US Pharm. 2006;7:14.

ACE Inhibitors Lead to Congenital Malformations
Infants who were exposed to angiotensin-converting enzyme (ACE) inhibitors during the first trimester of pregnancy had a higher risk of major congenital malformations, compared to infants with no exposure to antihypertensive drugs. These study findings were published in the New England Journal of Medicine (2006;354:2443-2451).

This study, reported as the first large epidemiologic study on first-trimester exposure, involved 29,507 infants born between 1985 and 2000. Authors identified 209 infants exposed to ACE inhibitors in the first trimester alone, 202 infants exposed to other antihypertensive drugs in the first trimester alone, and 29,096 infants with no exposure to antihypertensive medications at any time during pregnancy.

A significantly higher risk of major congenital malformations was found in infants with first-trimester exposure to ACE inhibitors (risk ratio, 2.71), compared to infants who had no exposure to antihypertensive drugs. The increased risk of malformations in the ACE inhibitor group included the cardiovascular system (risk ratio, 3.72) and central nervous system (risk ratio, 4.39). However, first-trimester exposure to other antihypertensive drugs did not increase the risk of malformations (risk ratio, 0.66). Researchers concluded, "Exposure to ACE inhibitors during the first trimester cannot be considered safe and should be avoided."

 

Decaf Coffee May Fight Off Diabetes

Postmenopausal women who drink six or more cups of coffee a day have a reduced risk of type 2 diabetes, based on data published in Archives of Internal Medicine (2006;166:1311-1316).

The association between coffee intake and diabetes may be due to minerals, phytochemicals, and antioxidants in the coffee, but the effect of caffeine is unclear, authors noted. To evaluate this link, investigators analyzed data from 28,812 postmenopausal women (free of diabetes and cardiovascular disease) from the Iowa Women's Health Study conducted from 1986 to 1997. Women were divided into groups based on their intake: none, less than one cup, one to three cups, four to five cups, and six or more cups per day. During the 11-year follow-up, 1,418 women were diagnosed with diabetes.

Women who drank six or more cups of coffee a day had a 22% lower risk of diabetes than women who did not drink any coffee. This reduced risk was largely associated with decaffeinated coffee, not regular coffee. Coffee ingredients magnesium and phytate were not influential factors in this association. The particular ingredients in coffee that may explain the protective effect remain unknown.

 

Pesticide Exposure Elevates Risk of PD

Individuals who were exposed to pesticides had a much higher incidence of Parkinson's disease (PD), according to study results reported in the Annals of Neurology (published online at www3.interscience.wiley.com).

To determine whether pesticide exposure elevates the risk of PD, authors examined men and women involved in an American Cancer Society study that began in 1992. Of the 143,325 people who returned surveys in 2001 without a diagnosis or symptoms of PD at baseline, 7,864 participants (5.7%) reported being exposed to pesticides. This group included 1,956 farmers, ranchers, or fishermen.

People exposed to pesticides had a 70% higher incidence of PD than those not exposed (adjusted relative risk, 1.7). No link was found between PD risk and exposure to asbestos, chemical/acids/solvents, coal or stone dust, or other occupational exposures. "Future studies should seek to identify the specific chemicals responsible for this association," authors commented.
--Jessica Jannicelli

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