Lack of Physical Activity and All-cause Mortality Rate

Non-vigorous physical activity and all-cause mortality: systematic review and meta-analysis of cohort studies
International Journal of Epidemiology, 07/16/2010  Evidence Based Medicine

Woodcock J et al. – The authors found that 2.5 h/week (equivalent to 30 min daily of moderate intensity activity on 5 days a week) compared with no activity was associated with a reduction in mortality risk of 19%, while 7 h/week of moderate activity compared with no activity reduced the mortality risk by 24%. 

The authors found a smaller effect in studies that looked at walking alone. Being physically active reduces the risk of all–cause mortality. The largest benefit was found from moving from no activity to low levels of activity, but even at high levels of activity benefits accrue from additional activity.

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New Drug Helps Patients Lose Weight and Maintain the Loss

Lorcaserin, a selective serotonin 2C receptor agonist, helps patients both lose weight and maintain their weight loss, according to a phase III study conducted by the drug's manufacturer and published in the New England Journal of Medicine.

Some 3200 overweight or obese adults were randomized to take lorcaserin or placebo twice daily for a year, after which lorcaserin recipients continued the drug or switched to placebo for another year. All participants also received nutrition and exercise counseling.

At 1 year, more patients in the lorcaserin group than placebo group had lost at least 5% of their body weight (48% vs. 20% of patients; mean weight loss: 5.8 kg vs. 2.2 kg). In addition, lorcaserin patients who stayed on the drug for a second year were more likely to maintain their weight loss than those who switched to placebo.

Serious adverse events did not differ between lorcaserin and placebo recipients. Unlike some other serotonergic agents, lorcaserin did not increase risk for valvular heart disease.

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Vitamin D Deficiency Associated with Dementia and Parkinson Disease

Two studies seem to point to vitamin D deficiency as having a role in both cognitive decline and Parkinson disease, but commentators aren't certain about the clinical implications.

One study, published in the Archives of Internal Medicine, followed some 850 older adults for about 6 years. Low serum levels of vitamin D at the outset of the study were associated with substantial cognitive decline (as measured by the Mini-Mental State Examination) by study's end. Editorialists caution that "low vitamin D levels may simply be a marker for lower health status than a cause of it." They write that "a rigorous evidence base ... does not currently exist" to favor using vitamin D supplementation to improve health outcomes.

The other study, published in the Archives of Neurology, found an association between low levels of vitamin D and the development of Parkinson disease by follow-up some 30 years later. An editorialist finds the results promising but preliminary.

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Coenzyme Q10: Therapy for Hypertension and statin-induced muscle pain?

Coenzyme Q10: A therapy for hypertension and statin-induced myalgia?

1. MARCIA WYMAN, PharmD

+ Author Affiliations

1. 
   
   Drug Information Pharmacist, Department of Pharmacy, Cleveland Clinic

1. ADDRESS: Marcia Wyman, PharmD, Drug Information Center, Department of Pharmacy, Hb-105, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; e-mail wymanm@ccf.org.

1. MANDY LEONARD, PharmD, BCPS*

+ Author Affiliations

1. 
   
   Assistant Director, Drug Information Services and Formulary Management, Department of Pharmacy, Cleveland Clinic

1. THOMAS MORLEDGE, MD

+ Author Affiliations

1. 
   
   Medical Director for Wellness Enterprise, Center for Integrative Medicine, Cleveland Clinic

Abstract

Some small clinical trials seem to show that coenzyme Q10 supplements can be used to lower blood pressure and to treat or prevent myalgia caused by hydroxymethylglutaryl coenzyme A reductase inhibitors (statins). However, larger trials are needed to determine if they are truly effective for these purposes. The authors examine the evidence and also discuss issues such as bioavailability, elimination, safety, and cost.

KEY POINTS

In some clinical trials, coenzyme Q10 supplements significantly lowered diastolic and systolic blood pressure.

Statins may lower coenzyme Q10 serum levels, and some investigators have evaluated the relationship between coenzyme Q10 deficiency and statin-related myalgia, but more evidence is needed to support the use of coenzyme Q10 supplements to prevent or treat myalgia.

Coenzyme Q10 supplementation appears to be relatively safe. Most clinical trials have not reported significant side effects that necessitated stopping therapy. Gastrointestinal effects include abdominal discomfort, nausea, vomiting, diarrhea, and anorexia. Allergic rash and headache have also been reported.

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