UPDATES:OPTICIANS BLIND TO GLAUCOMA

Opticians are not properly testing for glaucoma, or high blood pressure in the eye, which affects about 2 per cent of people. As a result, only about a half of cases are ever detected and, of these, 20 per cent have already suffered a major loss of v

Ronald Crick and Maurice Tuck from the International Glaucoma Association, based in London, say that several routine tests such as tonometry and perimetry would take just six minutes to complete, and could detect most cases in the early stages (BMJ, March 4, 1995).

Heart drugs win the day

Just when medicine thought magnesium was going to be the safe, inexpensive and effective treatment for people with heart problems, new research has come out showing that drugs are still the way forward. The drug captopril was found to be particularly beneficial.

It’s worth noting that the pharmaceutical giant Bristol-Myers Squibb funded the £6m research study, and just happens to be the manufacturer of captopril.

The findings fly in the face of several earlier research studies, which seemed to suggest a major breakthrough in heart treatment. A first study of 200 heart patients showed that magnesium, given intravenously, reduced the numbers of deaths. The findings were confirmed in a larger study of 2,216 patients, when it was found that magnesium reduced the death rate among patients by 24 per cent.

The new study, covering 58,000 patients at 1,086 hospitals, came up with quite different results. Magnesium seemed to have little or no effect, with 2,216 deaths reported among the 29,011 patients receiving the treatment, against 2,103 deaths among the 29,039 given standard treatment.

Patients on captopril, however, had a 7 per cent lower death rate after five weeks. Another treatment, mononitrate, also seemed to have little beneficial effect.

When the results of the new study were first announced, the trial was condemned by some heart specialists as being unreliable, and that those who were enrolled into the magnesium programme were unsuitable (The Lancet, March 18, 1995).

More evidence that diet against cholesterol doesn’t work. People attending a doctor’s surgery in Oxfordshire were able to reduce cholesterol levels by only about 1.5 per cent by following the advice of a dietician, a nurse or from a leaflet (BMJ, March 4, 1995).

Women have a lower survival rate after heart transplant. After six months, 75 per cent of women were still living, against 84 per cent of men. The gap widened after three years, to 64 per cent of women, compared with 76 per cent of men (Circulation, February 15, 1995).