Most Adults in US Have Low Risk of Heart Disease

　　More than 80 percent of US adults have a less than 10 percent risk of developing heart disease in the next 10 years, according to a report in the Journal of the American College of Cardiology. Just 3 percent have a risk that exceeds 20 percent.
　　“I hope that these numbers will give physicians, researchers, health policy analysts, and others a better idea of how coronary heart disease is distributed in the US population,” lead author Dr. Earl S. Ford, from the Centers for Disease Control and Prevention1 in Atlanta, said in a statement.
　　The findings are based on analysis of data from 13,769 subjects, between 20 and 79 years of age, who participated in the Third National Health and Nutrition Examination Survey from 1988 to 1994.
　　Overall, 82 percent of adults had a risk of less than 10 percent, 15 percent had a risk that fell between 10 to 20 percent, and 3 percent had a risk above 20 percent.
　　The proportion of subjects in the highest risk group increased with advancing age, and men were more likely than women to be in this group.2 By contrast3, race or ethnicity had little effect on risk distributions.
　　Although the report suggests that most adults have a low 10–year risk of heart disease, a large proportion have a high or immediate risk4, Dr. Daniel S. Berman, from Cedars-Sinai Medical Center in Los Angeles, and Dr. Nathan D. Wong, from the University of California at Irvine, note in a related editorial.
　　Aggressive treatment measures and public health strategies are needed to shift the overall population risk downward, they add.

Dangers Await Babies with Altitude

　　Women who live in the world’s highest communities tend to give birth to under-weight babies, a new study suggests. These babies may grow into adults with a high risk of heart disease and strokes.1
　　 Research has hinted that newborns in mountain communities are lighter than average. But it wasn’t clear whether this is due to reduced oxygen levels at high altitude or because their mothers are under-nourished — many people who live at high altitudes are relatively poor compared with those living lower down.
　　To find out more, Dino Giussani and his team at Cambridge University studied the records of 400 births in Bolivia during 1997 and 1998.The babies were born in both rich and poor areas of two cities: La Paz and Santa Cruz. La Paz is the highest city in the world, at 3.65 kilometers above sea level, while Santa Cruz is much lower, at 0.44 kilometers.
　　Sure enough, Giussani found that the average birthweight of babies in La Paz was significantly lower than in Santa Cruz. This was true in both high and low-income families. Even babies born to poor families in Santa Cruz were heavier on average than babies born to wealthy families in lofty La Paz. “We were very surprised by this result,” says Giussani.
　　The results suggest that babies born at high altitude are deprived of 2 oxygen before birth. “This may trigger the release or suppression of hormones that regulate growth of the unborn child.3 ”says Giussani.
　　His team also found that high-altitude babies tended to have relatively larger heads compared with their bodies4. This is probably because a fetus starved of oxygen will send oxygenated blood to the brain in preference to the rest of the body5.
　　Giussani wants to find out if such babies have a higher risk of disease in later life. People born in La Paz might be prone to heart trouble in adulthood, for example. Low birthweight is a risk factor for coronary heart disease. And newborns with a high ratio of head size to body weight are often predisposed to high blood pressure and strokes in later life.

Better Control of TB Seen If a Faster Cure Is Found

　　The World Health Organization estimates that about one-third of all people are infected with bacteria that cause tuberculosis. Most times, the infection remains inactive. But each year about eight million people develop active cases of TB, usually in their lungs. Two million people die of it. The disease has increased with the spread of AIDS and drug-resistant forms of tuberculosis.
　　Current treatments take at least six months. Patients have to take a combination of several antibiotic drugs daily. But many people stop as soon as they feel better. Doing that can lead to an infection that resists treatment. Public health experts agree that a faster-acting cure for tuberculosis would be more effective. Now a study estimates just how effective it might be. A professor of international health at Harvard University led the study. Joshua Salomon says a shorter treatment program would likely mean not just more patients cured. It would also mean fewer infectious patients who can pass on their infection to others.
　　The researchers developed a mathematical model to examine the effects of a two-month treatment plan. They tested the model with current TB conditions in Southeast Asia. The scientists found that a two-month treatment could prevent about twenty percent of new cases. And it might prevent about twenty-five percent of TB deaths. The model shows that these reductions would take place between two thousand twelve and two thousand thirty. That is, if a faster cure is developed and in wide use by two thousand twelve.
　　The World Health Organization developed the DOTS program in nineteen ninety. DOTS is Directly Observed Treatment, Short-course. Health workers watch tuberculosis patients take their daily pills to make sure they continue treatment.
　　Earlier this year, an international partnership of organizations announced a plan to expand the DOTS program. The ten-year plan also aims to finance research into new TB drugs. The four most common drugs used now are more than forty years old. The Global Alliance for TB Drug Development says its long-term goal is a treatment that could work in as few as ten doses.