The Harvard Health Letter’s Top 10 Health Stories of 2004

BOSTON, Dec. 3 /PRNewswire/ — As it does every December, the Harvard Health Letter has chosen the top 10 health stories of the year. Here are this year’s winners:

1. Lowdown on cholesterol, high-dose statins. Revised government

guidelines carved out a new “very-high-risk” category and set a

super-low standard of 70 mg/dL or less of “bad” LDL cholesterol for

people in this new category.

2. Cloning for stem cells. Two controversial research paths crossed this

year when South Korean scientists announced that they had created 30

cloned human embryos and harvested embryonic stem cells from one of

them. If this “therapeutic” cloning becomes acceptable and practical,

this breakthrough would make a steady supply of stem cells available.

Not only that, but the stem cells could contain the patient’s own

genes, reducing the risk that they would be rejected by the immune

system.

3. The rise and fall of Vioxx. In September, Merck yanked its blockbuster

“super aspirin” off the market after a study showed that it doubled

heart attack and stroke risk in people who took it longer than 18

months.

4. Making smart drugs even smarter. The latest generation of cancer drugs

zeroes in on abnormalities particular to tumor cells, as opposed to

traditional cancer drugs, which attack all dividing cells.

5. Bad news about drugs should see the light of day. A new solution has

been proposed to make sure that the findings of drug trials get

reported. Researchers would have to post information about trials in

a public database before they embarked on them to make sure the media

and the public know what trials are taking place, and when they

should look for results.

6. Take your brain for a walk. Taking regular walks may also be good for

your mind according to recent studies. Results from Harvard’s Nurses’

Health Study suggest that regular physical activity, including plain

old walking, lowers the risk for cognitive impairment by 20% for

women in their 70s. Results from another study also found that

walking seemed to afford some protection against dementia.

7. PSA: Speed may matter. Judging by the declining mortality statistics

for prostate cancer, most experts agree that PSA screening for the

disease does more good than harm. But there are other important

factors to consider besides the PSA number, including how fast PSA

levels have increased — often called “PSA velocity.” One study found

that patients whose PSA levels had increased by more than 2.0 in the

year before a diagnosis of prostate cancer had a much higher

mortality rate than those with slower rates of increase.

8. Cost shifting to pay-tients. For the third year in a row, private

health insurers have tried to rein in double-digit premium increases

by shifting costs to their customers. One way they do it is by

increasing copayments for doctor and hospital visits. Many insurers

have tiered their drug coverage: low copayments for generic drugs,

more for brand-name medications on a “preferred” list (a formulary),

and much more for brand-name drugs that aren’t on the formulary. Some

companies are applying the same approach to hospital care.

9. Controversy over coronary calcium scanning. Scanning coronary arteries

for signs of calcium is a high-tech way to uncover atherosclerosis

early. However skeptics believe that this test adds more cost than

benefit. Even people with minimal atherosclerosis (and almost all

Americans have some) may have a “positive” scan that leads to

unnecessary further tests and even treatment. After a press report

said the American Heart Association was getting ready to endorse the

scans, the organization decided against publishing a new statement

and reemphasized the position it took in 2000: The scans are best

used as tie-breakers when some criteria indicate increased risk and

others do not.

10. The flu vaccine shortage. The flu vaccine shortage this winter shows

that the American system for immunizing people may be a disaster

waiting to happen. Part of the problem is economic-because vaccines

aren’t big money-makers, American companies shy away from them.

Proposals to realign economic incentives to lure American companies

back into vaccine manufacturing may help, as would new advances in

the flu vaccine itself.

The Harvard Health Letter is available from Harvard Health Publications, the publishing division of the Harvard Medical School. You can subscribe for $28 per year at http://www.health.harvard.edu/health or by calling 1-877-649- 9457 toll-free.

Media: Contact Christine Junge at Christine_Junge@hms.harvard.edu for a complimentary copy of the newsletter, or to receive our press releases directly.

Harvard Health Publications

CONTACT: Christine Junge of Harvard Health Publications, +1-617-432-4717,Christine_Junge@hms.harvard.edu

Web site: http://www.health.harvard.edu/