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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