High Blood Sugar Tied to Pregnancy Complications

By Serena Gordon
HealthDay Reporter Wed May 7, 11:46 PM ET

WEDNESDAY, May 7 (HealthDay News) -- Women with high blood sugar levels during pregnancy face an increased risk of complications, even if the high blood sugar readings don't meet the criteria for gestational diabetes.
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In a large, international study, researchers found that for each standard deviation increase in blood sugar, there was a greater risk of complications, such as having a large birth weight baby or needing a Caesarean section delivery.

"We found strong independent associations between a mother's blood sugar levels during an oral glucose tolerance test and 28 weeks of gestation and the pregnancy outcomes," said the study's lead author, Dr. Boyd Metzger, the Tom D. Spies professor of metabolism and nutrition at the Feinberg School of Medicine at Northwestern University in Chicago.

What this means for pregnant women right now, however, isn't clear.

"Because the relationship between the mother's blood glucose level and risk tend to be continuous and linear, it is not clear where the risk reaches the point where treatment should optimally begin," said Metzger.

"We were hoping there would be a breakpoint," explained another of the study's authors, Dr. Don Coustan, professor and chair of obstetrics and gynecology at the Warren Alpert Medical School of Brown University in Providence, R.I. "But, the relationship between glucose levels and outcomes were continuous, which means it will be difficult to decide where to put the 'treating' point."

Coustan added that there will be a conference in June where pregnancy and diabetes experts will likely debate the pros and cons of treating hyperglycemia. For now, he said, he suspects that "doctors will still use the glucose threshold they're currently using."

One thing that was clear from the study is that higher odds of complications, like an increased risk of C-section or a large baby, are related to high blood sugar and not to other conditions, such as obesity or older maternal age, according to Metzger.

Results of the study were published in the May 8 issue of the New England Journal of Medicine.

The study included more than 23,000 pregnant women from 15 centers in nine countries. None of the women had diabetes. All of the women underwent glucose tolerance testing between 24 and 32 weeks of gestation. This test is performed by first taking a fasting blood sugar reading, then having the woman drink a high-carbohydrate liquid -- in this case a 75-gram carbohydrate drink; 100 grams is standard in the United States -- and then rechecking blood sugar levels at one and two hours to assess how the body is processing the high sugar load.

The higher a woman's blood sugar levels were, the more likely she was to have a C-section, to develop preeclampsia, have premature delivery and to have the delivery complication known as shoulder dystocia, the study found.

Babies born to women with higher glucose levels were more likely to have high insulin levels, low blood sugar, and to have a large birth weight, all indications of exposure to high glucose levels.

The odds of these complications changed continuously as blood sugar levels rose. For example, a woman with the highest levels of blood sugar (but not diabetes) had large babies 26 percent of the time, compared to just 5 percent for women with the lowest blood sugar levels.

"Basically, what they found out is that there is no threshold where you know to treat. That makes it difficult to know what to do with these findings," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

A second study in the same issue of the journal looked at the use of the oral diabetes medication metformin, versus insulin, the standard treatment for gestational diabetes. The study included 751 women, randomly assigned to receive metformin or insulin treatment.

The researchers found that metformin was well-tolerated, although almost 43 percent of the women eventually required the use of supplemental insulin. There were no serious adverse events reported for mother or baby from the use of metformin, according to the study.

Of this study, Zonszein said, "My guess is that until we have larger studies, there's not going to be a big change in recommendations, because we have so much experience with insulin." But, he added, many women and obstetricians may welcome these findings because "giving a pill is easier than giving insulin." He said another oral medication, glyburide, was also found effective in another small trial.

Mom's high normal blood sugar risky: study

By Karla Gale Thu May 8, 8:54 AM ET

NEW YORK (Reuters Health) - Pregnant women who have blood sugar levels above normal but below those signaling full-blown diabetes are more likely than women with lower blood sugar levels to experience several adverse pregnancy outcomes, new research indicates.

It is well known that high blood sugar levels indicative of the diabetes that occurs during pregnancy present risks for expectant mothers and their infants. The current study is believed to be the first to show that higher blood sugar levels -- not high enough to be considered diabetes -- also convey these increased risks.

In a study of nearly 24,000 pregnant women who had their blood sugar levels tested between 24 and 32 weeks of pregnancy, researchers found that the higher the mother's blood sugar level, the greater the chances that she would require Caesarean delivery and deliver an abnormally large baby.

Dr. Boyd E. Metzger from Northwestern University Feinberg School of Medicine in Chicago, and colleagues also found that the higher the mother's blood sugar levels, the more likely the women were to develop a potentially serious condition called preeclampsia marked by a spike in blood pressure and the more likely their infants were to be born prematurely, and to experience shoulder dystocia -- a condition in which an infant's shoulder becomes lodged inside the mother's body, effectively halting the birth process.

"These relationships are continuous and generally increase incrementally over the range of blood (sugar) levels we saw in the study," Metzger noted in a statement.

The question remains, Metzger told Reuters Health, "at what level of risk should we intervene? That is a big question that can't be addressed by this research."

He noted that a meeting to discuss these issues is scheduled next month immediately following the annual meeting of the American Diabetes Association.

SOURCE: The New England Journal of Medicine, May 8, 2008.

Gene May Be Key to Pregnancy Complication

By Steven Reinberg
HealthDay Reporter Mon May 12, 11:47 PM ET

MONDAY, May 12 (HealthDay News) -- A gene called COMT, already known for its role in schizophrenia, also plays a significant part in the dangerous obstetric complication known as preeclampsia, a new study finds.

Although the current study was done in mice, the researchers envision a time when the findings could be used as a test to identify women at risk of preeclampsia -- and even as a means of preventing the condition.

"This gene regulates the oxygenation of the placenta," explained lead researcher Raghu Kalluri, a professor of medicine at Harvard Medical School. "Preeclampsia is a pregnancy disorder where the placenta is hypoxic (isn't receiving enough oxygen)," he added.

Preeclampsia, which affects about 5 percent of all pregnancies, is a leading cause of sickness for pregnant women and their infants. Symptoms of preeclampsia include high blood pressure, protein in the urine and swelling.

The COMPT (catechol-O-methyltransferase) gene is involved in breaking out estrogen into a metabolite called 2ME (2-methoxyestradiol), which prevents a shortage of oxygen in the placenta. When the gene does not function properly, levels of 2-ME are reduced, setting in motion a series of events that lead to preeclampsia, Kalluri explained.

The report was published online in the May 12 issue of Nature.

In their current experiments, the researchers worked with mice that did not have the COMT gene, and therefore do not produce 2-ME. After 14 weeks of gestation -- equivalent to the third trimester of human pregnancy -- the mice developed high blood pressure and other symptoms of preeclampsia, the researchers found.

The mice also delivered their pups earlier than normal, with a high incidence of stillborn offspring. Once the pups were delivered, the mother's health return to normal, the researchers found.

However, when the mice were given supplemental 2-ME, symptoms of preeclampsia disappeared, Kalluri said.

Kalluri's team found that COMT levels were deficient, and 2-ME levels were also lower, in women diagnosed with preeclampsia.

Because 2-ME is found in the blood and urine, the researchers hope to use their finding to develop a urine test that would identify women at risk from preeclampsia, Kalluri said. "This can be designed as a urine strip test, like pregnancy tests are," he said.

In addition, giving 2-ME to women who have low levels of this protein may prevent them from developing preeclampsia, Kalluri said. "We can give back the missing amount to bring levels back to where they should be," he said.

One expert believes the results are promising, but said more work is needed before 2-ME could become either a screening test or treatment.

"This is an interesting and novel study, which gives insight into the pathophysiology of preeclampsia," said Dr. Arun Jeyabalan, an assistant professor in the division of maternal fetal medicine in the department of Obstetrics, Gynecology and Reproductive Sciences at Magee Women's Hospital, University of Pittsburgh.

Jeyabalan said that it will be sometime before these findings can be extended to patients. Using these findings to develop a screening test is something worth looking into, she added.

"Most of this work is of animals, and I think we have to be cautious before we extend these findings to humans," Jeyabalan said. "But it is something that is definitely worth testing in the future."

Breastfeeding halves rheumatoid arthritis risk

Tue May 13, 1:55 AM ET

LONDON (Reuters) - Women who breastfeed their babies longer are less likely to get rheumatoid arthritis, Swedish researchers said on Tuesday.
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Mothers who breastfed for 13 months or more were half as likely to get the painful joint condition as women who never breastfed, said Mitra Pikwer and colleagues at the Malmo University Hospital in Sweden, who led the study.

"Although it is difficult to separate the effect of breast feeding from that of childbirth, our data suggest that rheumatoid arthritis is inversely associated with long-term breastfeeding, rather than with the number of children born," they said.

The researchers said they wanted to see if a larger, community-based study would echo earlier studies on the links between breastfeeding or the use of oral contraceptives and the condition affecting about 20 million people worldwide.

Rheumatoid arthritis is an autoimmune disease caused when the body confuses healthy tissues for foreign substances and attacks itself.

Some drugs to treat the condition seek to reduce inflammation directly while others tone down the immune system's response, which can leave some patients vulnerable to infections and cancer.

The Swedish team compared 136 women with rheumatoid arthritis and 544 women of similar age without the disease. They also found that breastfeeding for between up to 12 months made women 25 percent less likely to get the joint condition.

The findings bolster previous research linking breastfeeding to a reduced risk of the disease. But, as with other studies, the Swedish teams said they did not know the exact reason why.

Breastfeeding is known to provide multiple benefits for the baby and studies have shown the practice may also protect mothers from breast and ovarian cancers.

The study published in the British Medical Journal's Annals of the Rheumatic Diseases also suggested that oral contraceptives -- thought to offer protection because they contain certain hormones -- did not seem to make a difference.

(Reporting by Michael Kahn)

28 million women at risk of unwanted pregnancy

Tue May 13, 11:07 AM ET

CHICAGO (Reuters) - Each year, half of American women who would rather not get pregnant will have an unplanned pregnancy, often because they failed to use their contraceptive properly or forgot to use it at all, U.S. researchers said on Tuesday.

As a result, 28 million women in the United States are at risk for an unintended pregnancy, according to the study conducted by the Guttmacher Institute in New York.

They found one in four women is very likely to become pregnant because of inconsistent contraception use.

Some of this gap is due to lack of access to health care, with many women saying they cannot afford some of the more effective methods of contraception such as birth control pills that require a doctor's visit and prescription.

"It is critical to have a better understanding of what is preventing women from using contraception consistently and correctly, or even at all," Dr. Jennifer Frost, a senior research associate at Guttmacher, said in statement.

The research involved surveys of women and family planning providers nationwide. Among the results, they found that more than half of women who have a gap in contraceptive use of at least one month have experienced some type of major life event -- such as the end of a relationship, a move, job change or personal crisis.

They also found that many women are not satisfied with their current method of contraception, a problem that can lead to missing birth control pills or failure to keep a condom handy, for example.

Last month the National Center for Health Statistics reported there were almost 6.4 million pregnancies in 2004, down 6 percent from 1990. Forty-five percent were to women who were not married, and there were 1.22 million abortions and 1.06 million stillbirths and miscarriages.

The researchers also found that many women who are lax about birth control are simply ambivalent about preventing a pregnancy and confessed that they would be very pleased if they found out they were pregnant.

The researchers said women who are the least motivated to avoid pregnancy are far less likely to use birth control pills, or any contraceptive method at all on a consistent basis.

They said a woman's attitude toward pregnancy, her satisfaction with her method and her experiences with gynecologists and other providers of contraception play a far bigger role in a woman's risk of pregnancy than other major risks, such as poor education and poverty.

Frost said doctors and other health providers should start by helping women to find the best contraceptive method for them.

"The more we can remove the remaining barriers to consistent use, the better we will be at ensuring that all women can avoid unwanted pregnancies and plan the children they want, when they want them," Frost said.

Beijing confirms first virus deaths: report

Wed May 14, 2:49 AM ET

BEIJING (AFP) - China on Wednesday confirmed the first two deaths in Beijing from hand, foot and mouth disease, bringing the national death toll to 42 children, state media reported, citing health officials.

One child from Beijing, host of this year's Olympics, died on Sunday, Xinhua news agency said citing city health department spokeswoman Deng Xiaohong.

Another child from Hebei also died in the capital after being transferred from the northern province for medical treatment, the report said.

The highly contagious disease, which is most dangerous to the young, has killed 42 children across China and infected nearly 25,000 people, the report said.

Most of the deaths have involved enterovirus 71, or EV71, which can lead to acute hand, foot and mouth disease and has been identified by China as a key factor in the severity of the outbreak.

Cases first emerged in large numbers in eastern China in early March but the problem was not made public until late April, prompting state press to accuse local officials of dragging their feet on raising the alarm.

Mother's mental health tied to child's development

By Anne Harding Wed May 14, 3:59 PM ET

NEW YORK (Reuters Health) - Evaluating the emotional health and social connectedness of pregnant women may help determine if their children will need extra help to meet developmental goals later on, Canadian researchers say.

If children get this assistance early, there's a good chance they will do just fine, Dr. Suzanne C. Tough of the University of Calgary in Alberta, the study's lead author, told Reuters Health.

But Tough and her team found that more than half of the three-year-olds in their study who were identified as being at high risk for developmental problems had never been referred for assessment to see if they actually did have speech and language delays.

"We miss these children when our early intervention can be most effective," the researcher continued. Kids with mild to moderate delays who could make "huge strides" without extensive help are actually the most likely to fall through the cracks, she added.

To investigate early risk factors for developmental problems, which can, in turn, increase the likelihood that a child will fail in school and have behavioral issues, Tough and her colleagues looked at 791 mothers who had participated in prenatal care study and their children, who were now pre-school-age. All of the women had uncomplicated pregnancies and deliveries.

While 11 percent of the children were gauged to be at high risk for developmental problems, just 43 percent of these high-risk kids had been assessed. Those who were born preterm were more likely to have been identified as at risk, as were children who had undergone hearing tests and those with vision problems.

Children were more likely to be at high risk for developmental problems if they were male, had ear infections, came from a low-income environment, or had a mother with poor mental health during the prenatal period and after the child was born. Problems typically included depression, a history of abuse and a poor level of contentment.

Fifty-three percent of the kids who met each of these criteria were at high risk. However, when the mother's poor mental health was removed from the equation, the risk fell by 30 percent, to 18 percent.

"The big surprise to me in this data was just how important maternal mental health can be," Tough said.

The women typically didn't have serious psychiatric problems, she added, but were simply in poor mental and emotional health and frequently lacked good connections in their community and to friends and family.

Tough and her team are now evaluating whether a program that brings pregnant women together to help them build social networks will improve children's outcomes.

SOURCE: BMC Pregnancy and Childbirth, published online May 6, 2008.

Childhood anxiety may worsen anorexia

Fri May 16, 3:58 PM ET

NEW YORK (Reuters Health) - Anorexic women with a history of childhood anxiety may have particularly severe symptoms of the eating disorder, a study suggests.

It's known that anxiety disorders, like social phobia and obsessive compulsive disorder, are far more common among people with anorexia than in the general population. Often, these anxiety disorders appear before the eating disorder does.

In the new study, published in the International Journal of Eating Disorders, researchers looked at whether a history of childhood "overanxious disorder" was related to the severity of women's anorexia.

Dr. Cynthia M. Bulik, of the University of North Carolina at Chapel Hill, and colleagues found that of 637 women with anorexia, 39 percent reported symptoms of childhood overanxious disorder. In nearly all cases, those symptoms arose before the onset of their anorexia.

In general, the researchers found, women with a history of childhood anxiety exhibited "more extreme personality traits" and attitudes -- like perfectionism and obsessive tendencies related to food -- than women without a history of early anxiety disorders.

They were also more likely to purge, by vomiting or abusing laxatives, in addition to strictly limiting their food intake.

According to Bulik's team, childhood anxiety disorders "may represent one entree" into anorexia. This, they say, underscores the importance of recognizing and treating these conditions early on.

SOURCE: International Journal of Eating Disorders, May 2008.

Health Tip: Traveling During Pregnancy

Thu May 15, 11:47 PM ET

(HealthDay News) -- If you're planning to take a trip while pregnant, you should check with your doctor to be sure it's safe for you to travel. Unless you have complications with your pregnancy, most women can travel safely.

Here are some travel tips to keep you safe and comfortable during pregnancy, courtesy of the American Pregnancy Association:

* Travel during the second trimester is usually most comfortable -- after morning sickness has passed and the fatigue of the third trimester is still ahead.
* Wear comfortable, loose clothing and comfortable shoes.
* Take things to make you more comfortable, like a pillow from home and some snacks that satisfy you.
* If you're driving, stop to get up and stretch often and take plenty of bathroom breaks.
* Always take your prenatal records with you on the road.
* Be safe: Wear your seat belt and follow safety instructions for whatever transportation you use.

Heart risks high in childhood cancer survivors

By Julie Steenhuysen Thu May 15, 9:27 PM ET

CHICAGO (Reuters) - Children who survive cancer while they are young are five to 10 times more likely than their healthy siblings to develop heart disease, U.S. researchers said on Thursday.

The finding comes from a study of more than 14,000 survivors of childhood cancers, and suggests that cancer survivors and their doctors need to be vigilant about heart risks.

"This study clearly shows for children, and particularly children treated with radiation therapy to the chest or certain drugs that are particularly toxic to the heart, there are significant risks of cardiovascular disease at a far younger-than-expected age," said Dr. Richard Schilsky of the University of Chicago.

The preliminary results were released ahead of a meeting later this month of the American Society of Clinical Oncology.

Schilsky, who is president-elect of ASCO, said the study highlights the challenges faced by cancer survivors, who have to live with the health consequences of having had cancer and having been treated for cancer.

Dr. Daniel Mulrooney of the University of Minnesota and colleagues conducted the study, which looked at 14,358 survivors of childhood leukemia, central nervous system tumors, Hodgkin's and non-Hodgkin's lymphoma, kidney tumors, bone cancers, neuroblastoma and soft-tissue sarcoma between 1970 and 1986.

They compared these to 3,899 of their siblings. Cancer survivors on average were 7 years old at diagnosis and 27 at follow up.

The cancer survivors were 10 times more likely to have clogged arteries, 5.7 times more likely to have heart failure, 4.9 times more likely to have heart attacks, 6.3 times more likely to have pericardial disease -- affecting the sac surrounding the heart -- and 4.8 times more likely to have diseased heart valves compared with their siblings.

"We found 5-year survivors of childhood and adolescent cancers are at an elevated risk for early cardiovascular disease," Mulrooney told reporters in a telephone briefing.

They also found the risks were two to five times greater in people who had been treated with chest radiation and chemotherapy from the anthracycline class of drugs, such as doxorubicin, compared to survivors who did not have those treatments.

Mulrooney said there are about 270,000 childhood cancer survivors in the United States, or about 1 in every 900 young adults. He said the findings may lead to better cancer treatments that protect the heart.

"We still use radiation therapy," he said, but newer radiation treatments are more targeted, and he hopes they will have less impact on the heart.

Schilsky said other studies have found long-term cancer survivors are at greater risk of premature osteoporosis, infertility, thyroid problems, anxiety and depression and the risk of another cancer.

"It becomes incumbent on the patient and the primary care physician to be aware of their cancer history and the potential consequences of their treatment," Schilsky said.

(Editing by Maggie Fox)

Study finds heart risks in young cancer survivors

By MARILYNN MARCHIONE, AP Medical Writer Thu May 15, 9:03 PM ET

Children who survive cancer face a much greater risk of heart problems later in life than their brothers and sisters who did not have cancer, new research shows.

Doctors have long known that certain chemotherapy drugs and radiation can harm the heart, but it has been seen as a relatively small price to pay for beating cancer. Cancer itself may damage the heart. And even though the risk was higher, heart problems still were relatively rare.

The study used a national registry to track 14,358 cancer survivors diagnosed in the 1970s and 1980s, when treatments were harsher than those commonly used today, and compared them to about 4,000 healthy siblings.

The survivors had one of eight forms of the disease, including leukemia, brain tumors, Hodgkin's or non-Hodgkin's lymphoma and kidney tumors.

Compared to their healthy siblings, they had five to 10 times greater risk of heart problems, ranging from clogged arteries to heart failure and valve disease.

The risk often showed up when they were still young adults — an age when few doctors would think to check them for heart problems. The survivors were diagnosed with cancer at an average age of 8, and their average age was 28 when the follow-up study was done.

There are about 270,000 childhood cancer survivors in the United States today, said the study's leader, Dr. Daniel Mulrooney at the University of Minnesota.

"They have to live with the health consequences of having had cancer and having been treated for cancer," he said.

Still, the incidence of problems was low: 2 percent had hardening of the arteries, 4 percent had heart failure, 1 percent suffered a heart attack and 4 percent had a valve problem.

Study results were released Thursday by the American Society of Clinical Oncology and will be presented at the group's annual meeting later this month.

France reports leveling childhood obesity rates

By Michael Kahn Thu May 15, 9:40 AM ET

GENEVA (Reuters) - France is the first EU country to report a leveling off of childhood obesity rates, suggesting that healthier diet programs and a ban on vending machines in schools is paying off, researchers said on Thursday.

The findings from two separate studies of school-age children signal a shift in France after decades of increase, researchers told the 2008 European Congress on Obesity.

"The rates of children who are overweight are undergoing an overall stabilization in France among all socio-economic backgrounds," said Sandrine Lioret, an epidemiologist at the French Food Safety Agency, who led one of the studies.

Obesity is a major problem worldwide that increases the risk later in life of type 2 diabetes, cancer and heart disease. The World Health Organization classifies around 400 million people as obese, including 20 million children under age 5.

Many Western governments -- where the obesity problem is greatest -- have adopted programs in recent years to promote healthier diets and lifestyles to keep children from growing up to be overweight and obese.

The French findings are important because they show that government policies are a potential weapon in the fight against childhood obesity, said Tim Lobstein, a director of the International Obesity Task Force in London.

But he cautioned that only time would tell whether the French results are a one-off blip or part of a long-term trend.

"The tidal wave (of obesity) is continuing to surge in most European countries," he said. "We are seeing that wave roll on through to adulthood."

France is about in the middle when it comes to European childhood obesity rates, with the lowest seen in Scandinavia and the highest in poorer nations in Southern Europe, the researchers said.

In one of the studies, Lioret's team at the French Food Safety Agency showed no statistically significant change in the prevalence of obesity rates among randomly-selected school children age 3 to 17 in surveys taken eight years apart.

The other research from the French National Institute for Health Surveillance found that the number of obese children aged 7 to 9 had remained steady at around 18 percent in 2000 and 2007.

Government policies, a growing awareness of the dangers of obesity and the fact that children are eating less all seem to be playing a role, the researchers said.

One worry, though, is that even as the overall rate has flattened, poor children were up to three times more likely to be obese compared to wealthier children, they added.

(Reporting by Michael Kahn, Editing by Jon Boyle)

Childhood obesity levelling in France

Thu May 15, 6:15 AM ET

GENEVA (AFP) - Childhood obesity may be levelling in France in contrast to the general trend in Europe where more youngsters are growing fat, according to two new studies presented Thursday.
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Researchers say they are yet unable to link changes in public health policies to the stabilising trend, but stress that an increased awareness of the obesity problem may have had some impact.

However, the studies presented at the European Congress on Obesity in Geneva also show that children from poorer socio-economic backgrounds are more prone to fat.

France has moved to introduce measures to combat childhood fat, with vending machines banned in schools since 2005.

In latest measures unveiled, Health Minister Roselyne Bachelot in February called for the advertising of certain foods to be stopped voluntarily from children's television programming.

She had warned that if companies do not take voluntary action to remove such advertising, laws will be proposed.

"Public health policy has changed a lot in France since 2000, but we cannot prove that the stabilisation is due to these interventions.

"There has been an increased awareness of the issue of obesity in children and it's possible that this general awareness has had some impact," said Katia Castetbon, who heads the nutritional epidemiology and surveillance unit at the French National Institute for Health Surveillance.

Castetbon's group looked at the prevalence of obesity among seven to nine-year-olds in 2000 and 2007, and found that there was little change in the rates in seven years.

In the second survey by the French Food Safety Agency's dietary unit, results for 2006-2007 were compared with 1998-1999 and found not to show significant deviation.

However, the survey found that overweight rates were 2.5 to three times higher in children from the lowest socio-economic group than those from the highest level.

Castetbon's study also garnered similar findings.

"That indicates that more work needs to be done to adapt the approaches to address the needs of these children so that the gap can be narrowed," she said.

The EU said in 2007 that an estimated three million Europeans are obese, with about 85,000 more children becoming obese every year.

Childhood Cancer Survivors Prone to Early Heart Trouble

By Amanda Gardner
HealthDay Reporter Fri May 16, 11:46 PM ET

FRIDAY, May 16 (HealthDay News) -- Adults who had cancer as children or teens are more likely to experience cardiovascular disease, a new study found.

And the heart problems surface at a much earlier age than in people who did not suffer cancer as children.

Childhood cancer survivors "have approximately a five to 10 times increased risk of having heart disease compared to their healthy siblings," said study lead author Dr. Daniel A. Mulrooney, assistant professor of pediatrics at the Masonic Cancer Center of the University of Minnesota, Minneapolis.

Mulrooney was expected to present his findings Thursday night at the American Society of Clinical Oncology annual meeting, in Chicago.

There are an estimated 270,000 survivors of childhood cancer in the United States, and 11 million cancer survivors total.

While the cancer survivors in the new study ranged in age from 8 to 51, the average age of those with heart problems was only 27.5 years.

"We're talking about a very young population that's having very significant cardiac disease and is likely not being monitored appropriately," Mulrooney added. "It is very important that they be followed and that risk factors and cardiovascular monitoring that we would think of in an older population be implemented in a younger population."

The findings aren't entirely surprising. Previous research, much of it with the same group of survivors, has shown an increased risk of cardiovascular disease in survivors of childhood and adolescent cancer.

The new analysis, the longest follow-up to date, provides updated information on 14,358 five-year survivors of childhood cancer. All the participants were diagnosed with one of eight cancers (including leukemia, lymphoma and brain malignancies) at 21 years of age or younger, between 1970 and 1986.

The study participants provided information on their own heart health, which was then compared to a control group of 3,899 healthy siblings.

Compared to the healthy brothers and sisters, the survivors of childhood cancer were almost six times more likely to report congestive heart failure; about five times more likely to report having had a heart attack or valvular heart disease; more than six times likelier to have pericardial disease (the pericardium is the sac that surrounds the heart); more than eight times as likely to have had an angiography; and 10 times more likely to have atherosclerosis, or hardening of the arteries.

Exposure to the chemotherapy drug anthracycline increased the risk of congestive heart failure about fourfold, roughly doubled the risk of pericardial and valvular disease, and almost tripled the odds of having had an angiography, the study found.

Radiation treatment to the heart doubled the risk of congestive heart failure, heart attack and pericardial disease, almost tripled the risk of valvular disease, and increased the risk of atherosclerosis by a factor of more than five, according to the study.

Dr. Karen Burns is clinical director of the ATP5+ Clinic for Childhood Cancer Survivors at Cincinnati Children's Hospital. She said most of the heart problems seen in survivors of childhood cancer come from the class of chemotherapy drugs called anthrocyclines, which cause problems with cardiac muscle, and from radiation, if the radiation field included the heart.

Although monitoring for heart disease in childhood cancer survivors is already in place in many specialized facilities, Burns said she hoped that, "if this study is available to the general public, it will encourage people who are survivors to get closer follow-up."

Mulrooney added: "We see this in our long-term follow-up clinic. We identify patients who are at risk based on this analysis and may do an echocardiogram or a lipid panel, things we might not typically do in a 20-year-old. There are tools out there, and getting this knowledge out there as well would be helpful so primary-care physicians will be more aware, oncologists and cardiologists will be aware, and patients as well."