Health Newsfeed – Johns Hopkins Medicine Podcasts

Deaths from heart disease declined a lot until the last decade, and then began to level off. Ditto for deaths from certain cancers, a recent study finds. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says there is a common denominator. 

Nelson: Certainly I think if you look broadly at cancer mortality declines and you look by specific diseases that there have been profound declines. But if you look at diseases like pancreas cancer, gall bladder cancer, liver cancer they may actually even be on the rise and so I think what they’re seeing here is that obesity may be a contributor to why they’re on the rise in that they’re tracking with heart disease mortality, where obesity may be a contributor.   :24

Nelson notes that just as with many risk factors for both cancer and heart disease, obesity is within an individual’s control and should be acknowledged as risky. He says that since obesity develops over time, people should monitor their weight and intervene early, perhaps seeking the advice of a nutritionist to help. At Johns Hopkins, I’m Elizabeth Tracey.

Women and non-Hispanic Black persons were more likely to experience sunburns when taking the blood pressure medicine hydrochlorothiazide than other groups, research by Anna Chien and colleagues at Johns Hopkins has shown. Chien says protecting one’s skin requires a number of strategies.

Chien: These days we’re really emphasizing a multimodal approach to sun protection because sunscreen itself, it’s not perfect. It’s using multiple methods, sunscreen, it’s picking something broad spectrum, at least SPF of thirty, and the key and the challenge is always reapplying every few hours with exposure. That coupled with seeking out shade, avoiding that peak sun from 10 to 2, insuring you have hats, sunglasses, sun protective clothing, with UPF labels, those would all be helpful.     :28

Chien says both reducing one’s risk for skin cancer by avoiding sunburn and managing high blood pressure are important, so she urges using all of these skin protective measures. At Johns Hopkins, I’m Elizabeth Tracey.

High blood pressure is known to increase the risk for heart attack and stroke, so treating it is important, and often starts with medicines like hydrochlorothiazide. Yet research by Anna Chien and colleagues at Johns Hopkins has shown that for some groups of people taking this medicine, sunburns do occur more often and these are known to increase the risk of skin cancer. Chien says don’t panic.

Chien: My recommendation in alignment with FDA has stated is we’re not asking patients to stop this blood pressure medicine. We know managing blood pressure is essential, it can lead to severe comorbidity, to heart attack, to strokes, so it’s important to still take this medicine but to be aware of this potential risk for skin cancer and to protect oneself, especially in that beginning period of treatment, especially in certain populations, may need additional counseling to insure that they’re protected while they’re on this medicine.  :30

Chien notes that there are alternative medicines but these may be more expensive or come with their own side effects. At Johns Hopkins, I’m Elizabeth Tracey.

Sunburn is associated with an increased risk of skin cancer and should be avoided. Yet a very common blood pressure medicine, hydrochlorothiazide, is associated with increased sun sensitivity, with new research by Anna Chien and colleagues at Johns Hopkins showing that for certain groups of people, sunburns are increased.

Chien: For hydrochlorothiazide many studies have shown that women and non-Hispanic Black patients actually respond quite well to this medicine in treating their blood pressure. And what we found in our study population that hydrochlorothiazide was indeed used more commonly in this group but yet this was the exact group that had the greatest odds of developing sunburns. So there are other medications out there as well for high blood pressure, in fact some of them have also been associated with sun sensitivity so I think more research is needed.  :30

Rather than switch from a medicine that might be working well, Chien recommends a range of sun protection practices for people taking this medicine. At Johns Hopkins, I’m Elizabeth Tracey.

Hydrochlorothiazide is a common blood pressure medication known to increase sun sensitivity. Now a study by Anna Chien and colleagues at Johns Hopkins has shown that certain groups of people were much more likely to experience sunburns while taking this medicine than others.

Chien: Compared to those who were not taking the medication, non-Hispanic Black individuals, particularly women, taking this medicine had increased odds of getting sunburn. Interestingly, non-Hispanic white men we actually found had lower odds of sunburn compared to non-Hispanic white women. The other thing we found was that in the first three years, it’s really in the beginning phase of this medication in which the sunburn risk was the highest, and thereafter was sort of leveled out between the two groups.  :28

Chien notes that physicians must ask their patients about sun protection measures they are using and advise them about additional strategies. She says that even those with black or brown skin are at risk for sunburn. At Johns Hopkins, I’m Elizabeth Tracey.

If you have high blood pressure you may be taking a commonly prescribed medicine called hydrochlorothiazide, one of the first line treatments for the condition.  it’s also known to increase sun sensitivity. Now a study by Anna Chien and colleagues at Johns Hopkins has shown that certain groups of people get sunburns more often when taking hydrochlorothiazide.

Chien: We looked at data over nine years and included over 19,000 people in our study. We were interested in individuals who use hydrochlorothiazide, how they compare to folks who did not take this medicine. We looked at sun protection measures from sunscreen use, wearing protective clothing, to staying in the shade, and then we looked at self-reported sunburns. What we found was that indeed, hydrochlorothiazide did affect the risk of sunburn. We found that the sunburn risk was associated with race, sex, and how long someone had been taking this medicine.  :32

Chien says the study points to the need to make people aware that they must employ sun protection measures when taking this medication. At Johns Hopkins, I’m Elizabeth Tracey.

If you’ve been told your blood pressure is normal you might feel there’s nothing to worry about, yet a new report by a federal task force suggests otherwise. Greg Prokopowicz, a blood pressure expert at Johns Hopkins, explains.

Prokopowicz: There’s a fair number of patients who have what we call ‘masked hypertension.’ So there are patients whose blood pressure in the clinic is normal, but if they were to check it at home they would find that it’s high, and this is a much more problematic group of patients to understand and treat appropriately.  :18

Prokopowicz says how many people have masked hypertension isn’t known.

Prokopowicz: We don’t really know exactly how common it is but what they found is half the people out there with high blood pressure will actually have normal readings in the clinic.  :09

Prokopowicz says this is a compelling argument for everyone to have the ability to monitor their own blood pressure at home. At Johns Hopkins, I’m Elizabeth Tracey.

Home blood pressure measurements help confirm a diagnosis of high blood pressure, a federal task force states. Greg Prokopowicz, a blood pressure expert at Johns Hopkins, says a number of such measurements are needed for a couple of reasons.

Prokopowicz: It’s worth pointing out that to really measure blood pressure properly in the office, you’re supposed to have the patient sit down and relax for five minutes before you even check the blood pressure but very few clinics can actually implement that because the workflow is such that you just don’t have the time to do that, so we’re really not measuring blood pressure entirely correctly in most clinics. So that heightens the need to get additional data outside of the clinic. And that would imply maybe ten or twenty home readings.  :31

Prokopowicz says having a large number of blood pressure readings taken at different times of day helps develop the most accurate picture of whether someone really has high blood pressure and needs treatment. At Johns Hopkins, I’m Elizabeth Tracey.

You’ve been told you have high blood pressure and now need confirmation. Can you accomplish that goal with a home blood pressure monitor? Greg Prokopowicz, a blood pressure expert at Johns Hopkins, says the latest guidelines say you can.

Prokopowicz: There’s been a greater acknowledgement that home blood pressure monitoring is probably going to be where we should focus our energy. The current guidelines recommend getting an office reading and then confirming it with home readings, so that’s a sensible recommendation, because there are a lot of people who will have a high reading in the office due to the stress of the environment, maybe they’re not given an adequate chance to relax before their blood pressure is measured, and their home readings would be completely normal. And we don’t want to put those people on medications, so it is really important to do that.  :32

Prokopowicz says a home monitor also helps make sure your medicines are working to keep blood pressure under control. At Johns Hopkins, I’m Elizabeth Tracey.

Many people have elevated blood pressure when they visit their doctor’s office, so if you’ve been told your blood pressure is high that needs to be confirmed before you are put on any medicines to lower it. That’s according to new guidelines from the US Preventive Services Task Force. Greg Prokopowicz, a blood pressure expert at Johns Hopkins, explains.

Prokopowicz: A single office blood pressure measurement doesn’t tell the whole story. So you want to confirm that with some sort of out of office blood pressure monitoring. And in previous guidelines they’ve often emphasized ambulatory blood pressure monitoring, which is where you wear a monitor and walk around with it for 24 hours and it takes a blood pressure reading every twenty to thirty minutes. That set of measurements is the best way to get a sense of where you stand with respect to blood pressure it terms of your risk for future problems related to your blood pressure meaning heart attack, stroke, and kidney disease. :32

At Johns Hopkins, I’m Elizabeth Tracey.