February 20, 2004
Carol J. Schlueter
Phone: (504) 865-5714
First, the good news. Coronary disease and cardiovascular disease are "somewhat on the decline" in America, although they remain the
leading causes of death in this country by far.
You know what's coming next, and it hits New Orleanians right where it hurts. And right in the middle of King Cake season.
The bad news: hypertension is still poorly controlled in almost three out of four of the 60 million Americans with high blood pressure, and diabetes mellitus is clearly on the increase.
Both diabetes and hypertension are being caused or worsened by obesity. All of these issues were addressed in the Presidential Symposium on Jan. 28.
"There is a reciprocal relationship between kidney disease and hypertension, hence the combination of the two in our center," said Lee Hamm as he opened the symposium's public forum, "Silent Killers: High Blood Pressure and Kidney Disease."
The Tulane Hypertension and Renal Center of Excellence organized the symposium, which included a scientific session at the School of Medicine and a public forum on the uptown campus. Hamm and Gabriel Navar are the center's directors. Robert Alpern, one of the four nationally known researchers brought in to discuss these problems, is especially concerned about the potential for kidney disease in children.
"There is clearly an epidemic of kidney disease that's occurring and that's going to get worse, driven by hypertension and also driven by obesity," said Alpern, dean of the medical school at the University of Texas Southwestern Medical Center in Dallas. "As our children sit in front of their computers and play electronic football instead of real football, what we're gong to see is that they're all going to be predisposed to hypertension and diabetes."
People who have a family history of diabetes have to make the right lifestyle choices, said Josephine Briggs, a nephrologist from the National Institute of Diabetes and Digestive and Kidney Diseases. "Certainly, doing your best to maintain your ideal body weight and regular exercise is enormously important," she said.
Finding the right diet is crucial, but staying on it is even more important, said Teri A. Manolio, from the National Heart, Lung and Blood Institute. "The biggest problem in obesity control is not initial loss of weight ... the problem is keeping that weight off. It means lifelong lifestyle changes and increased activity."
The easy availability of calorie-intense foods, promoted by prevalent advertising, has become a public health concern. "I think in the end as a society we're going to have to come to grips with this," said Paul Whelton, senior vice president for the health sciences at Tulane and an internationally recognized expert on hypertension and cardiovascular disease. "We're going to have to approach this from a societal viewpoint of changing our food chain."
Some diets and treatments for individuals are better than others because of genetics, said Jean-Marc Lalouel, professor of human genetics at the University of Utah.
"This is the hope of the geneticist, that down the road we would understand more about the underlying predisposition to common disease." The researchers felt that the use of adult stem cells holds promise in the repair of organs such as the kidney, though much research is needed in this area. "What could possibly happen with stem cells could be greater than any other field of therapy," Alpern said.
Tulane University, New Orleans, LA 70118 504-865-5000 firstname.lastname@example.org