Romanow fears `end of medicare'
TRACEY TYLER LEGAL AFFAIRS REPORTER Sep. 17, 2005. 08:19 AM
Romanow fears `end of medicare'
Says buying health care violates Charter Court ruling is `body blow' to Canada
The Supreme Court of Canada's 4-3 decision to strike down Quebec's ban on private health insurance could be "the end of medicare as we know it" and a "serious body blow" to the future of Canada, Roy Romanow says.
In a hard-hitting speech in Toronto yesterday, the former Saskatchewan premier, who headed a royal commission into the future of health care, accused the four-judge majority in the Chaoulli case — which many see as opening the door to two-tier health care — of meddling in social policy decisions better left to elected politicians.
"The net legal effect of the Chaoulli decision is that, in grappling with medicare, the court has ventured beyond constitutional and legal principles and into complex social policy, an area that has traditionally been in the domain of elected lawmakers," said Romanow, who was speaking at a legal forum on the implications of the June ruling, organized by the University of Toronto's faculty of law.
The court's "somewhat startling" decision showed a "remarkable" level of judicial activism, he said. Romanow questioned whether some judges in the majority were looking for a "mandate" to venture into the world of politics.
"Seems so, and they did it in such a thunderous way," he said.
By allowing privileged Canadians to buy health care, the court has used the Charter, and in particular its guarantees of life, liberty and security of the person, to protect the economic rights of citizens, something that was never intended when the Charter was drawn up nearly 25 years ago, Romanow said. He helped draft a 1981 compromise agreement that led to the Charter's enactment and the patriation of the Constitution.
The most charitable interpretation of the decision is that it was an "aberration," said Romanow, who said he hopes the court will "recalibrate" its approach in future cases.
If not, it will "radically alter Canada" and could lead to the dismantling of other social programs, he warned.
"Without sounding too apocalyptic about it, I think it could sound the end of medicare as we know it and (deliver) a very serious body blow to Canada as we know it," he told reporters later.
Last month, without providing reasons, the court suspended its judgment until June, 2006.
Romanow said he finds it difficult to be so harshly critical of the court but said there are larger issues at stake.
The ruling flies in the face of what Canadians told him they want in their health-care system, he said.
"The implied conclusion that timely access to health-care services will be improved with the establishment of a parallel private scheme flies in the face of all the evidence with which I grappled for 18 months as a royal commissioner," he said.
Until yesterday, Romanow, now a public policy expert at two Canadian universities, has said very little publicly about the decision, which found in favour of Jacques Chaoulli, a physician who wants to operate a private hospital, and George Zeliotis, a patient who was left on a waiting list for a hip operation.
Four of the court's judges said there was ample evidence that some Canadians have suffered grave consequences while on waiting lists and the public health system's failure to deliver medical care in a timely, reliable way had jeopardized their liberty, health and psychological well-being.
Justice Marie Deschamps, in the majority decision, said that banning private health-care options was a violation of the Quebec Charter.
The remaining six judges were evenly split on whether such a ban also violated the Canadian Charter of Rights and Freedoms.
As a result, the decision only applies in Quebec.
But Romanow said yesterday the "clear implication" is that it's a violation of the Canadian Charter, as well.
"The court basically said that the prohibition of private health insurance enacted by a democratically elected provincial government was bad public policy," he said.
While the court based its decision on the evidence it had before it, that evidence wasn't from the millions of Canadians who receive "great health care" and continue to support it, despite their concerns about the future of the system, he said.
Instead, it was from the Canadian Medical Association, individual doctors unhappy with the constraints of a publicly funded system and senators who were oddly granted intervenor status, Romanow said.
Although privately funded health care would be a radical step for Canada, Allan Hutchinson, a professor at Osgoode Hall Law School in Toronto, challenged Romanow's claim that the Chaoulli decision is an "aberration."
The Supreme Court has used the Charter repeatedly to uphold conservative principles, he said.
Despite all the talk by Romanow and his political counterparts in the early 1980s of it being a "people's Charter," the court has used it to protect tobacco companies and deny treatment to autistic children, Hutchinson said.
"It's turned out to be a very strange group of people who have benefited by the Charter," he added. "There's nothing new about the Chaoulli decision. Nothing new. This is a case where all the conservative chickens have come home to roost."
http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_
Type1&call_pageid=971358637177&c=Article&cid=1126907414361
Smoking ban burns clubs -AB
Vernon Clement Jones The Edmonton Journal Sunday, September 18, 2005
Bingo parlour dropoff cuts into fundraising for charities, athletics
EDMONTON -- Last year bingo brought in $91,000 for the Association of Evergreen Youth.
"It's huge for us," says Alice Hobbins, executive director of the not-for-profit organization.
"At least it was huge."
So far this year, Hobbins' organization has taken in slightly more than $30,000 from its bingo nights. She blames the drop, in part, on Edmonton's smoking ban, which took effect on July 1, 2005.
She is not alone.
While the bylaw has lifted the blue cloud of cigarette smoke hanging in the city's bingo halls, it has lowered the takings of the civic organizations and charities using them to raise money.
Edmonton's 15 parlours are reporting drops in attendance from 10 to 40 per cent.
"City councillors didn't listen to us then and I doubt they will listen to us now, but we have got to voice our concerns," she says.
Like other clubs, Evergreen -- devoted to providing after-school programs to youths -- sends out a team of volunteers to work bingo events each month. Those workers spend two to five hours handing out cards and attending to patrons, all eager to yell "bingo!"
The clubs then share the profits each month, after deductions for prize money and hall expenses.
Last week, Hobbins joined officials from other civic clubs in a letter-writing campaign to the mayor and council, calling for an end to the smoking ban, at least in bingo halls.
Action couldn't come soon enough, says one volunteer who has seen profits for all three of the organizations she works decline. But the ban has brought positive change as well, says Melissa Webb, 24.
Before, "if you were working and walking around the hall, you felt like you had smoked a thousand cigarettes," she says, while volunteering at Parkway Bingo. "It's now easier to get volunteers to come out. The air is fine now."
There are about 120 playing and paying customers out for Parkway's afternoon event. That's only about 20 to 30 fewer than would likely have come before the smoking ban, bingo manager Susan Moore says.
"But when you lose 20 people in attendance you lose an awful lot more in profits," she says, pointing to the multiple cards most players purchase.
Edmonton halls also lose money when those patrons go for cigarette breaks.
"When they're outside that means they're not inside buying Bonanza and satellite cards -- money that goes to the charities," she says.
But that may be the least of Moore's worries. Bingo halls in neighbouring Spruce Grove and Wetaskiwin still allow smoking. In fact, they have been smokier than ever since the change in Edmonton.
"Our increase is about a 23-per-cent increase since the ban," says John Wanless, manager of Spruce Grove Bingo, pointing to a growing number of players from Edmonton. "Travelling the 20 minutes to Spruce Grove is no worse than driving 20 minutes to a hall in Edmonton.
"When the cold weather hits and going outside for a cigarette break at an Edmonton bingo hall becomes even less
attractive, we will probably go up more."
About 37 non-profit clubs share profits at Wanless's bingo parlour. Those groups, ranging from Spruce Grove
Minor Hockey to the community's Kinsmen centre, have seen a 40-per-cent increase in their monthly takes since the ban took effect.
The hall isn't looking to take on any more charities. Even if it were, he said Alberta Gaming and Liquor Commission rules prevent him from considering clubs from the city of Edmonton.
"From a compassionate point of view, it's a shame that our gain is at the expense of other bingo halls," he said.
Local bingo parlours are likely experiencing temporary pain, says Doug Baker, a regional services director for the Canadian Cancer Society. "Within a year, revenue levels will likely be back to where they were before the smoking ban."
He points to studies in other Canadian cities that have stamped out smoking in public places.
"We have to look beyond the short-term losses of charities to the long-term health of Albertans, especially those working in bingo halls," he says.
As a charity, the Cancer Society does not use bingo halls as a vehicle for raising cash, but relies on a diversified fundraising strategy. It's an approach other charities will have to adopt, says one bingo volunteer.
"They have to be more creative to keep the customers if they want to keep on making it," Hector Labbe says, outside an east-end hall. A cigarette dangles from his mouth.
"I'm not sure they were making it before."
Warning: Smoking is a Leading Cause of Vision Loss
Global survey shows low awareness of link TORONTO, Sept. 19 /CNW/ - Smoking, well known to cause lung cancer and heart disease, is also a major contributor to blindness. According to an international report, however, global awareness of the causal link between smoking and vision loss is alarmingly low.
The report also documents scientifically proven studies showing that smokers are two to four time more likely to develop AMD as compared to non-smokers. AMD is recognized as the leading cause of blindness in developed countries by the World Health Organization.
"Smoking is the only proven and preventable risk factor for the development of AMD, a disease that affects more than 25 million people around the world," said Dr. Patricia Harvey, Retina Specialist, University Health Network, Toronto. "The AMD Alliance International report clearly shows a dire need for more AMD education, along with the need to increase knowledge that smoking is as harmful to eye health as it is to one's overall health."
References -------------------------
(1) Klein, R. et al. Prevalence of age-related Maculopathy: the Beaver Dam Study. Ophthalmology 1992; 99:933-43 and Vingerling JR, et al. Epidemiology of Age-related Maculopathy. Epidemiol Rev 1995;17(2):347-360 and Statistics Canada
(2) Cost of Blindness Symposium Committee. A CLEAR VISION: Solutions to Canada's Vision Loss Crisis. Available from www.costofblindness.org .
(3) CNIB. National Consultation of the Crisis of Vision Loss. Toronto: Oct 2 - Oct 5, 1998. Available from www.cnib.ca/eng/publications/pamphlets/nccvl/chapter2.htm .
****For further information: to arrange an interview with Dr. Harvey or Gerrard Grace, or for a copy of the "AMD Campaign Report 2005" please contact: Andrew Leopold, John Elias, Weber Shandwick Worldwide, (416) 642-7949, (416) 642-7965, aleopold@webershandwick.com , jelias@webershandwick.com ; Wanda Hamilton, Executive Director, AMD Alliance International, (416) 486-2500 ext. 7505, executivedirector@amdalliance.org
http://www.newswire.ca/en/releases/archive/September2005/19/c0749.html
Welcome to mini Cali -AB
Sept 20, 2005
FIRST, WE have to alienate smokers, then banning certain breeds of dogs becomes an issue, and now city council is considering banning firepits? Thank goodness there is always someone around to save me from myself. Welcome to mini-California.
C. McLachlan
(The firepit plan got panned.)
http://www.edmontonsun.com/Comment/Letters/2005/09/19/1226611.html
Doctor urges trustees to reconsider butt-ban vote
By STAFF September 20, 2005
School divisions can't expect students to take anti-smoking campaigns seriously when they're still allowed to light up on school property, according to one parent and advocate.
"Teens are extremely sensitive to hypocrisy on the part of adults," Dr. Mark Taylor told Winnipeg School Division trustees last night. "For them to be learning about the dangers of tobacco in class and then see that the school provides a special place for them to smoke outside, demonstrates hypocrisy."
Taylor spoke last night at a special meeting of the province's largest school division, offering a response to a recent decision by trustees to not implement an all-out smoking ban at its 77 schools.
A motion for a ban was defeated 5-4 several weeks ago. Last night. Taylor encouraged trustees to reconsider.
He cited extensive studies showing educational campaigns have had "disappointing results" when not coupled with non-smoking policies and reminded them smoking is already banned in many public and private spaces in Manitoba and North America.
http://www.winnipegsun.com/News/Winnipeg/2005/09/20/1226926-sun.html
Federal grant targets youth smoking -AB
By DAVE BREAKENRIDGE, CALGARY SUN Sept 20, 2005
Young people are starting to get the message about smoking but more needs to be done to curb tobacco addiction, says Canada's health minister.
To that end, Ujjal Dosanjh yesterday announced a $250,000 Health Canada contribution to the Calgary Health Region's project aimed at a mass media campaign designed to change how tobacco is viewed by youth between the ages of 12 and 18.
The content of the ads will be designed with input from people in that age group.
"I think it's important to let them decide and design print, radio and television messages for the people we're trying to aim at," Dosanjh said.
He said smoking rates among young people have dropped from 22% in 2002 to 18% this year.
The money will go toward the production of ads, which a CHR youth co-ordinator said will be released in early 2006.
The project is partnered with Lord Beaverbrook high school, the Canadian Cancer Society, Calgary Urban Vibe and AADAC.
http://calsun.canoe.ca/News/National/2005/09/20/1226992-sun.html
WORKPLACE ETHICS 101
Wednesday, September 21, 2005 Page C6
Ethics: A set of principles of right conduct; a theory or a system of moral values.- Canadian Dictionary
Every day, people are faced with moral dilemmas at work. Here's a chance to put your two cents into the ethical pot. Please include your full name and address. Responses may be edited for clarity and brevity.
Last week's question You're trying hard not to sound like a reformed smoker, having quit a couple of years ago, but even you are becoming miffed at how a couple of co-workers with whom you share responsibilities are taking several smoke breaks every day at times that are problematic for you from a work standpoint. Do you raise it with them without sounding like a hypocrite?
One side
I see no quandary here. Whether it is smoking or coffee breaks, excessive time away from work, which affects productivity, should be confronted and resolved.
Paul Henry, New Jersey
Presuming that smoke breaks are allowed by company policy, speak directly to your immediate supervisor and inform him/her that you want a memo sent regarding the minimum people needed at all times in the work area.
Brian Pease, Scarborough
The issue here is not whether they are smoking; the issue is the effect their repeated absences are having on my performance, and ultimately the business. Perhaps this habit has been allowed to go on for some time, so my co-workers think nothing of it. I would approach my co-workers in a non-judgmental manner, and focus my communication on ways we can all take a reasonable amount of break time throughout the day and not inconvenience our co-workers as a result.
Richard Williams, Morinville, Alta.
I would talk to the co-workers but focus on how their availability is impacting my ability to work. I would see if there is some sort of agreement we could come to.
Darrell Grainger, Toronto
There is nothing hypocritical about wanting to get the work done. Early in the work period, prior to their usual smoke breaks, talk to your co-workers about scheduling your work time together. Follow up at the end of the work day with a brief review of how matters went. Maybe more co-ordination is needed. Your focus is your shared work task. How they handle their smoke breaks is their business.
Mary Valentich, Calgary
Your status as a reformed smoker is irrelevant in this problem. As you well know, a smoker is unlikely to quit to please someone else. Your co-workers' apparent neglect of work responsibilities is similar to the effect of a worker who has to take frequent breaks due to a medical condition. Your goal should be to work out a schedule that shares the break times so there is less difficulty for you, as you would try to do for a medical problem. If a co-operative approach along those lines fails to reduce the problem, you would be within your rights to ask your superior for help in seeing that the work responsibilities are being shared fairly.
Dave Prebble, Fredericton, N.B.
You sure do raise your concern with them. Two choices: sound like a hypocrite or do their work for them. . . . I'll take hypocrite.
Tim Brooke, Guelph Ont.
I would raise this issue with the co-worker from a health standpoint. I would explain to them how I was a heavy smoker myself previously and how I went about changing my habits. I would then tell them indirectly that it causes a lot of work to be built up as well. But I would definitely approach this issue by showing them that I am concerned about their health rather than the workload that builds up for me.
Anjum Sajjad, Mississauga
I wouldn't say anything to them directly, but I would tell my company because this problem should be solved by the company. It's not fair for non-smokers and smokers to have different working times. Don't you think we can compromise with each other?
Kiyomi Fuji , Wakayama, Japan
Absolutely raise the issue of timing of smoke breaks. All breaks are subject to operational requirements and should be scheduled at times that are convenient for the business, not the individual. In practice of course, one would try to accommodate the individual, but the business provides for their employment and must be considered first. In addition, smoke breaks should not be in addition to legislated coffee breaks or lunch; if they are taken in addition, then that person is stealing time from their employer.
Shery Yoner, Vancouver
The other side
Reformed smokers are the worst. It's like working with your mother-in-law or a Toronto Maple Leafs fan, but worse. Lighten up. I am sure the chains to the desk can be unlocked for a few minutes for those others who have yet to become reformed smokers like you. Your shared responsibilities will get done. If the three of you are so interlinked that when one is not there nothing gets done, what do you do during summer holidays, when one is sick, or when one is in the washroom? Yes, you are being a hypocrite, and reformed smokers are the best doing just that.
Norm Greenfield, Calgary
Everyone needs a break once in a while. While some smoke, others just need to stretch. Suggest to the team that irregular breaks are hampering your work efforts. Find what can be done in terms of your and their schedules to make things work better. If someone brings up your past, demonstrate how you have moved on and for their own health, you wish they would too.
Tom Breuer, Ottawa
Having been a smoker, you must realize how your co-workers enjoy their smoke breaks. Since you all share responsibility for the work, and you are all paid to do it as quickly as possible, you should pick a time that is agreeable to all and take a break then. No one should be allowed to wander off whenever he/she feels like it. Work comes first.
Frances Jeaurond, St. Catharines, Ont.
Studies show that 45 per cent of all productivity losses at work are related to "water cooler" chit-chat and socializing, followed closely by unauthorized use of the Internet and personal phone calls. In terms of productivity losses, unauthorized smoke breaks are only sixth or seventh down the list. Before broaching the issue with others, it might be wise to examine your own motivation to ensure that you are not, in fact, irked by their choices as opposed to the so-called "extra work" imposed on you. Who does your work when you stop to chat with other workers or take time for that personal phone call? Is this a case of the pot calling the kettle black?
As an employee, it is not your place to complain about the working ethics of others. Worry first about your performance and let the supervisors and managers worry about the bigger picture.
Remember, most people don't get fired because of incompetence but rather, because of a difficulty in fitting into the existing corporate culture.
Michelle Gervais, London, Ont.
As a former smoker, you should be the most sympathetic of all toward your co-workers still in the clutches of a tobacco addiction. If there is an important project under way at work, try to get the group to agree beforehand on convenient times to take breaks. On routine workdays, try to ignore the smoke breaks. Focus instead on being an inspiring example of a person who has successfully overcome the addiction.
Carolyn Tytler, St. Catharines, Ont.
Reformed smokers (of whom I am one) must be the most paranoid of zealots. This week's question is not a moral dilemma -- it is not really an ethical issue -- and actually has nothing to do with smoking. Employees have a right to take breaks -- what they do while on those breaks is their own business (as long as it's legal). The issue here is the timing of the breaks. If timing is interfering with work flow, surely the response should be to simply say: "Now is really not a good time; why don't we finish this task , and then we can all take our break?"
Dr. Basil W. Johnston, Peterborough, Ont.
http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20050921/CAETHICS21/TPBusiness/
Using the media for advocacy: http://strategyguides.globalink.org/guide01_10.htm
Italy
Film gets flak from anti-smokers
Award-winning movie under fire over cigarette-hooked cast (ANSA) - Rome, September 19 - An Italian film which scooped a prize at the Venice Film Festival has come under fire from the anti-smoking lobby because of its cigarette-hooked cast . La Bestia nel Cuore (The Beast in the Heart) stars acclaimed Italian actress Giovanna Mezzogiorno as chain-smoking Sabina, a woman whose happy existence is torn apart when buried memories of abuse return to haunt her . Mezzogiorno's performance bagged her the top acting award for a woman at the Venice fest earlier this month . But consumer group Codacons was less impressed and has asked magistrates to investigate the Cristina Comencini-directed film for alleged "indirect advertising for smoking products" . "Too often directors opt to heighten moments of tension or unease with a cigarette. That's something we do not agree with because it is too simplistic and harmful," said Codacons President Marco Donzelli . "As for this film, it's excessive. The actors smoke one cigarette after another," Donzelli said . There have been growing calls to limit smoking in films and on TV as part of a general crackdown on cigarettes . Former Health Minister Girolamo Sirchia, who spearheaded a ban on public smoking, recently resurrected his proposal that health warnings accompany old films on TV in which movie icons are seen puffing away on cigarettes . The minister maintained that Hollywood legends like Humphrey Bogart, the smoker supreme, set a dangerous example for youngsters, making cigarettes look sexy and glamorous . Italy's smoking law, which came into effect in January, is one of the toughest in Europe and has virtually ended smoking in cafes, restaurants, bars and clubs . Any establishment wishing to cater to smokers - and there is no obligation to do this - must have separate rooms for them with automatically closing doors and smoke extractors . Smoking is also banned from all work places . The Health Ministry insisted there was nothing prohibitionist about the new measures, which came on top of a 1975 law banning smoking from public places such as cinemas, schools, libraries, hospitals and underground trains. Cigarette sales have dropped some 10% since the new law .
http://ansa.it/main/notizie/awnplus/english/news/2005-09-19_1313344.html
WI
Mayor Wants Truce, Ads For Smoke-free Bars
The Capital Times :: METRO :: 1B
Saturday, September 17, 2005 By Bill Novak The Capital Times
Madison Mayor Dave Cieslewicz is willing to put up $10,000 in room tax revenue to help promote Madison bars, but only if the anti-smoking and pro-smoking forces also kick in some cash.
The mayor issued a challenge Friday to both sides in the smoldering fight, urging the combatants to put down their rattling sabers and come together to see what can be done about the financial loss some Madison bars have reported since the smoking ban took effect on July 1.
"I'm concerned about the relatively small number of tavern owners, especially on Madison's periphery, who say our smoke-free ordinance is hurting their business," Cieslewicz said in letters sent to smoking ban supporters SmokeFree Wisconsin and the Tobacco-Free Dane County Coalition, and to smoking ban protesters including the Coalition to Save Madison Jobs and the Dane County Tavern League.
SmokeFree Wisconsin accepted Cieslewicz's challenge and urged the others to do likewise.
"We accept the mayor's challenge and commit up to $10,000 to this effort," said Maureen Busalacchi of SmokeFree Wisconsin. "A positive promotional campaign to benefit Madison's hospitality industry is far more beneficial to the industry and the community than a prolonged and heated debate."
Cieslewicz is committing the $10,000 from room tax revenues, which are earmarked to be spent on helping promote Madison business. Property tax revenues won't be used for the challenge.
"I am willing to commit city resources to help taverns gain new customers to replace those who may have left because of the (smoking) ban," the mayor said. "But this needs to be a partnership with tavern owners and smoke-free advocates."
Tavern owners are hoping to be allowed to show they've suffered a hardship because of the smoking ban so that patrons can light up once again while enjoying a beer.
Some bar owners and others against the ban want a referendum but the mayor prefers the challenge route.
"This is a far better option than a referendum," Cieslewicz said.
The council is scheduled to vote Tuesday on whether to hold an advisory referendum in April.
Cieslewicz said it's far more beneficial to have opposing groups come together and try to promote the city's bars, instead of seeing if the smoking ban can be done away with. Repealing the ban, which was attempted once but failed this summer, again has little chance of being rescinded by the City Council.
"Tavern owners and smoke-free advocates have two choices," the mayor said. "They can both spend substantial amounts of money battling each other for the next seven months for the public's support of their respective positions, or they can pool their resources and join together to help taverns thrive under the ban so they both win."
There was no word Friday from the Dane County Tavern League if it would accepting Cieslewicz's challenge.
\ E-mail: bnovak@madison.com
http://www.madison.com/archives/read.php?ref=tct:2005:09:17:514805:METRO
Painkiller use, hypertension linked?
Published: Sunday, Sep. 18, 2005
The question: Consider that nearly one in three adults in the United States has high blood pressure and that painkillers are the medication taken most often by Americans. Might the two be connected? The latest: This study analyzed data on 5,123 female nurses participating in two long-term studies on chronic diseases. None of the women had high blood pressure at the start of the study. In a three- to four-year period, those who regularly took more than 500 milligrams a day of acetaminophen were nearly twice as likely to develop high blood pressure as those who took none. Women who took more than 400 milligrams daily of nonsteroidal anti-inflammatory drugs (mainly ibuprofen) had a 60 percent to 78 percent greater chance of developing high blood pressure than those who never took NSAIDs, with the likelihood increasing with age. Taking aspirin did not affect blood pressure readings. Who may be affected by these findings? Women who take sizable doses of painkillers regularly. Caveats: The findings were based on self-reporting of hypertension, but the authors considered the reports reliable because all participants were registered nurses. The study did not determine whether the risk of high blood pressure varied for ibuprofen, naproxen or other NSAIDs. The study considered participants’ family history, physical activity and use of such products as caffeine, alcohol and tobacco; whether participants’ health problems might have affected their blood pressure was unclear. Find this study: Aug. 15 online issue of Hypertension; abstract available at www.hypertensionaha.org . Learn more about high blood pressure at www.americanheart.org and www.mayoclinic.com.
http://www.nashuatelegraph.com/apps/pbcs.dll/article?AID=/20050918/HEALTH/50917059
Non-Narcotic Analgesic Dose and Risk of Incident Hypertension in US Women
John P. Forman; Meir J. Stampfer; Gary C. Curhan
From the Renal Division (J.P.F., G.C.C.), Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Channing Laboratory (J.P.F., M.J.S., G.C.C.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass; and Department of Epidemiology (J.P.F., M.J.S., G.C.C.), Harvard School of Public Health, Boston, Mass.
Correspondence to John P. Forman, Channing Laboratory, Third Floor, 181 Longwood Ave, Boston, MA 02115. E-mail jforman@partners.org
Acetaminophen, ibuprofen, and aspirin are the most commonly used drugs in the United States. Although the frequency of their use has been associated with hypertension, prospective data examining the dose of these drugs and risk of hypertension are lacking. Furthermore, whether certain indications for analgesic use, particularly headache, mediate the association is unclear. We conducted 2 prospective cohort studies among older women 51 to 77 years of age (n=1903) from the Nurses’ Health Study I and younger women 34 to 53 years of age (n=3220) from the Nurses’ Health Study II who completed detailed supplemental questionnaires pertaining to their analgesic use and who did not have hypertension at baseline. We analyzed incident hypertension according to categories of average daily dose of acetaminophen, nonsteroidal anti-inflammatory drugs, and aspirin. Information on indications for analgesic use as well as relevant confounders was also gathered prospectively. Compared with women who did not use acetaminophen, the multivariable adjusted relative risk for those who took >500 mg per day was 1.93 (1.30 to 2.88) among older women and 1.99 (1.39 to 2.85) among younger women. For nonsteroidal anti-inflammatory drugs, similar comparisons yielded multivariable relative risks of 1.78 (1.21 to 2.61) among older women and 1.60 (1.10 to 2.32) among younger women. These associations remained significant among women who did not report headache. Aspirin dose was not significantly associated with hypertension. Higher daily doses of acetaminophen and nonsteroidal anti-inflammatory drugs independently increase the risk of hypertension in women. Because acetaminophen and nonsteroidal anti-inflammatory drugs are commonly used, they may contribute to the high prevalence of hypertension in the United States.
http://hyper.ahajournals.org/cgi/content/abstract/46/3/500