Health and Fitness News and Notes

The most effective way to monitor blood pressure may be to do it yourself.

British researchers randomly assigned 1,003 patients with hypertension to one of three groups. The first took their own readings daily for one week every month over the course of a year and mailed them to a doctor. A second used a phone app, sending their readings to the doctor through a web-based system. A control group was assigned to “usual care,” in which patients had their blood pressure checked at their doctor’s office. The data gathered was used to adjust medication.

The average systolic reading (the top number) for all patients was about 153 at the start. By the end of 12 months, members of the control group had lowered their average to 140. But the telemonitoring group and the self-monitoring group had cut theirs to 136 and 137, respectively. The authors estimate these lower numbers would lower stroke risk by 20 percent and coronary artery disease risk by 10 percent. The study was published in Lancet.

“People who monitor their own blood pressure and share the readings with their physician get better control,” said the lead author, Dr. Richard J. McManus, a professor of primary care at the University of Oxford.

The monitors were provided free by their manufacturer.

Probiotics and fish oil supplements during pregnancy and breast-feeding may reduce the risk for food allergies and eczema in early childhood, researchers report.

In a review of hundreds of studies, they found 19 randomized controlled trials with strong evidence showing that compared with no supplements, probiotics taken after the 36th week of pregnancy and the first months of lactation were associated with a 22 percent reduction in the risk for eczema in children.

They also analyzed six randomized trials with solid evidence that women who took omega-3 fatty acid supplements during pregnancy and lactation reduced the risk for childhood allergic reaction to eggs, the most common food allergy, by 31 percent.

The meta-analysis, in PLOS Medicine, found no evidence that avoiding certain foods or taking vitamin and mineral supplements during pregnancy had any effect on childhood eczema or food allergy.

Fish oil has known anti-inflammatory effects, which could explain why it may reduce the risk for food allergies, but the reasons for the possible effect of probiotics on the risk for eczema is unknown.

Opioids are no better than nonopioid pain relievers for treating the chronic pain of osteoarthritis, a clinical trial has found.

Researchers randomized 240 patients with moderate to severe chronic back pain or hip or knee osteoarthritis to either an opioid (morphine, oxycodone or hydrocodone) or to nonopioid pain relievers (such as Tylenol, topical lidocaine or a nonsteroidal anti-inflammatory drugs). The study, in JAMA, used 11-point pain and function scales to measure the effect of treatment, with higher scores indicating poorer results. This is, the authors write, the first randomized trial of opioid therapy to report long-term pain and function outcomes.

At the end of 12 months, the opioid group scored an average 3.4 on the function scale, and the nonopioid group 3.3, an insignificant difference. On the pain scale, the nonopioid group did slightly better — 3.5, compared with 4.0 for the opioid group.

Unsurprisingly, there were significantly more medication side effects in the opioid group than in those taking nonopioids.

“Should we use opioids if nonopioids don’t work?” asked the lead author, Dr. Erin E. Krebs of the Minneapolis Veterans Affairs Health Care System. She answered her own question: “No. We tried four different nonopioids — don’t give up on them too soon — and we should also be using exercise and rehab for most osteoarthritic pain.”