Health Topics – Johns Hopkins Medicine Podcasts

What helps people be less susceptible to Covid-19 infection and severe illness? Several recently published scientific papers appear to support the so-called ‘nicotine hypothesis,’ suggesting that nicotine may be beneficial. Micheal Blaha, a cardiologist at Johns Hopkins and tobacco cessation advocate, says this is part of a trend.

Blaha: There’s no doubt that tobacco companies are still trying to infiltrate research and scientific thinking and trying to pull opinions in their direction. This is happening with traditional combustible cigarettes but it’s also happening quite a bit with the makers of electronic cigarettes, who are trying to recruit scientists, recruit post-doctoral fellows to do research for them, and of course serve the purpose of their tobacco products.  :23

Blaha says before accepting any assertions based on so called scientific studies it is always good to ask yourself if this study really makes sense. Abundant information has established the harms of nicotine delivery methods such as electronic and combustible cigarettes. At Johns Hopkins, I’m Elizabeth Tracey.

If you’ve been diagnosed with cancer of a solid organ, things like prostate or breast, genetic analysis of your tumor may prove to provide important information on the best way to manage your disease, a recent study shows. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, explains.

Nelson: They did a study of 1138 patients with solid organ cancer. They could get good sequences from 1015 of them. They looked at either the whole genome or the key suspicious genes, there’s about 1700 of them. What was interesting is they found so called ‘actionable’ gene alterations, the kinds of things you were looking for and so would make a difference in treatment, in 817, which is a what 80 plus percent of the folks.  :27

Nelson says there’s also a place for looking at recurrent cancers since genes change, or mutate, and may also have implications for cancer treatment. At Johns Hopkins, I’m Elizabeth Tracey.

Magnetic resonance imaging or MRI is sometimes used to examine the prostate gland when cancer is suspected and a biopsy is being considered. Now a new study demonstrates its benefits. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, explains.

Nelson: The advantage to the MRI was that there were a significant number of men, a third of them, that you didn’t need to biopsy at all, so that’s an advantage. The difficulties now are the availability of the instrumentation and eyes to examine it. The worry you sometimes get is that are the people who do only the examining of prostates through magnetic resonance imaging all day long every day, are they better at it than people who are more deployed across the country who have to look at many different things? And I think the answer to that is probably yes.  :30

Nelson says for now, men in this situation can ask about having an MRI as well as the volume a center does in this specific application. At Johns Hopkins, I’m Elizabeth Tracey.

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.