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American Thoracic Society news tips for January

American Thoracic Society

Action plan and oral steroid use cut asthma deaths dramatically

The use of oral steroids to control a severe asthma attack reduced the risk of death from the disease by 90 percent and a written asthma action plan outlining treatment options was associated with a 70 percent reduction in risk of death, according to a study by Australian investigators. They examined data on 89 asthma deaths, while studying the records of 229 control patients. The controls were individuals with acute severe asthma who required broncho- dilators during emergency department visits to four participating hospitals. During the 1980s, Australia and New Zealand had more deaths from asthma than any other countries in the world. In Australia, the death rate from asthma rose in 1989 to about six persons per 100,000 population per year, a rate which fell to three individuals per 100,000 per year by 1996. In their study, the researchers found a written action plan could reduce the risk of death significantly as well as seriously reduce the hospitalization rate. They also found patients who died were significantly less likely than control patients to use oral steroids for attacks of asthma. The study appears in the January American Journal of Respiratory and Critical Care Medicine.

Lung function decline with aging significantly less in african-american women

Tests on elderly African-American women showed significantly lower lung function values than for white persons, but the black women's rate of decline, as they aged, was also significantly less. At the beginning of the study, which was directed at cardiovascular disease in the elderly, investigators performed the testing to measure lung function capacity, repeating the process four and seven years later. Decline in lung function has been shown to be a strong independent risk factor for death from heart disease in middle-aged persons. Lung function also declines slowly throughout life, and analyses have shown the process may accelerate after age 70. In the study results published, currently smoking elderly white men, women, and African American men experienced greater declines in lung function than never or former smokers. Elderly African- American women experienced a relatively low rate of decline in their lung function with age, regardless of smoking status. The study appears in the January issue of the American Journal of Respiratory and Critical Care Medicine.

Cardiovascular disease linked to mild sleep-disordered breathing

An increased risk for cardiovascular disease was detected in persons with mild sleep-disordered breathing during the Sleep Heart Health Study. Researchers examined the association between sleep-disordered breathing and a self-report of heart disease in 6,424 individuals who underwent overnight, unattended sleep monitoring at home. The participants were attached to a monitor by electrodes to measure sleep stages, arousals, and other physiologic variables. Sleep disordered breathing was determined by the number of apnea-like episodes that occurred. With apneas, the sleeping person repeatedly stops breathing long enough to decrease the amount of oxygen in the blood and brain and to increase the carbon dioxide level. Sleep apnea and milder forms of sleep-disordered breathing was highly prevalent in this group. The average number of episodes detected was about 4.4 per hour of sleep. Also, about 15 percent of the participants reported at least one type of cardiovascular disease such as heart attack, angina, coronary revasculization procedure, heart failure, or stroke. From one to 10 apnea-like episodes per hour of sleep is typically considered a normal or only mildly elevated level. The research appears in the January American Journal of Respiratory and Critical Care Medicine.

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For either the complete text of these articles or to contact the investigators by e-mail, please see the ATS Journal Online Website at http://www.atsjournals.org. Medical and scientific journalists who would like to interview these researchers, receive a complimentary subscription to ATS journals, and/or receive the ATS news briefs by e-mail each months, should contact Lori Quigley at 212-315-6442, by fax at 212-315-6455, or by e-mail at lquigley@thoracic.org.

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