Many lives could be saved if GPs followed guidelines for reducing cholesterol in patients at high risk of heart disease, research suggests.

A study of 25,250 patients in Germany found that only about half were assigned the correct targets for lowering cholesterol.

Doctors believe the findings, published in the European Heart Journal, may apply in the rest of Europe.

Women are most at risk of being given insufficient treatment, they say.

The study found that about 50 to 80 fewer heart attacks, strokes and heart disease-related deaths per 1,000 patients could be avoided over a 10-year period if all doctors adhered to the guidelines on cholesterol-lowering targets.

Patients were more likely to be given correct targets if they had a history of heart attacks, coronary heart disease and diabetes, the researchers found.

Patient risk

Professor Heribert Schunkert, a clinical cardiologist who led the research in Lubeck, Germany, said the core question involved the perception of patient risk.

“Women are often perceived as having a lower cardiovascular risk compared to their real risk, and this may lead to insufficient treatment,” he said.

“This aspect has also been reported in other regions in the world.”

Professor Ian Graham, head of cardiovascular medicine at Trinity College Dublin. and a spokesman for the European Society of Cardiology said the UK did better when it came to giving out correct cholesterol targets.

But he cautioned: “There is a general principle of guideline fatigue. GPs are bombarded by targets.

“It’s important to make guideline information as easy and accessible as possible.”

Cholesterol is a fatty substance known as a lipid. It is carried in the blood on proteins called low-density lipoproteins (LDL).

LDL is known as bad cholesterol because it deposits cholesterol in the lining of the arteries.

The more LDL a person has, the more likely they are to develop heart disease.

Lowering cholesterol using drugs, diet and other lifestyle measures is an important preventative measure.

The government recommends that total cholesterol levels should be less than 5mmol/l.

On average, men in England have a cholesterol level of 5.5mmol/l and women have a level of 5.6mmol/l.

If men stay in good shape, they can enjoy more years of good sex, a study says

There is no evidence acupuncture or Chinese herbal medicine increase the chance of getting pregnant through IVF, fertility experts say in new guidance.

The methods are increasingly offered as a way of boosting the chances of a baby, but the British Fertility Society suggests couples may be wasting money.

They analysed 14 trials involving 2,670 people before issuing the new guidance.

But a leading practitioner said that better designed trials would show that the methods could help some couples.

All the trials involved acupuncture, in which needles were inserted into different areas of the body at different stages in the in vitro fertilisation (IVF) cycle.

No matter at what stage of the process acupuncture was used, it had no impact on the pregnancy or live birth rate, the BFS researchers found.

They did however also find it caused no harm, with no difference in miscarriage rates.

There were no published trials on the use of Chinese herbs which were rigorous enough for inclusion, so the team concluded that there was “currently no evidence to support the use of this in fertility treatments”.

As more couples seek IVF, there has been a growth in accompanying complementary therapies, and acupuncture has benefited.

It is the most popular option for patients because it is thought to improve blood flow and increase the chance of an embryo implanting.

Trial and error

But this sometimes comes at a cost which could buy a couple a further cycle of IVF.

Professor Adam Balen, head of BFS’s policy and practice committee, said patients needed to be aware of the lack of evidence on acupuncture and herbs before signing up to a course of treatment.

There was a “a great deal of discrepancy”, he added, in the way in which the trials were designed and the type of acupuncture used.

“Any future randomised controlled trials in this area need to ensure that they use a standardised acupuncture method, have a large sample size and include adequate controls to account for any placebo effects.”

One high-profile practitioner, Dr Xiao-Ping Zhai, of The Zhai Fertility Treatment Clinic, said there were indeed problems with the way in which these trials were designed and that different analysis would show the benefits.

“Certainly for those with unexplained fertility problems in particular, we know acupuncture and traditional Chinese medicine can be beneficial. What matters is both the expertise and experience of the practitioner, but most of all the treatment of the patient as an individual. It is the tailored treatment which is key.

“We need clinical trials that take this into account.”

A statement from the British Acupuncture Council noted: “Fertility focused acupuncture treatment has been found to help increase blood flow to the reproductive organs, balance hormone levels, regulate the menstrual cycle and help improve the lining of the uterus and quality of eggs released.

“BACC practitioners recognise that there are many factors which may cause infertility such as stress, irregular hormone levels and disrupted menstrual cycles. As a holistic therapy, acupuncture helps to identify underlying health issues which may cause disruption to the body’s natural balance, resulting in symptoms such as infertility.”

But one of the country’s leading experts on the efficacy of complementary medicine, Professor Edzard Ernst of Pensinsula Medical School, described the new guidelines as “long overdue clarification”.

“Infertile women have been misled for some time now to think that traditional Chinese medicine (TCM) can help them getting pregnant. This analysis shows two things very clearly: the totality of the acupuncture trials does not support this notion, and for Chinese herbs, we have no evidence at all.

“This will help infertile women not to waste their money or get disappointed by TCM practitioners who behave less than responsibly when recommending these treatments.”

The US soft drinks industry says it has dramatically cut the number of high-calorie soft drinks sold in US schools as part of a drive to tackle obesity.

The American Beverage Association said shipments of full-calorie drinks to schools were down 95%.

Nearly one in three children and teenagers in the US are overweight or obese and health experts say sugary drinks are part of the problem.

Several US states and cities are considering taxing soft drinks.

The reduction in sugary soft drinks in schools formed part of a deal between the major companies and the Alliance for a Healthier Generation, a joint initiative of the American Heart Association and the Clinton Foundation.

Under the voluntary guidelines, in place since 2006, full-calorie soft drinks were removed from school canteens and vending machines. Lighter drinks, including low-fat milk, diet sodas, juices, flavoured waters and teas were promoted in their place.

“There’s been a dramatic shift toward lower calorie and more nutritious beverages in schools, it could lay the foundation for broader changes in our society,” former US President Bill Clinton told a news conference on Monday.

Soda tax

Independent consulting firm Keybridge Research looked at what changes the guidelines had brought about and found that:

• the total beverage calories shipped to schools between the first half of the 2004-05 school year and the first half of the 2009-10 school year has decreased by 88%
• there had been a dramatic shift toward lower-calorie and higher nutrient beverages in schools, including waters, 100% juices, and portion-controlled sports drinks
• shipment volumes of full-calorie drinks were 95% lower in the first half of the 2009-10 school year compared with the first half of the 2004-05 school year.

The soft drinks industry has been a main target of critics who say the sugary beverages they sell are a key factor in the levels of childhood obesity in the US.

The state of California and the city of Philadelphia have introduced legislation to tax soft drinks, while both the New York Governor David Paterson and New York City Mayor Michael Bloomberg are also pushing for such a tax.

“In these tough economic times, easy fixes to our problems are hard to come by,” said Mr Bloomberg at the weekend. “But the soda tax is a fix that just makes sense, it would cut rising health costs.”

Susan Neely of the American Beverage Association, which includes major firms like Coca Cola, PepsiCo and Dr Pepper Snapple Group, said such a tax would not solve “a complex problem like obesity”.

Pregnant women in developing countries face the same risk of death as women in the UK did 100 years ago, according to a coalition of campaign groups.

They are using International Women’s Day to call for more action to reduce deaths among women during pregnancy.

They say improving mothers’ health is “the most off-target” of the UN’s eight Millennium Development Goals.

For every 100,000 live births in developing countries, 450 women die during pregnancy or labour.

The coalition, which includes White Ribbon Alliance, Amnesty International and Oxfam, says that in 1910, 355 women died per 100,000 live births in England and Wales.

In Scotland and the Irish Republic, the rate was higher - at 572 and 531 respectively.

In Ghana today the rate of pregnancy-related deaths is 560, while in Chad it is 1,500. The rate in the UK is now 14 deaths per 100,000.

The comparison has been drawn because it was 100 years ago that International Women’s Day was established.

The UN says although it is difficult to get accurate figures on maternal mortality, very little progress has been made in sub-Saharan Africa - and deaths in southern Asia “remain unacceptably high”.

Brigid McConville, the director of White Ribbon Alliance, which campaigns for safe motherhood, said: “There still remains a long way to go for the protection and security of pregnant women and their newborn children.”

Monday is the official launch of a week of events. Campaigners will march at the Millennium Bridge in London and lay white roses outside Parliament.

Preventable deaths

Some countries have made progress in improving women’s health - most notably Nepal and Rwanda.

In Mongolia, reduced deaths were achieved by educating women about the signs of complications in pregnancy and by helping them travel to special homes where they could wait to give birth.

Many of the medical problems are easily preventable if, for example, women have access to skilled health workers who can treat infections and use drugs to prevent haemorrhage.

The Millennium Development Goal also envisages preventing deaths that result from complications after unsafe abortions and allowing women access to contraception - to prevent riskier births in teenage mothers and to allow them to space their children.

The issue has become politically more significant in recent years, with the backing of the British Prime Minister’s wife Sarah Brown, who is patron of the White Ribbon Alliance.

The Women Deliver conference in Washington DC in June aims to put increased pressure on world leaders to tackle the problems.

Amnesty International’s UK director Kate Allen said: “It’s clearly been possible to cut back on the rate of maternal deaths here in the UK.

“We need to demonstrate that same level of commitment worldwide.”