The Washington Post - 12.11.2019

tuesday, november 12 , 2019. the washington post eZ ee e3

BY MIKE STOBBE

Health officials estimate that
millions of cases of heart disease
and other illnesses are linked to
abuse and other physical and psy-
chological harm suffered early in
life.
In a report released last week,
the Centers for Disease Control
and Prevention tried to estimate
the impact of harmful childhood
experiences on health in adult-
hood. Health officials acknowl-
edged the study does not prove
that these experiences directly
cause certain illnesses. And they
were not able to rule out other
possible factors, such as the stress
caused by financial family prob-
lems.
But the link is strong, and is
bolstered by many other studies,
said Jim Mercy, who oversees the
CDC’s violence prevention pro-
grams.
“ There’s a lot of evidence con-
necting these things,” and it’s be-
come clear that the more harmful
incidents a child suffers, the more
likely their health suffers later, he
said.
For at least two decades, re-
searchers have been looking at
how suffering or witnessing trau-
matic events as a child affects the
likelihood of physical injury or
illness later in life.
Researchers say such stressful
experiences can affect how the
body develops, and can also put a
child on a path to smoking, drug
use and other unhealthy behav-
iors.
The topic has been getting
more attention in recent years
from public health officials. Cali-
fornia’s new surgeon general has
made childhood trauma and what
is known as toxic stress a priority.
CDC has been involved in pre-
vious research on the topic, but

last week’s report is the agency’s

first on the national impact of the

problem.

Researchers are increasingly

focused on developing ways to

reduce what is now a well-estab-

lished link, said Dayna Long, a

researcher at the UCSF Benioff

Children’s Hospital Oakland. She

called the CDC report “critical”

because it adds important esti-

mates about the potential impact

preventive measures might have.

The findings are based o n ques-

tionnaires of about 144,000 adults

in 25 states that were conducted

in 2015, 2016 or 2017. The surveys

asked people about health prob-

lems. They also were asked about

childhood experiences with di-

vorce, a buse, domestic violence or

drug abuse in the home, or a

relative’s mental illness.

The survey did not assess how

severe the experiences were, and

it’s not clear if some types of

incidents are more harmful than

others. But CDC officials are rec-

ommending programs to try to

stop such incidents or lessen their

impact. They mentioned mentor-

ing programs, parent education

and paid family leave. The CDC

found:

l Adults who experienced the

most potentially traumatic events

were more likely to smoke and

drink heavily.

l Women, blacks and American

Indians and Alaska Natives were

more likely to experience four or

more kinds of harm during child-

hood.

l Preventing such events could

potentially reduce the number of

adults with weight problems by

2 percent, the number of adults

with coronary heart disease by

13 percent and the number of

adults with depression by 44 per-

cent.

— Associated Press

health news

Heart disease, other illnesses in adults linked

to childhood traumas, CDC report suggests

health scan

Pure. Healthy. Modern.
To day, you might see those
words on a product in a natural
foods store or an upscale juice
bar. But in the early 20th century,
they were used to describe lead.
Cheap and durable, lead was
ubiquitous in everything from
paint to gasoline to plumbing.
But though the dangers of lead
poisoning were known in the
United States, regulation lagged
for decades. Meanwhile, lead poi-
soning became a public health
crisis.
When humans breathe, eat,
drink or touch traces of lead, it
builds up in their bodies. Over
time, the toxic metal can cause
nerve disorders, create develop-
mental delays, increase blood
pressure, cause infertility and
affect every organ. It took a
concerted effort by concerned
citizens to turn the tide on lead.
“This Lead Is Killing Us,” an
online exhibition from the U.S.
National Library of Medicine,
tells the stories of activists who
mobilized against lead exposure.
T he exhibition features images
of industrial workers, public
housing residents, physicians
and others who agitated for
change. There are also vintage

advertisements that convinced

people lead was a desirable addi-

tion to their homes.

“Lead helps to guard your

health,” crows a 1923 advertise-

ment for Dutch Boy Paints pro-

duced by the National Lead Co.

Of course, it did anything but.

(The company later changed its

name to NL Industries, and Sher-

win-Williams acquired Dutch

Boy in 1980, just after lead was

banned in house paint.)

Activists helped usher in mod-

ern lead regulations, and be-

tween 1976 and 2016, the median

concentration of lead in the blood

of 1- to 5-year-olds decreased

95 percent.

But people still get lead poi-

soning. These days, the most

vulnerable groups are children

under 6, pregnant women, refu-

gees, workers and children who

have been adopted international-

ly.

You can view the exhibition at

bit.ly/NLMlead.

— Erin Blakemore

An online exhibition explores the long fight

against lead poisoning in the United States

this lead is Killing us

u.s. national library of Medicine

online exhibition

bit.ly/NLMlead

C

ases of high blood pres-

sure during pregnancy

rose sharply from 1970

to 2010, according to a

recent study published

in the journal Hypertension.

A key driver of the change:

more women giving birth at o lder

ages, says study author Cande

Ananth, professor and vice chair

of academic affairs and chief of

the division of epidemiology and

biostatistics in the department of

obstetrics, gynecology and repro-

ductive sciences at Rutgers Rob-

ert Wood Johnson Medical

School.

The study also found that black

women are more likely to have

high blood pressure during preg-

nancy than white women.

High blood pressure during

pregnancy — defined in this study

as hypertension diagnosed before

pregnancy or in the first five

months — threatens the health of

both mother and baby. It’s linked

with an increased risk of preterm

birth, low birth weight and severe

complications for the mother,

such as preeclampsia (a poten-

tially fatal condition defined by

high blood pressure during preg-

nancy plus signs of liver or kidney

damage).

Here’s what you need to know

about this study and about your

blood pressure if you’re pregnant

or thinking of becoming preg-

nant.

What the study found

Researchers reviewed Centers

for Disease Control and Preven-

tion data on more than 151 mil-

lion women who gave birth in

hospitals between 1970 and 2010.

(The researchers looked only at

data through 2010 because the

CDC’s d ata collection on hospital-

izations changed substantially af-

ter that year.)

The research revealed that

over the 40 years in question, the

rate of hypertension during preg-

nancy increased by about 6 per-

cent each year — from just

0.11 percent in 1970 to 1.52 per-

cent in 2010.

On average, during the period

studied, the prevalence of hyper-

tension in pregnancy was 0.53

percent among white women,

and 1.24 percent in black women.

Rates of hypertension during

pregnancy have been increasing

in part because more women are

giving birth later in life, research-

ers say, and the risk of high blood

pressure rises with age. Accord-

ing to the CDC, the average age of

first birth in 1970 was 21.4; in

2017, it was 26.8.

The study authors also took

into account data from a different

CDC source on national smoking

and obesity rates, because both

are significant risk factors for

high blood pressure. They w anted

to see whether either may have

played a role in the study’s find-

ings. But the researchers ob-

served only small effects from

these factors.

One limitation, the researchers

note, is that the definition of high

blood pressure has changed over

time. Since 1970, the threshold at

which someone can be diagnosed

with hypertension has gone

down. That alone may have

caused at least some of the rise in

rates, Ananth says.

And the study doesn’t indicate

why black and white mothers

have such different rates. But one

theory is that chronic stress may

contribute, especially the stress

that arises from confronting rac-

ism.

“People are leaning towards

the fact that this could be related

to the stress of being a minority

population in the United States,”

says James M. Roberts, an investi-

gator with the Magee-Womens

Research Institute and a profes-

sor in the department of obstet-

rics, gynecology and reproductive

sciences at t he University of Pitts-

burgh. He wasn’t involved in the

new study.

What to do to cut risk

If you already have high blood

pressure and you’re thinking

about having a baby, talk with

your doctor well before you be-

come pregnant, Roberts says.

That way, if you’re on medication,

you can figure out whether the

drugs you’re taking are safe for

pregnant women. You may need

to switch medications.

Lifestyle changes can help you

get your blood pressure down

before conceiving. Getting regu-

lar exercise, losing weight if you

need to, quitting smoking, ab-

staining from alcohol and im-

proving your diet can all help,

Ananth says.

If you do have high blood pres-

sure while you’re pregnant, Rob-

erts recommends finding a doc-

tor who specializes in high-risk

pregnancies, and working with

that physician to keep a close eye

on your blood pressure. Monitor-

ing your own blood pressure at

home may help. Ask your doctor

what level to aim for and at what

level you should call to alert them.

Know the warning signs of

preeclampsia. Key symptoms to

look out for: persistent head-

aches, abdominal pain, vision

changes such as blurred vision or

seeing spots or light, swelling of

the face or hands, nausea or vom-

iting, sudden weight gain, and

trouble breathing.

If you notice any of these symp-

toms, call your doctor. If you’re

diagnosed with preeclampsia,

your doctor may recommend

blood pressure medication and

close monitoring either in or out-

side of the hospital. Depending

on how far along you are in the

pregnancy, your doctor may also

suggest inducing labor.

Also, be aware that in many

cases, preeclampsia won’t have

any obvious symptoms. That’s a n-

other reason it’s c ritical to receive

regular prenatal care, Roberts

says. That way, your provider can

perform urine and blood tests

that can reveal liver or kidney

dysfunction.

© copyright 2019, consumer reports inc.

From consumer reports

Pregnancy vs. high blood pressure

istock

High blood pressure during pregnancy threatens the health of both

mother and baby, medical experts say.

consumer reports is an

independent, nonprofit organization

that works side by side with

consumers to create a fairer, safer,

and healthier world. cr does not

endorse products or services, and

does not accept advertising. cr has

no financial relationship with

advertisers in this publication. read

more at ConsumerReports.org.

BY LINDSEY TANNER

Office workers bemoaned driv-

ing home in the dark. Night owls

relished the chance to sleep in. On

Nov. 3, people changed their

clocks for daylight saving time.

But many sleep scientists and

circadian biologists are pushing

for a permanent ban because of

potential ill effects on human

health.

Losing an hour of afternoon

daylight sounds like a gloomy

preview for the dark winter

months, and at least one study

found an increase in people seek-

ing help for depression after turn-

ing the clocks back to standard

time in November — in Scandina-

via. Research shows the spring-

time start of daylight saving time

may be more harmful, linking it

with more car accidents, heart

attacks in vulnerable people and

other health problems that may

persist throughout the time

change.

Here’s what science has to say

about a twice-yearly ritual affect-

ing nearly 2 billion people world-

wide.

Bedtime effects

Time changes mess with sleep

schedules, a potential problem

when so many people are already

sleep deprived, says Phyllis Zee, a

sleep researcher at Northwestern

Medicine in Chicago.

About 1 in 3 U.S. adults sleep

less than the recommended sev-

en-plus hours nightly, and more

than half of U.S. teens don’t get

the recommended eight-plus

hours on weeknights. One U.S.

study found that in the week

following the spring switch to

daylight saving time, teens slept

about 2½ hours less than the

previous week. Many people nev-

er catch up during the subse-

quent six months.

Research suggests that chronic

sleep deprivation can increase

levels of stress hormones that

boost heart rate and blood pres-

sure, and of chemicals that trig-

ger inflammation.

Heart problems

It has also been shown that

blood tends to clot more quickly

in the morning. These changes

underlie evidence that heart at-

tacks are more common in gener-

al in the morning, and may ex-

plain studies showing that rates

increase slightly on Mondays af-

ter clocks are moved forward in

the spring, when people typically

rise an hour earlier than normal.

That increased risk associated

with the time change is mainly in

people already vulnerable be-

cause of existing heart disease,

said Barry Franklin, director of

preventive cardiology and cardi-

ac rehabilitation at Beaumont

Health hospital in Royal Oak,

Mich.

Studies suggest that these peo-

ple return to their baseline risk

after the autumn time change.

Automobile crashes

Numerous studies have linked

the start of daylight saving time in

the spring with a brief spike in car

accidents, and with poor perfor-

mance on tests of alertness, both

probably caused by sleep loss.

The research includes a Ger-

man study published this year

that found an increase in traffic

fatalities in the week after the

start of daylight saving time but

no such increase in the fall.

Other studies on how return-

ing to standard time in the fall

might affect car crashes have had

conflicting results.

Our internal clocks

Circadian biologists believe ill

health effects from daylight sav-

ing time result from a mismatch

among the sun “clock,” our social

clock — work and school sched-

ules — and the body’s internal

24-hour body clock.

Ticking away at the molecular

level, the biological clock is en-

trained — or set — by exposure to

sunlight and darkness. It regu-

lates bodily functions such as

metabolism, blood pressure and

hormones that promote sleep and

alertness.

Disruptions to the body clock

have been linked with obesity,

depression, diabetes, heart prob-

lems and other conditions. Circa-

dian biologists say these disrup-

tions include tinkering with stan-

dard time by moving the clock

ahead one hour in the spring.

A mismatch of one hour daily is

enough for ill effects, especially if

it lasts for several months, said

Till Roenneberg, a circadian

rhythm specialist at Ludwig Max-

imilian University of Munich.

Pressure to change

In the United States, daylight

saving time runs from the second

Sunday in March to the first Sun-

day in November. It was first

established 100 years ago to save

energy. Modern-day research has

found little or no such cost sav-

ings.

Federal law allows states to

remain on standard time year-

round but only Hawaii and most

of Arizona have chosen to. Pro-

posed legislation in several states

would have them join suit — or

switch to year-round daylight

saving time, which would require

congressional approval.

— Associated Press

W hy sleep researchers oppose daylight saving time

toxic chemicals

courtesy of national library of Medicine

A linotype machine circa 1917. Printers used lead-based metal type.
Workers were exposed to the heavy metal from printing machines.

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health & science

free educational seminar

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Updates to Minimally Invasive Spine Care

Speakers and topics:

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Spinal Stenosis: A Less Invasive

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Matthew Ammerman, M.D.,

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Navigated Spinal Surgery and

Options for Motion Preservation

in Spinal Surgery — Joshua

Wind, M.D., neurosurgeon

Wednesday, Nov. 20

6:30 to 8 p.m.

Sibley Memorial Hospital

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Conference Room 1

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