Hypertension is harder to diagnose in children than you think. A new app, which can work with multiple EMR systems, helps doctors interpret a child's blood pressure readings based on age, height, sex and measurement technique, and get the long-range view. (Click to enlarge)
The Affordable Care Act, now the law of the land, mandates free blood pressure screening for children as part of their health care coverage. Yet often hypertension in children is missed, while other children get evaluated and sometimes treated for high blood pressure readings that turn out to have been transient (often induced by kids’ fear of doctors). That has cardiologists like Justin Zachariah, MD, MPH, concerned.
“We’re both overdiagnosing and underdiagnosing hypertension,” says Zachariah, of the Boston Children’s Hospital Preventive Cardiology Clinic. “There must be a problem in the way we’re measuring it.”
Hypertension, or high blood pressure, is being seen more and more often in kids. Its prevalence 15 years ago was about 1 percent; now it’s nearly 5 percent, according to 2011 data from the American Heart Association, likely due to unhealthy diets and lack of exercise. Full story »
Medicine is a balancing act; how much of a drug is too much? A group of compounds called EETs provide a clear example of the possible dangers of giving patients too much of a good thing. (chris grabert/Flickr)
Usually when your doctor talks to you about lipids, he or she is talking about cholesterol (be it the good or bad kind). But cholesterol is only one kind of lipid. There are millions of these fatty molecules working in everyone’s body right now.
One family of lipids, known as EETs (or epoxyeicosatrienoic acids), is produced by the endothelial cells that line blood vessels, where they help control inflammation and the response to injury. Because EETs are also potent regulators of blood pressure, pharmaceutical companies are looking intently at compounds that raise bloodstream EET levels as a way of managing the cardiovascular aspects of more than 20 conditions, ranging from diabetes and stroke to kidney and eye diseases; some are currently in clinical trials.
There may be a catch, however: Some studies suggest that EETs promote angiogenesis, or blood vessel formation, and that the enzymes that process EETs have a relationship to cancer.
Dipak Panigrahy and Mark Kieran of Children’s Vascular Biology Program and the Dana-Farber/Children’s Hospital Cancer Center wanted to understand this relationship better: Could boosting EETs be dangerous? Full story »
