Geographical Variance in Heart Attack Risk

Northern European and American men with high blood pressure are three times as likely to die of a heart attack than men with the same blood pressure from Japan or the Mediterranean coast of Europe, a study found. Although genetics may explain some of the difference, diet also plays an important part, the researchers said.

Researchers from the Netherlands analyzed data on 12,031 middle-aged men in six geographic areas and found that in every region, the risk of death from coronary heart disease increased as blood pressure rose. Overall, the risk of death rose 28 percent for each 10-point increase in systolic blood pressure (the first number in the blood pressure reading) or each 5-point increase in diastolic blood pressure.

But the number of deaths varied widely from place to place. For example, among men with a systolic blood pressure of 140, there were about 70 deaths per 10,000 person-years in Northern Europe and the United States, compared with 20 deaths in Japan and the Mediterranean. A person-year is a measure of the number of years lived by the participants after the study began.

The study was published in today's New England Journal of Medicine.

Campaign Reduces Strep in Newborns

A U.S. public health effort to detect and treat streptococcus B in pregnant women has cut the rate of strep in newborns by 65 percent, a study found.

The most dramatic decrease came among black newborns, who got streptococcus B at nearly twice the rate of white newborns when the study began in 1993. The rate of infection for black infants fell from about 2.5 per 1,000 live births to 0.8 in 1998, close to the 1998 rate for white infants of 0.5.

Streptococcus B can cause death or disabilities, including mental retardation and vision and hearing problems, in newborns infected while passing through the birth canal. Transmission can be prevented by giving infected women antibiotics during labor.

The study, published in today's New England Journal of Medicine, involved monitoring, testing and treating the disease in eight areas of the United States.

Ultrasound Can Detect Fetal Anemia Cases

Ultrasound can detect virtually all cases of life-threatening anemia in fetuses, sparing many pregnant women the need for a riskier surgical test, a study found.

Serious anemia occurs in a small percentage of fetuses who inherit certain types of red blood cells from their fathers. If the mother doesn't have the same type, her immune system may form antibodies that attack the fetus's red blood cells, causing serious complications and even death in the fetus.

A study published in today's New England Journal of Medicine found that ultrasound was 100 percent effective at detecting moderate or severe fetal anemia.

Researchers used ultrasound to measure the speed of blood moving through the middle cerebral artery in 112 fetuses at risk for anemia.

The lower the level of red blood cells and the life-giving oxygen they carry, the faster the fetus's heart pumps, trying to get oxygen to the brain. The study found that fetuses in which the blood velocity was more than 1 1/2 times normal had either moderate or severe anemia, necessitating a blood transfusion before the 34th week of pregnancy.

The diagnosis was confirmed with the current standard test for fetal anemia: cordocentesis, which involves inserting a needle through the mother's uterus and into the umbilical cord to withdraw fetal blood.