Medical Bulletin 22/May/2025

New Delhi: A new study led by researchers suggests that people with high blood pressure can significantly reduce and possibly eliminate their increased risk of premature death by controlling several key health risk factors at once. The findings are published in Precision Clinical Medicine.

The study tracked more than 70,000 people with hypertension and over 224,000 without it, using data from the UK Biobank. Researchers followed participants for nearly 14 years to understand how managing these risk factors affected early mortality -- defined as dying before age 80.

The eight health risk factors evaluated in the study include blood pressure, body mass index, waist circumference, LDL "bad" cholesterol, blood sugar, kidney function, smoking status, and physical activity. Notably, researchers found that hypertensive patients who had addressed at least four of these risk factors had no greater risk of an early death than those without high blood pressure.

Hypertension, defined as a blood pressure of 130 mmHg or higher, is the leading preventable risk factor for premature death worldwide.

The study found that addressing each additional risk factor was associated with a 13% lower risk of early death, a 12% lower risk of early death due to cancer, and a 21% lower risk of death due to cardiovascular disease, the leading cause of premature death globally.

"Our study shows that controlling blood pressure is not the only way to treat hypertensive patients, because high blood pressure can affect these other factors," said corresponding author Dr. Lu Qi, HCA Regents Distinguished Chair and professor of epidemiology in the Celia Scott Weatherhead School of Public Health and Tropical Medicine at Tulane University. "By addressing the individual risk factors, we can help prevent early death for those with hypertension."

"Optimal risk" control"—having 7 or more of the risk factors addressed -- was linked to 40% less risk of early death, 39% less risk of early death due to cancer and 53% less risk of early death due to cardiovascular disease.

Only 7% of hypertensive participants in the study had seven or more risk factors under control, highlighting a major opportunity for prevention. Researchers say the findings underscore the importance of personalized, multifaceted care -- not just prescribing medication for blood pressure, but addressing a broader range of health behaviors and conditions.

Reference: https://news.tulane.edu/pr/controlling-these-8-risk-factors-may-eliminate-early-death-risk-those-high-blood-pressure

Can Blood and Urine Reveal How Much Ultra-Processed Food You Really Eat?

New Delhi: A new study published in the open-access journal PLOS Medicine has identified specific chemical signatures in blood and urine that reliably reflect how much ultra-processed food (UPF) a person consumes. Conducted by Erikka Loftfield and colleagues at the National Cancer Institute, USA, the research offers a new tool for objectively measuring ultra-processed food intake, which has been linked to various chronic diseases.

The study analyzed biological samples from 718 older adults, alongside detailed self-reported dietary data. Researchers identified a wide range of metabolites—small molecules produced during digestion and metabolism—that were closely associated with the proportion of energy participants derived from ultra-processed foods.

Using this data, the team developed a “poly-metabolite score,” a chemical profile that serves as a biomarker for ultra-processed food consumption. This score could be calculated using a combination of 28 blood metabolites or 33 urine metabolites. The researchers found that these scores accurately reflected the participants' reported ultra-processed food intake levels.

To validate their findings, the team conducted a tightly controlled feeding study at the NIH Clinical Center. Twenty inpatients were provided with diets either rich in or free of ultra-processed food. The metabolite scores were able to clearly distinguish between high- ultra-processed food and no- ultra-processed food diets within the same individuals, demonstrating the reliability of these biomarkers in real-world dietary conditions.

"The identified poly-metabolite scores could serve as objective measures of ultra-processed food intake in large population studies to complement or reduce reliance on self-reported dietary data," the authors say.

"Poly-metabolite scores should be evaluated and iteratively improved in populations with diverse diets and a wide range of ultra-processed food intake."

The authors add, "We developed and tested poly-metabolite scores in blood and urine that were predictive of diets high in energy from ultra-processed food intake in an observational study of free-living adults and in a highly controlled feeding trial, respectively. These poly-metabolite scores could serve as objective measures of ultra-processed food intake in large population studies to complement or reduce reliance on self-reported dietary data. Additionally, these findings could provide novel insight into the role of ultra-processed food in human health."

Reference: Leila Abar, Eurídice Martínez Steele, Sang Kyu Lee, Lisa Kahle, Steven C. Moore, Eleanor Watts, Caitlin P. O’Connell, Charles E. Matthews, Kirsten A. Herrick, Kevin D. Hall, Lauren E. O’Connor, Neal D. Freedman, Rashmi Sinha, Hyokyoung G. Hong, Erikka Loftfield. Identification and validation of poly-metabolite scores for diets high in ultra-processed food: An observational study and post-hoc randomized controlled crossover-feeding trial. PLOS Medicine, 2025; 22 (5): e1004560 DOI: 10.1371/journal.pmed.1004560

Worsening Depression May Predict Future Pain in Older Adults: UCL Study Finds

New Delhi: Middle-aged and older adults who experience frequent pain are more likely to have had worsening symptoms of depression and loneliness up to eight years before the pain began, according to a new study published in eClinicalMedicine by researchers at University College London. The findings suggest that early mental health support may help prevent or reduce physical pain later in life.

The study analysed 21 years of data from the English Longitudinal Study of Ageing, which surveys a nationally representative group of adults over age 50 every two years. Researchers compared 3,668 adults who frequently experienced moderate to severe pain with an equal number of people who did not report significant pain.

They found that in the pain group, symptoms of depression worsened sharply in the years leading up to the onset of pain, peaked when pain began, and remained high afterwards. In contrast, the non-pain group had fewer and more stable depressive symptoms. A similar pattern was observed for loneliness, which increased before and after the onset of pain in the pain group but remained low in the non-pain group.

Most participants with pain reported back, knee, hip, or foot issues. While the exact causes of pain were not identified, researchers emphasised that mental health factors such as depression and loneliness might increase inflammation and alter how the body perceives pain.

The study also found that the link between depression and pain was stronger among people with lower education and wealth, underscoring the need to support vulnerable populations with better access to mental health and community care.

Lead author Dr Mikaela Bloomberg (UCL Epidemiology & Public Health) said, “Our study shows that depressive symptoms and loneliness worsen long before pain begins. This is important as it suggests the potential for early mental health and social support to reduce or delay later pain.”

“Our findings highlight the importance of approaching pain not just from a biological perspective. Mental health interventions may be important too.”

Reference: Trajectories of loneliness, social isolation, and depressive symptoms before and after onset of pain in middle-aged and older adults, Bloomberg, Mikaela et al. eClinicalMedicine, Volume 0, Issue 0, 103209