in the United States, after April.

According to Gerald Kominski, a professor of health policy at UCLA in Los Angeles, the US does "little to regulate prices, in contrast to all other high-income nations."

"Medical tourism from a high-income nation like the US is indicative of a problem with affordability, as opposed to quality," he added.

Universal coverage

But even if "Medicare for All" were introduced as Sanders and Warren have urged, Americans likely would not stop seeking cheaper care abroad, says Medical Tourism Association CEO Jonathan Edelheit. 

After President Barack Obama's health care reforms in 2010, which required all adults to have insurance plans whether through work or the government, medical tourism by Americans expanded, he said.

Some employers whose medical costs "almost doubled since Obamacare was in place" sent staff abroad, he said, citing a company that saved $20 million in five years by sending employees for orthopedic and weight-loss operations outside the US.

Under universal care proposals, the US would likely end up with a system where, like in Canada and Europe, non-urgent procedures such as stomach operations require years on a waiting list.

"Wait times... will push people to go for medical tourism" to get treatment earlier, he predicted.

Indeed, many of the foreign patients at Oasis of Hope hospital are Canadian.

Europe is a sought-after destination for US medical tourists, though it does little to attract them, unlike emerging economies such as Singapore, Thailand and the Philippines.

The United States itself receives health tourists -- its highly advanced health care system appeals to patients with massive purchasing power from Arab and Asian countries.

But that is a luxury Merrill cannot afford. 

source: news.abs-cbn.com

PH, India lead nations with highest obesity levels

MANILA, Philippines - While the world is focusing on global hunger and malnutrition, another ugly “monster” has emerged.

Obesity, a new form of malnutrition, has surfaced as an urgent challenge affecting several countries.

According to the United Nations Food and Agriculture Organization (FAO), the Philippines and India are among the developing countries with high levels of obesity and under-nutrition.

Obesity as a form of malnutrition often coexists with under-nutrition and results from shifts from local and traditional diets to foods that are increasingly heavy in salt, sugar and fat or processed foods.

The shift to a steady diet of processed food is due to the increasing cost of nutritious and natural food, the FAO said.

The global prevalence of combined overweight and obesity has risen in all regions, increasing among adults from 24 percent to 34 percent between 1980 and 2008.

The FAO said the prevalence of obesity among children has increased even faster, doubling from six percent to 12 percent over the same period.

“Overweight can co-occur with underweight within the same household, and is on the rise in countries with a high level of under-nutrition,” the FAO added in the report.

A 2011 survey by the Food and Nutrition Research Institute (FNRI) showed that 22.3 percent of Filipino adults are overweight and 6.1 percent are obese.

The prevalence of overweight Filipinos is expected to increase significantly by 2015.

“If this trend continues, it is highly likely that more will suffer from high-risk diseases that could lead to death,” the FNRI report said.

The factors leading to obesity in developing countries like the Philippines are numerous.

One leading factor is increasing world and domestic food prices, forcing increased purchase of unhealthy processed food over healthy and staple but expensive food.

Price increases threaten food security for poor households. For example, the 2011 increase in the price of basic grains meant that, in many developing countries, the cost of a kilogram of wheat doubled from about $.15 to $.30, a critical difference for people who live on little more than a dollar a day.

Food represents a substantial portion of the expenditure of poor households in poor countries.

For countries in Asia and Africa, expenditure on food was generally over 50 percent in the early 2000s, prior to the 2007-2008 crisis. In the Philippines, expenditures on food amount to 63 percent of a person’s income.

Biggest risk

Obesity is the biggest risk factor for type 2 diabetes mellitus. It likewise aggravates hypertension and raises blood cholesterol levels, which are major predisposing factors to the development of heart attacks and strokes.

In overweight men, the occurrence of impotence and sterility is higher than average while in obese women, there is a higher than average incidence of menstrual disorders, infertility and complicated pregnancies.

In both sexes, obesity increases the risk for gallbladder stones.

Obesity is likewise associated with cancers of the breast, uterus, cervix, ovary and gallbladder among women, and colon, rectum, prostate, pancreas and stomach among men.

source: www.abs-cbnnews.com

'Lifestyle diseases' are new threat to Asia

MANILA - Asia-Pacific countries face serious challenges from "lifestyle" diseases and ageing populations even as they overcome more traditional illnesses, the World Health Organisation's regional director said Monday.

Western Pacific WHO director Shin Young-soo said such ailments, often arising from a change in diets and less exercise, were sharply rising in Asian nations.

He said recent studies showed that as many as 12 percent of Chinese adults had diabetes, while as many as 50 percent had a "pre-diabetes" condition, meaning they were on the borderline of developing the illness.

This was a huge jump from the estimated 3-4 percent diabetics in China's adult population in the 1990s.

About 10 percent of adults in countries like South Korea, Japan and even Vietnam also had diabetes, Shin told reporters at a WHO regional meeting in the Philippine capital.

"It is because of the big change in our diets in the last 30-40 years' time. There is also a very interesting observation that Asian people... tend to have more diabetes than Western people," he said.

"We must have behaviour change. The whole society must tackle the issue," Shin said.

Other non-communicable ailments like hypertension and high cholesterol were also on the increase despite the fact that they could all be prevented, he said.

Shin said countries such as some Pacific island nations were experiencing diabetes among 40 percent of adults while 75 to 80 percent were suffering from obesity.

"Over many years, this will lead to huge health care costs. Societies will lose this productive labour power," he warned.

Shin also said ageing populations in some Asia-Pacific countries like Australia, Japan and China would force these nation to spend more on caring for the elderly.

Other problems facing the region like relatively high rates of blindness and the spread of drug-resistant diseases will also be discussed at the WHO meeting being held in Manila this week.

source: www.abs-cbnnews.com