Pharma news: Hidden killer in your cold meds

Pharma news: Hidden killer in your cold meds

Hidden killer in your cold meds

Dear flocks 

Most people hear "over the counter" and think "safe." If you can buy it at your local drugstore without a prescription, it must be okay to take, right?

Not so fast…

Taking popular OTC cold medicines can actually raise your risk of heart attack.

By now you probably know that taking NSAIDs (nonsteroidal anti-inflammatory drugs) can be bad news for your heart.

In fact, the FDA actually boosted label warnings on NSAIDs in 2015 to say they can increase the risk of heart attack or stroke.

Now a recent study discovered that patients who are suffering from a common cold or flu are also at greater risk.

And when you take NSAIDs while you have a cold or the flu, you triple your chance of having a heart attack.¹

When you have even a mild illness — like a cold or sinus infection — your body produces inflammatory proteins and thickens your blood. That can result in blood clots.

Taking NSAIDs not only causes your blood pressure to go up, it can also cause your blood platelets to clump together and may constrict your blood vessels.

Put them together and your risk for heart attack skyrockets… you're at 3.5 times greater risk than when you're healthy and not taking NSAIDs.

This is concerning because many OTC cold and flu medications contain NSAIDs. Because they can help with fever and pain, they're commonly added to many well-known cold and flu remedies.

I tell my patients to leave these dangerous medications on the shelf and take a walk in the sunshine instead.

A new study published in the British Medical Journal backs up what I've been saying for years — a daily dose of vitamin D can prevent millions of people a year from coming down with colds and flu.

This landmark study included over 11,000 patients. It found that among patients with the lowest levels of vitamin D, supplementation reduced their risk for acute respiratory infection by half.²

I encourage my patients to keep their levels in the range of 40 to 60 ng/mL. You can ask your doctor for a simple blood test if you don't know what yours are.

Sun exposure is the most natural and effective way to make sure your vitamin D levels are where they need to be. But gloomy winter weather and the epidemic use of sunblock means up to 58% of all Americans are deficient in vitamin D.³

If you can, spend at least 15-20 minutes outside every day. Make sure to uncover parts of your body that aren't normally exposed to sunlight.

Wear a hat to protect the delicate skin on your face, but bare your legs, torso or back… anyplace that isn't typically exposed.

The farther north you are from the equator — or the bleaker your winter weather — the more sun you need. If it's not practical to spend enough time in the sunlight every day (making sure not to burn), you should consider supplementing.

Vitamin D supplements are available as vitamin D2 (ergocalciferol) or D3 (cholecalciferol). Make sure to take vitamin D3 because vitamin D2 breaks down rapidly in your body.⁴

I recommend 5,000 IU of vitamin D3 every day.

To Your Good Health,

Effects of Maternal Age and Age-Specific Preterm Birth Rates on Overall Preterm Birth Rates — United States, 2007 and 2014

    Reductions in births to teens and preterm birth rates are two recent public health successes in the United States (1,2). From 2007 to 2014, the birth rate for females aged 15–19 years declined 42%, from 41.5 to 24.2 per 1,000 females. The preterm birth rate decreased 8.4%, from 10.41% to 9.54% of live births (1). Rates of preterm births vary by maternal age, being higher among the youngest and oldest mothers. It is unknown how changes in the maternal age distribution in the United States have affected preterm birth rates. CDC used birth data to assess the relative contributions of changes in the maternal age distribution and in age-specific preterm birth rates to the overall decrease in preterm birth rates. The preterm birth rate declined in all age groups. The effects of age distribution changes on the preterm birth rate decrease were different in younger and older mothers. The decrease in the proportion of births to mothers aged ≤19 and 20−24 years and reductions in age-specific preterm rates in all age groups contributed to the overall decline in the preterm birth rate. The increase in births to mothers aged ≥30 years had no effect on the overall preterm birth rate decrease. The decline in preterm births from 2007 to 2014 is related, in part, to teen pregnancy prevention and the changing maternal age distribution. Effective public health strategies for further reducing preterm birth rates need to be tailored to different age groups.

     National Vital Statistics System data for all live births to U.S. residents in 2007 and 2014 were analyzed for the effects of maternal age on the decline in preterm birth rates. The analysis was limited to births with gestational age ≥20 weeks, as determined by the obstetric estimate. The year 2007 was the first year the obstetric estimate was available nationally (1,3). The year 2014 was the most recent year with final birth data available at the time of analysis. Preterm birth rates were defined as <37 completed weeks of gestation and expressed as a percentage of live births. Maternal age was categorized as ≤19, 20−24, 25−29, 30−34, and ≥35 years. Using rate decomposition methods, the change in preterm birth rates from 2007 to 2014 was divided into two components: 1) changes in the maternal age distribution, and 2) changes in the age-specific preterm birth rates (4). The two components were calculated relative to each other; one was held constant (by using the average value for the 2 years) as the observed variation in the other component was assessed. The sum of the two components across the age groups equaled the total preterm birth rate difference (4).

From 2007 to 2014, maternal age increased from a mean of 27.4 years to 28.3 years (Figure). A decrease in the percentage of births to mothers aged ≤24 years was observed, which included a 39.5% decrease in births to teens and an increase in births to women aged ≥25 years (Table).

From 2007 to 2014, the preterm birth rate decreased from 10.41% to 9.54%, an absolute rate difference of -0.87% (Table). A U-shaped relationship between maternal age and preterm birth was present in both years with the lowest preterm birth rate occurring among women aged 25−29 years (Table) (Figure). The decrease in preterm birth rates from 2007 to 2014 was observed for mothers at all ages <42 years. The absolute rate difference was highest among teens and lowest among women aged ≥35 years (Table).

   The decomposition analysis partitioned the overall observed rate difference of -0.87% into two parts, age distribution and age-specific rate components (Table). The change in age distribution contributed to the preterm birth rate decrease (as indicated by the negative values) only among mothers aged ≤24 years. In contrast, the age distribution component for mothers aged ≥25 years, and especially for mothers aged ≥30 years, offset this decline. When the age distribution components were summed across the age groups, a negligible effect (0.01) was observed on the overall change in preterm birth rates. The change in age-specific preterm birth rates contributed to the decline in preterm birth rate across all age groups.

    Examining the total effect of both components on the preterm birth rate decline by age group, the largest total effects were observed among mothers aged ≤19 and mothers aged 20−24 years (Table). In these two groups, the change in age distribution had a larger effect than the change in the age-specific preterm birth rate. For mothers aged 25−29 years, the total effect also contributed to the overall preterm birth rate decline because the age-specific rate component was greater than the age distribution component. For mothers aged ≥30 years, the total effect of both components did not contribute to the overall preterm birth rate decrease; the rate increases from the age distribution components were greater than the rate decreases from the age-specific rate components.

These analyses included all births; however, sensitivity analyses restricting to singleton births produced similar results. The overall absolute rate difference for singletons during this period was -0.85%, compared with the -0.87% for all births.

Discussion

     The overall decline in the preterm birth rate from 2007 to 2014 was related to declines in age-specific preterm birth rates and a decrease in prevalence of births to teens and women aged 20−24 years. The contribution from mothers aged ≥24 years to the age-distribution component was offset by an increased prevalence of births to older mothers who have high rates of preterm birth. Thus, the total age distribution component masked divergent influences of younger and older mothers on the overall preterm birth rate decline. Because of this, the influence of younger mothers on the overall preterm birth rate decline is more appropriately indicated by examining the age-specific total effects in the decomposition analysis. Considering relative effects of both age distribution and age-specific preterm birth rate components, only mothers aged ≤29 years contributed to the overall rate decline, with the largest contributions from teens and women aged 20−24 years.

   Other studies have documented increased preterm birth rates among teen and older mothers compared with mothers in their mid-twenties to early thirties. Although teen and older mothers might share some common preterm birth risk factors, such as low socioeconomic status, extremes of body mass index, and smoking, physiologic immaturity is a risk factor for teen mothers and the prevalence of preexisting chronic disease is greater among older mothers. This heterogeneity of risk for preterm births according to maternal age and the variation in changes in age-specific preterm birth rates, combined with the changes in maternal age distribution over time, suggest the need for varying preterm birth prevention strategies across the reproductive life span.

The findings in this report are subject to at least one limitation: the relationship of preterm birth with maternal age is associative, not causal. The analysis did not assess the impact of other pregnancy outcomes, such as elective termination or fetal death, or of potential confounders, such as maternal race/ethnicity, obstetric history, smoking, socioeconomic status, body mass index, chronic or pregnancy-related conditions, prenatal care, and delivery method. The effects on preterm birth rates of maternal 17-hydroxyprogesterone use, a preterm birth prevention strategy that increased during this period , were not examined and the effects of maternal age on spontaneous, medically indicated, early, or late preterm births were not assessed.

The overall decline in the preterm birth rate from 2007 to 2014 is related in part to the changing maternal age distribution associated with the success of teen pregnancy prevention and declines in unintended pregnancy. Teen pregnancy prevention is one of CDC’s Winnable Battles . Although teen pregnancy prevention and family planning have many positive health and societal effects, the results of this analysis suggest these programs might also have direct effects on reducing preterm birth rates. Based on recent data, 75% of pregnancies to teens aged 15−19 years and 59% of pregnancies to women aged 20−24 years are unintended . The need for prevention of first and repeat teen pregnancies continues. Prevention of unintended pregnancy and encouragement of optimal birth spacing is one part of a five-part strategy for preterm birth prevention. Other strategies include improved access to preconception care, preterm birth risk identification and treatment, reduction of elective delivery before 39 weeks gestation, and single embryo transfer in assisted reproductive technology. These strategies need to be implemented throughout the reproductive life span to reduce preterm births for all maternal ages.

 FIGURE. Percentages of live births (LBs) and preterm births (PTBs), by maternal age —United States, 2007 and 2014

                         

November is National Prematurity Awareness Month

In 2016, about 1 in 10 babies was born too early in the United States. Learn about the problem, risk factors, and what we can do to reduce premature birth.

About Premature Birth

A developing baby goes through important growth throughout pregnancy—including in the final months and weeks. Premature (also known as preterm) birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. The earlier a baby is born, the higher the risk of death or serious disability. In 2015, preterm birth and low birth weight accounted for about 17% of infant deaths. Babies who survive can have breathing issues, intestinal (digestive) problems, and bleeding in their brains. Long-term problems may include developmental delay (not meeting the developmental milestones for his or her age) and lower performance in school.

Preterm Birth in the United States

Reducing preterm birth is a national public health priority. Preterm birth rates decreased from 2007 to 2014, and CDC research shows the decline in preterm births is partly due to fewer teens and young women giving birth. Despite this success, the preterm birth rate rose for the second straight year in 2016, and about 1 in 10 babies (10%) was born too early in the United States. Additionally, racial and ethnic differences in preterm birth rates remain. For example, in 2016, the rate of preterm birth among non-Hispanic black women (14%) was about 50% higher than the rate of preterm birth among non-Hispanic white women (9%).

Risk Factors

Experts don’t know all the reasons that some babies are born too early. Some things (called risk factors) can increase the chance that a woman will have a preterm birth. However, a woman can still have a premature birth even if she has no known risk factors.
Risk factors for preterm birth include—

• Social characteristics
  • Black race
  • Teens and women over age 35
  • Low socioeconomic position

• Health behaviors
  • Tobacco use
  • Alcohol or drug abuse
• Medical and pregnancy characteristics
  • Mental health (stress, depression)
  • Pregnancy history (short time between pregnancies, delivering a baby preterm in the past, being pregnant with multiples)
  • Pregnancy complications (preeclampsia, placenta previa or placental abruption)
  • Medical disorders (thyroid disease, obesity, asthma, diabetes, high blood pressure)
  • Fertility treatments (assisted reproductive technology or other treatments)
  • Infection within the uterus

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