High Blood Pressure

Lab Notes — Fall 2019

The Key to Allergies

An unexpected source drives severe allergies, researchers from UConn Health, The Jackson Laboratory for Genomic Medicine, and Yale University report in Science. An antibody known as high-affinity IgE is often behind the most severe food allergies, triggering anaphylactic shock. The researchers looked at mice with a genetic immune problem that causes severe food allergies including anaphylaxis. They found a subtype of immune cells called Tfh13 signal to B cells, another category of immune cell, telling them to make high-affinity IgE. When the researchers deleted Tfh13 cells in mice, the allergies disappeared. People with severe allergies tend to have elevated Tfh13 levels compared with nonallergic peers. The findings could point the way to better allergy testing and perhaps new approaches for treating allergies.


Just Breathe

Yoga practice that emphasizes mental relaxation and breathing techniques can have as much of a beneficial impact on high blood pressure as aerobic exercise, according to research by Yin Wu, Ph.D., a postdoctoral fellow in UConn’s Department of Kinesiology. The study, published in Mayo Clinic Proceedings, highlights the potential for yoga as an alternative antihypertensive therapy, particularly for those unable or unwilling to perform aerobic exercise. “We are not telling people to use yoga to substitute for aerobic exercise,” says Wu. “Aerobic exercise is the gold standard for antihypertensive lifestyle therapy. But yoga provides an additional option that can be just as effective.”


Caution: Falls Ahead

Antidepressant drugs known as selective norepinephrine reuptake inhibitors, or SNRIs, can lead to adverse events in adults over 65, according to a team of researchers from UConn School of Pharmacy, UConn Health, and Yale University. Among this drug class, duloxetine, which is commonly known as Cymbalta, was shown to most likely increase the risk of falls over time, according to the study published in the Journal of the American Geriatric Society. SNRIs, particularly duloxetine, should be avoided or used with caution in older adults, the researchers say.


Halting Hypertension’s Effects

Elderly people with hypertension who took a high dosage of medicine to manage their high blood pressure showed significantly less accumulation of harmful brain lesions compared to those taking a lower dose of the same medicine, UConn Health researchers reported at the American College of Cardiology’s 68th Annual Scientific Session. However, the reduction in brain lesions did not translate to a significant improvement in mobility and cognitive function. The INFINITY study is the first to demonstrate an effective way to slow the progression of cerebrovascular disease, a condition common in older adults that restricts the flow of blood to the brain. In addition to seeing beneficial effects in the brain, those who kept their blood pressure lower also were less likely to suffer major cardiovascular events, such as a heart attack or stroke.

Working Together for Better Public Health

Q&A with Dr. Raul Pino, commissioner of the Connecticut Department of Public Health and a UConn Health board member

Q

What are some of the major public health issues facing Connecticut?

There are many public health issues facing both Connecticut and the nation as a whole. At the Department of Public Health, our emphasis is on the Centers for Disease Control and Prevention’s 6|18 initiative, which targets six major health conditions — asthma, high blood pressure, tobacco use, hospital-acquired infections, teen pregnancy, and diabetes — with 18 evidence-based public health interventions.

Each of these conditions is common, preventable, and costly, but importantly, all have proven interventions that can be effectively employed across the health care spectrum to improve both individual and community health, saving lives and dollars. Other areas where I believe we can see good results in Connecticut by employing evidence-based interventions include addressing HIV and the rising number of syphilis cases.


Q

How can physicians assist the DPH daily to address and reduce these issues?

Doctors, particularly primary care physicians, are the main point of contact with the public for health education. We need to engage practitioners in addressing the six major health conditions with their patients — screening for the conditions; educating in advance to enhance prevention of disease; and providing effective, evidence-based treatments when needed. Physicians play a critical role on the front lines of health care to shift our focus from treatment to prevention through lifestyle changes and other healthy choices. They are an indispensable part of the continuum of care between DPH, health care practitioners, and public health.


Q

As DPH commissioner, what drives your daily public health passion and mission?

I am convinced that we — as a nation, a state, and as public health professionals — can do more than we are currently doing to impact public and population health. Addressing the health disparities that continue to plague our population, costing millions of lives and countless health care dollars, is what drives me. We are so fortunate to live in one of the richest countries, and states, in the world, yet we spend so little on public health. My mission is to spread the message that modest investments of money, time, and effort in proven education and prevention methods can lessen these disparities, which will save millions of dollars in health care costs and, more importantly, save lives.


Q

Tell us about your connection to UConn Health and what you hope to accomplish as a member of the board of directors.

I am a 2009 graduate of the UConn Master of Public Health program and receive my own health care at UConn Health. Spending time there for my education and health care has really crystallized for me that UConn Health is the epicenter of clinical care and education in Connecticut. UConn Health is where advances in science and medicine happen, which allows patients to get the best in cutting-edge care. As a member of the board of directors, I am looking to learn and understand better the role that this large institution plays in public health work. I hope my passion for public health and the elimination of health disparities will allow me to give a voice to the importance of integrating education, prevention, public health, and clinical care in order to strengthen our health care system, curb rising health care costs, and foster healthy communities and individuals.