Posted by Phillipa on October 17, 2009, at 21:12:14
Not deleting the target audience this time. Full article. Eating fish with mercury levels that are hight raise blood pressure? Could this be of help to those on blood pressure lowering med ie Maoi? Phillipa
From Heartwire CME
Mercury/Blood-Pressure Link Should Guide Fish Choices CME/CE
News Author: Shelley Wood
CME Author: Désirée Lie, MD, MSEdAuthors and Disclosures
CME/CE Released: 10/08/2009; Valid for credit through 10/08/2010
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CME/CE Information
Target Audience
This article is intended for primary care clinicians, cardiologists, and other specialists who care for patients at risk for hypertension.Goal
The goal of this activity is to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care.Authors and Disclosures
Shelley Wood
Shelley Wood is a journalist for theheart.org, part of the WebMD Professional Network. She has been with theheart.org since 2000, and specializes in interventional cardiology. She studied literature at McGill University and the University of Cape Town and received her graduate degree in journalism from the University of British Columbia, specializing in health reporting. She can be reached at SMWood@webmd.net.
Disclosure: Shelley Wood has disclosed no relevant financial relationships.Brande Nicole Martin
is the News CME editor for Medscape Medical News.
Disclosure: Brande Nicole Martin has disclosed no relevant financial information.Désirée Lie, MD, MSEd
Clinical Professor, Family Medicine, University of California, Orange; Director, Division of Faculty Development, UCI Medical Center, Orange, California
Disclosure: Désirée Lie, MD, MSEd, has disclosed no relevant financial relationships.Laurie E. Scudder, MS, NP
Accreditation Coordinator, Continuing Professional Education Department, MedscapeCME; Clinical Assistant Professor, School of Nursing and Allied Health, George Washington University, Washington, DC; Nurse Practitioner, School-Based Health Centers, Baltimore City Public Schools, Baltimore, Maryland
Disclosure: Laurie E. Scudder, MS, NP, has disclosed no relevant financial relationships.Learning Objectives
Upon completion of this activity, participants will be able to:1.Describe the effect of mercury exposure on systolic and diastolic blood pressure.
2.Describe the association between body mass index, waist circumference, and waist-to-hip ratio and blood pressure.
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October 8, 2009 An association seen between mercury levels and blood pressure (BP) in a recent analysis [1] has researchers warning physicians and consumers about the need to weigh the risks and benefits of fish consumption and to choose with caution the type of fish they eat.In an analysis of 732 Nunavik Inuit men and women--the indigenous people of northern Quebec--Dr Beatriz Valera (Centre de Recherche du CHUQ, Quebec, QC) and colleagues found mercury levels to be more than 50 nmol/L. That's more than 10 times higher than levels in the general US population in the National Health and Nutrition Examination Survey (NHANES) study of 4 nmol/L, an American Heart Association (AHA) press release notes [2]. These higher levels stem largely from the preponderance of fish and marine mammals in the traditional Inuit diet, Valera et al point out in their paper, which appears online October 5, 2009 in Hypertension. Mercury levels become more concentrated higher in the marine food chain, with the highest concentrations seen in predators that over the course of a lifetime consume smaller species that have also absorbed environmental mercury from algae and bacteria.
According to Valera et al, mean blood-pressure and pulse-pressure levels were elevated in the Inuit adults studied, and tellingly, mercury was strongly associated with systolic BP levels in multivariate analyses. Every 1% increase in blood mercury levels was associated with a 0.02-mm-Hg increase in systolic BP, they write. An association with diastolic BP was also documented but did not reach statistical significance. Strikingly, the adverse blood-pressure effects of mercury persisted when the purported benefits of fish consumption were taken into account--namely omega-3 fatty acids and selenium.
In the paper, the authors acknowledge that their paper is only one of many that have attempted to characterize the cardiovascular toxicity of mercury, but they believe it to be the first to take into account omega-3s and selenium in an analysis of BP effects of mercury. These fish nutrients, they write, "had a strong confounding effect, suggesting that not adjusting for these substances could lead to an underestimation of the effect size."
"Our results suggest that eating large quantities of species containing a high mercury content and low omega-3s such as big predator fish--tuna, swordfish, marlin, sharks, etc--is not a good idea for our health," study coauthor Dr Eric Dewailly (Centre de Recherche du CHUQ) commented in a press release.
In the same release, however, the AHA, which recommends people eat oily fish two times per week, tries to put the results in perspective. "Many Americans can safely enjoy eating fish as a regular part of their diet to achieve the health benefits of omega-3 fatty acids, and this includes canned light tuna, which is significantly lower in mercury than white tuna," the release quotes Dr Penny Kris-Etherton (Pennsylvania State University, University Park), of the AHA's Council on Nutrition Metabolism and Physical Activity Nutrition Committee.
While children and nursing mothers should steer clear of fish with the highest mercury contamination (shark, swordfish, king mackerel, or tilefish), the US Food and Drug Administration ( FDA) has said that the benefits of fish consumption outweigh the mercury risks in middle-aged and older men, plus postmenopausal women, the AHA notes.
References
1.Valera B, Dewailly E, Poirier P. Environmental mercury exposure and blood pressure among Nunavik Inuit adults. Hypertension 2009; DOI:10.1161/HYPERTENSIONAHA.109.135046. Available at: http://hyper.ahajournals.org.
2.American Heart Association. Mercury in fish seems to raise blood pressure in spite of nutrients [press release]. October 5, 2009. Available here.
Additional InformationMore information about fish intake and mercury in fish related to cardiovascular disease is available on the American Heart Association's Web site.
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