Older Americans' Cholesterol Down

Older Americans have lowered their cholesterol levels, thanks to popular statin drugs, but adults of all ages have resisted making lifestyle changes to reduce their levels, a study said yesterday.

The decline in average blood cholesterol levels was observed between 1995 and 2002 among men 60 and older and women 50 and older but not among younger adults, the Centers for Disease Control and Prevention said. Statins -- which include Lipitor, Pravachol and Zocor -- are prescribed to lower levels of low-density (LDL) cholesterol.

Cholesterol levels among all adults decreased on average from 206 milligrams per deciliter of blood during the 1988-1994 period to 203 milligrams per deciliter in 1999-2002, Margaret Carroll wrote in the Journal of the American Medical Association. Older adults accounted for the drop, while levels in younger adults did not change. Doctors generally recommend a total cholesterol level below 200.

Breast Cancer Mortality Gap Remains

Black women with breast cancer do not live as long as white women with the disease, largely because of higher rates of diabetes, high blood pressure and other concurrent ills, researchers said.

The finding helps explain the disparity beyond previously recognized differences such as black women having advanced stages of the cancer when diagnosed, receiving inferior medical treatment and often living in poverty, said the report from Brock University at St. Catharines, Ontario.

In general, white breast cancer patients have an 89 percent chance of surviving for five years, compared with 75 percent for black women, the study found.

A review of more than 900 black and white breast cancer patients in a Detroit health care system found that other conditions -- specially diabetes and high blood pressure -- accounted for more than 76 percent of the survival disparity, concluded the report in the Journal of the American Medical Association.

Incentives for Doctors Questioned

Paying doctors to reach clinical targets, a hot trend in the push to improve health care quality, may not lead to hoped-for improvements, researchers said.

A two-year study, featured in the Journal of the American Medical Association, found that paying bonuses for hitting quality goals mainly rewards doctors who are already top performers and produces some increase in the number of patients screened for disease.

In one of the first studies of the plans, researchers evaluated a pay-for-performance program offered by insurer PacifiCare Health Systems Inc. The study compared group practices that used the program with practices that did not use it over more than two years.

The study found that doctors already at the target levels received 75 percent of the bonus money.

Smallpox Vaccine Carries Warning

Wyeth's smallpox vaccine will carry a new "black box" warning about cardiac problems that have occurred after immunization, the Food and Drug Administration said.

A black-box warning is the strongest type of warning for prescription drugs and vaccines. The warning says cases of myopericarditis, a heart inflammation, have occurred after vaccination with Dryvax in healthy adults.

-- From News Services