Current Events in January 2017

American Honda Motor Co. is recalling a total of 882 Goldwing motorcycles.

Included are model year 2006-2009 and 2012 Honda GL1800 (Goldwing) motorcycles originally sold, or ever registered, in Alabama, California, Florida, Georgia, Hawaii, Louisiana, Mississippi, South Carolina, Texas, Puerto Rico, American Samoa, Guam, the Northern Mariana Islands (Saipan), and the U.S. Virgin Islands, or "Zone A."

Additionally, if not included in "Zone A," Honda is recalling certain 2006-2009 Honda GL1800 (Goldwing) motorcycles originally sold, or ever registered, in Arizona, Arkansas, Delaware, District of Columbia, Illinois, Indiana, Kansas, Kentucky, Maryland, Missouri, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Virginia, and West Virginia, or "Zone B."

Additionally, if not included in Zone A or Zone B above, Honda is recalling certain 2006-2008 Honda GL1800 (Goldwing) motorcycles originally sold, or ever registered, in the states of Alaska, Colorado, Connecticut, Idaho, Iowa, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, New York, North Dakota, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington, Wisconsin, and Wyoming.

These vehicles are equipped with airbag inflators assembled as part of the air bag modules used as original equipment or replacement equipment. In the event of a crash necessitating deployment of the front airbags, these inflators may rupture due to propellant degradation occurring after long-term exposure to absolute humidity and temperature cycling.

An inflator rupture may result in metal fragments striking the operator resulting in serious injury or death.

What to do

Honda will notify owners, and dealers will replace the air bag module, free of charge. The recall is expected to begin January 24, 2017.

Owners may contact Honda Motorcycle Customer Support at 1-866-784-1870. Honda's number for this recall is KE5.

Right now, the biggest controversy in the healthcare field is the price of prescription medications. Politicians from Elizabeth Warren to Donald Trump have blasted them as being too high.

What often escapes notice is the cost of seeing an out-of-network specialist, but researchers at Johns Hopkins, writing in JAMA, say privately-insured consumers are often blindsided with huge bills from these providers.

When you choose a provider, you likely do a little research, especially making sure the provider accepts your health insurance. When you see internists, family doctors, or psychiatrists, you have some choice in the matter and have a way to control costs.

But the Hopkins medical and business school researchers, who looked at cases where patients were treated by out-of-network providers, found a huge difference in costs.

Emergency situations

In many cases, patients have no choice in the matter because the situation is an emergency. They don't have time to find an in-network provider.

In those cases, the researchers found the average anesthesiologist charged six times what Medicare pays. An emergency room doctor charged four times more.

As the study points out, these charges don't just affect the uninsured, but also the well-covered when they see physicians out of their insurer’s network. Yes, you probably expect to pay more if you have to go out-of-network, but the researchers say patients are often shocked at how much more it costs.

“The doctors with the highest markups are often the ones that patients don’t actually choose,” said Gerard F. Anderson, PhD, a professor in the Department of Health Policy and Management at the Bloomberg School and the study's lead author.

Bill shock

What happens, he says, is two months later the patient gets a bill from a doctor he or she never really met. In nearly every case, he says, the price is outrageous.

While the numbers are based on a national average, the researchers note that distinct geographic variations exist. For example, doctors in Wisconsin have almost twice the markup of doctors in neighboring Michigan. The largest mark-ups were for anesthesiologists.

What's especially infuriating, the researchers say, is when patients deliberately select a hospital and physician that are in their insurance network, only to learn after-the-fact that one or more of the doctors was out-of-network and outrageously expensive.

What's the remedy? The researchers say Congress should require physicians to disclose their network status to each patient before delivering the service. It would also improve transparency, they say, if doctors were required to post out-of-network prices.

Hypertension, or high blood pressure, is called "the silent killer." Elevated blood pressure can eventually lead to heart attack and stroke, and millions of people with hypertension don't know it.

There is very effective medication to control blood pressure -- and a healthy lifestyle also helps -- but first you have to know that your blood pressure is too high.

As we first reported back in early December, doctors have begun to worry about what they call "masked hypertension." A patient goes to the doctor and his blood pressure reading is a perfectly acceptable 129/82.

But then he goes about his daily life -- going to work, picking up the kids, cleaning out the garage, and while he's doing all that his blood pressure might be an unhealthy 147/96. He doesn't know, of course, because he doesn't have a blood pressure cuff at home to measure it.

Numbers are alarming

Researchers at Stony Brook and Columbia universities have studied this phenomenon by attaching 24-hour ambulatory blood pressure monitors to subjects in their study. They now say that not only is the condition real, the numbers associated with it are alarming.

They found 12.3% of people display a normal blood pressure reading in the clinic, are not taking blood pressure lowering medicines, have never had a heart attack or stroke, but have high blood pressure during their daily activities. This amounts to about one in eight adults over age 21 -- approximately 17.1 million people in the U.S.

Lead investigator Joseph Schwartz of Stony Brook says the study is breaking new ground in estimating the size of the problem. He says it could lead to new guidelines to help identify patients with high blood pressure and improve hypertension preventive methods.

What to do

Until then, it is helpful to know the hypertension risk factors. People over age 50 are at risk of developing hypertension. So are those who are overweight or obese, or have a sedentary lifestyle with little physical exercise.

Diet can also be a big risk factor. Eating unhealthy foods, especially those high in sodium, can increase the risk for hypertension. African-Americans are at a higher risk than other races.

If you think you might fall into one of those risk categories, consider investing in a home blood pressure monitoring cuff and learn how to properly use it.

Measuring your blood pressure two or three times a week, at different times of the day, might let you know if you are suffering from "masked hypertension," even though your readings at the doctor's office look just fine.

Maintaining a healthy heart is vital to having good overall health, but there are many issues that can get in the way. Being obese or smoking, for example, can stress the heart and lead to cardiovascular problems, but a new study shows that there is another condition that can be just as harmful.

Researchers from Helmholtz Zentrum München, along with colleagues from the Technical University of Munich and the German Center for Cardiovascular Disease, have found that depression poses just as great a risk to heart health. Further, they believe that finding how it interacts with other risk factors is of paramount importance.

“There is little doubt that depression is a risk factor for cardiovascular diseases,” said group leader Karl-Heinz Ladwig. “The question now is: What is the relationship between depression and other risk factors like tobacco smoke, high cholesterol levels, obesity or hypertension – how big a role does each factor play?”

Comparable risk factor

For the purposes of the study, Ladwig and his colleagues analyzed data from nearly 3,500 male patients between the ages of 45 and 74 for a total of 10 years. During that time, they tracked how depression impacted four other major risk factors for cardiovascular health.

The results indicated that depression led to the development of a fatal cardiovascular disease just as often as elevated cholesterol levels or obesity. The only risk factors that had a greater association were high blood pressure and smoking. Across the entire sample, the researchers say 15% of cardiovascular deaths could be attributed to depression.

“That is comparable to the other risk factors, such as hypercholesterolemia, obesity and smoking,” said Ladwig, pointing out that other risk factors caused between 8.4% and 21.4% of cardiovascular deaths.

The researchers believe that their work may have large implications on how the medical community evaluates depression as a condition. They point out that the findings indicate that the disorder has a “medium effect size within the range of major, non-congenital risk for factors for cardiovascular diseases.”

Ladwig says diagnostic investigation of co-morbid depression should become an industry standard, especially for high-risk patients.

The full study has been published in Atherosclerosis.