Podcasts about American Heart Association

In this episode, Aleah Johnson, Senior Program Lead, American Heart Association, and Jilyana Miklos, Community Health Director, YMCA Buffalo Niagara, discuss how the YMCA is supporting hypertension awareness through blood pressure kiosks, self-monitoring programs, education and community partnerships. They also explore how community-based organizations can help connect patients with clinical care and promote heart health.This episode is sponsored by American Heart Association

What if one of the most powerful tools for improving your cardiovascular resilience was already built into your body—and completely free? In this science-forward solo episode, Darin dives into the fascinating physiology of breath holding and the mammalian dive response, an ancient survival mechanism humans share with seals, whales, and dolphins. Simply holding your breath triggers an extraordinary cascade inside the body: your heart rate slows, blood vessels constrict to preserve oxygen for vital organs, and your spleen contracts to release oxygen-rich red blood cells into circulation. Darin explores research on elite freedivers, Southeast Asian sea nomads, cardiac hypoxic resistance, and the remarkable ways the human body can adapt to repeated breath-hold training. But he also separates the evidence from the hype, explaining why breath holding alone isn't a miracle intervention and why some of the most promising benefits appear when hypoxic stress is combined with movement and resistance exercise. This episode is a reminder that some of the most extraordinary tools for improving human performance aren't expensive supplements or complicated technologies—they're capacities your body has possessed all along. What You'll Learn What happens inside your body the moment you hold your breath How the mammalian dive response slows your heart rate and redirects blood flow Why your spleen acts like a biological reservoir for oxygen-rich red blood cells How humans share this ancient survival mechanism with marine mammals Why Southeast Asian sea nomads developed remarkable adaptations for freediving How breath-hold training can amplify the body's natural dive response What researchers discovered when elite divers reached extraordinarily low blood oxygen levels How repeated training may create greater hypoxic resilience in the heart Why the long-term benefits of breath-hold training in everyday people are still being studied Why combining hypoxic stress with movement may be more powerful than breath holding alone Chapters 00:00:03 – Welcome to SuperLife 00:00:34 – Sponsor: Alkemis 00:03:26 – The incredible thing happening when you hold your breath 00:03:57 – The ancient survival program you share with dolphins and whales 00:04:31 – The hidden cardiovascular tool almost nobody trains 00:05:03 – A free physiological capacity already built into your body 00:05:38 – What the science actually says about breath-hold training 00:06:09 – Understanding the mammalian dive response 00:06:37 – Your heart, blood vessels, and spleen react within seconds 00:07:11 – Your spleen is a biological oxygen reservoir 00:08:05 – Sponsor: Manna Vitality 00:09:59 – Why cold water amplifies the dive response 00:10:07 – The extraordinary physiology of Southeast Asian sea nomads 00:10:39 – Humans performing underwater like marine mammals 00:11:14 – The mammalian dive response is trainable 00:11:54 – What happened when elite divers reached extremely low blood oxygen 00:12:30 – How the heart adapts during extreme breath holds 00:13:08 – Cardiac hypoxic resistance and a stronger trained heart 00:13:55 – The important limitations of the current research 00:14:41 – Why breath holding alone isn't a miracle 00:15:09 – Combining hypoxic stress with resistance exercise 00:15:42 – Breath holding as a multiplier, not a replacement 00:16:33 – Practical takeaways for training the dive response 00:17:48 – Final thoughts and closing Thank You to Our Sponsors Alkemis: Go to https://alkemispaint.com/ and use code DARIN10 for 10% off your order. Manna Vitality: Go to mannavitality.com/ and use code DARIN12 for 12% off your order. Join the SuperLife Patreon: This is where Darin now shares the deeper work: - weekly voice notes - ingredient trackers - wellness challenges - extended conversations - community accountability - sovereignty practices Join now for only $7.49/month at https://patreon.com/darinolien Find More from Darin Olien: Website: darinolien.com Instagram: @darinolien Book: Fatal Conveniences Platform & Products: superlife.com New Show: Roadmap to Happiness Key Takeaway "You already have an ancient cardiovascular survival mechanism built into your body. Breath holding can trigger measurable changes in heart rate, blood flow, oxygen availability, and the body's response to hypoxic stress—and with training, that response appears capable of adapting. The goal isn't to treat breath holding like a miracle hack. It's to recognize it as another powerful physiological tool that may become even more effective when intelligently combined with movement and training. Bibliography/Sources Hypoxic Training & Cardiovascular Adaptation Bosco, G., et al. (2021). Effect of apnea-induced hypoxia on cardiovascular adaptation and circulating biomarkers of oxidative stress in elite breath-hold divers. Frontiers in Physiology . https://pmc.ncbi.nlm.nih.gov/articles/PMC8458773/ Combined training in hypoxic environments improves cardiometabolic health in older adults: A systematic review and meta-analysis of randomized controlled trials. (2025). Frontiers in Medicine . https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1728637/full Costalat, G., et al. (2021). Physiology, pathophysiology and (mal)adaptations to chronic apnoeic training: A state-of-the-art review. European Journal of Applied Physiology, 121, 2669–2685 . https://link.springer.com/article/10.1007/s00421-021-04664-x Palada, I., Bakovic, D., Valic, Z., et al. (2007). Cardiovascular regulation during apnea in elite divers. Hypertension, 50(2) . https://www.ahajournals.org/doi/10.1161/hypertensionaha.108.127530 Patrizio, I., et al. (2021). Cardiac hypoxic resistance and decreasing lactate during maximum apnea in elite breath-hold divers. Scientific Reports, 11, 3676 . https://www.nature.com/articles/s41598-021-81797-1 The Mammalian Dive Reflex & Genetic Adaptations Ilardo, M. A., Moltke, I., Korneliussen, T. S., et al. (2018). Physiological and genetic adaptations to diving in sea nomads. Cell, 173(3), 569–580 . https://news.berkeley.edu/2018/04/19/enlarged-spleen-key-to-diving-endurance-of-sea-nomads/ Schagatay, E. (2000). Studies on trained apnea divers' amplification of the diving response. Mid Sweden University . https://freedivecafe.com/2019/06/04/42-transcript-erika-schagatay-the-science-of-freediving/ Speck, D. F., & Bruce, D. S. (1978). Effects of varying thermal and apneic conditions on the human diving reflex. Undersea Biomedical Research . https://www.scientificamerican.com/article/breath-holding-dive-reflex-extends/ Inspiratory Muscle Strength Training (IMST) Craighead, D. H., Heinbockel, T. C., Freeberg, K. A., et al. (2021). Time-efficient inspiratory muscle strength training lowers blood pressure and improves endothelial function, NO bioavailability, and oxidative stress in midlife/older adults with above-normal blood pressure. Journal of the American Heart Association, 10(13) . https://www.ahajournals.org/doi/10.1161/JAHA.121.022203

Our hearts are restless, says Saint Augustine, until they find their rest in God. The biological science and the spiritual metaphor are in agreement here. Over the course of billions of beats, our hearts never stop to rest.  Your magnificent heart exchanges or pumps your entire blood volume, just over a gallon, every single minute. (Athlete hearts can pump up to 10 gallons per minute!) In this episode, Mark Labberton discusses matters of the heart with his close friend Dr. David Anderson, a cardiologist of four decades who trained at Johns Hopkins and helped launch one of the first interventional cardiology programs in San Francisco. Anderson reflects on the medical science of cardiology, the profound life-saving medical advances over the past forty years, heart disease versus coronary artery disease, how the brain and the heart communicate, and what happens during a heart attack. In the second half of their conversation, they move from physiology to spirituality of the heart: Pharaoh's hardened heart, "out of the heart the mouth speaks," and the human need to find somewhere to locate the self. Anderson closes with what a cardiologist would tell anyone worried about their own heart, and with a case for medicine as a noble profession. Episode Highlights "When I first began in cardiology, if your heart was damaged, imagining that the heart could actually improve its function was like imagining someone could grow back a new arm." "One of the distinctive things about the heart is unlike other muscles, it doesn't have a time to rest. When it gets insufficient blood supply, it can't just say, 'Whoa, I'm gonna stop here.' It asks you to slow down because it starts hurting." "I think that's part of the intrigue of the heart, that it is inside us … but in some ways it's apart from us. It's responding to environmental things that we're not really even aware of. … I think it's this sense of detachment of the heart from us—but yet its centrality—that has led people to posit the soul or the will or the passions or almost anything that you would think was the real you. "Atherosclerosis … I would describe as it's like having a pimple inside your artery." "First of all, know yourself. That is, it's not a time to be fatalistic because your father had a heart attack in his fifties or your brother just had a heart attack. It's a time to be proactive." About David Anderson David Anderson is a cardiologist who practiced for more than four decades before retiring. He studied at Stanford as an undergraduate and earned his medical degree at Johns Hopkins University School of Medicine. He stayed at Hopkins for residency, then trained in San Francisco at the dawn of interventional cardiology, helping to build an angioplasty program in the early 1980s. Helpful Links and Resources Alta Bates Summit Medical Center, Sutter Health, the Oakland hospital Anderson thanks by name: https://www.sutterhealth.org/about-us/our-hospitals/alta-bates-summit-medical-center DeWood et al., "Prevalence of Total Coronary Occlusion during the Early Hours of Transmural Myocardial Infarction," the 1980 study that identified clot as the cause of heart attack: https://www.nejm.org/doi/full/10.1056/NEJM198010163031601 Waagstein et al., "Effect of chronic beta-adrenergic receptor blockade in congestive cardiomyopathy," the Swedish beta-blocker work behind the recovery he describes: https://pubmed.ncbi.nlm.nih.gov/1191416/ What Is Atherosclerosis, National Heart, Lung, and Blood Institute: https://www.nhlbi.nih.gov/health/atherosclerosis Warning Signs of a Heart Attack, American Heart Association: https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack Angina (Chest Pain), American Heart Association, on the exertional pain he describes at the close: https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain Show Notes The impact of family gene pool, lifelong heart awareness How David Anderson got into medicine, and cardiology in particular A Hopkins autopsy elective, a teenager dead in a parking lot, a mentor who followed From internists interested in the heart to interventionists inside it Catheters, pressures, and the arrival of echocardiography Seeing a beating heart inside a living body for the first time, as a senior resident A colleague's heart attack in 1979 The 1980 angiography study that identified clot as the trigger Spring 1983: an artery occludes, the cath lab opens it, pain gone in fifteen minutes Bypass surgery before that: elective, scheduled, never mid-attack Prevention running under the technology: blood pressure, smoking, the lipid theory Fixing one artery and never having to fix another Coronary artery disease versus disease of the muscle itself Plasticity, not regeneration Adrenaline as an emergency system built for days, not decades Moving from technological advances to molecular-based understanding of heart problems Understanding of the pathophysiology of atherosclerosis and its prevention Beta blockers, ejection fraction, and hearts that came back The heart as a muscle with no rest The heart's own electrical center, and the backup pacemakers below it Your heart doesn't rely on you or your consciousness to beat Why the ancients may have located the self in the heart organ Jeremiah's pounding heart, Pharaoh's hardened one Pascal, the soul, and needing somewhere to put "the real you" Maintaining an appropriate degree of separation from the patient and their family in order to care properly and effectively The difficulty of delivering bad news to patients and their familes Digging for a shared history to call on in a crisis "Medicine is a noble profession." Heart care advice from a cardiologist: First, know yourself. Heart health checklist: cholesterol, blood pressure, weight, knowing your own history The pain that warrants a phone call #Conversing #MarkLabberton #Cardiology #Heart #MedicalScience #HeartHealth #Biology #ChristianHumanism Production Credits Conversing is produced and distributed in partnership with Comment magazine and Fuller Seminary.

Dr. Hoffman continues his conversation with cardiologist and electrophysiologist Dr. Gregory Marcus, chair of the American Heart Association scientific statement writing group.

Cardiologist and electrophysiologist Dr. Gregory Marcus, chair of the American Heart Association scientific statement writing group, reveals evidence on coffee/caffeine and cardiovascular health. He discusses how earlier assumptions that caffeine triggers arrhythmias are complicated by genetics, individual risk factors, and mostly observational research. Marcus reviews randomized and observational findings: the CRAVE trial showed no increase in premature atrial contractions but more premature ventricular contractions on coffee days; a trial in post-cardioversion patients found less atrial fibrillation with daily coffee. Observational data suggest lower risks of type 2 diabetes, heart attack, stroke, and AFib among coffee drinkers, while heart failure risk may be lower at low intake but higher around 4–5 drinks/day. He cautions against extrapolating benefits to energy drinks, discusses additives like sugar, touches on alcohol, cannabis, Mediterranean/DASH diets, pollution, and evolving AFib treatments, wearables, and pacing/ablation technologies.

Biscuit welcomes in Jacob Dockery to talk about his work with the American Heart Association and upcoming charity events. They also talk about the upcoming football season.See omnystudio.com/listener for privacy information.

CardioNerds (Dr. Apoorva Gangavelli, Dr. Cory Sejo, and Dr. Joseph Kassab), discuss tricuspid regurgitation evaluation and management with Dr. Sunil Mankad. This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. This discussion was planned in collaboration with the Mayo Clinic Cardiovascular Board Review Course.  Audio editing by CardioNerds intern Emma Winakur. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Key Points: Tricuspid regurgitation is common and associated with increased mortality at every stage, regardless of etiology. Outcomes are worse with worsening severity, so accurate grading is critical. Etiology is critical to guide treatment decisions. Etiology includes primary vs secondary (atrial or ventricular) vs CIED-related TR. 3D echocardiography can be very helpful in determining TR etiology, especially in CIED-related TR. Diuresis with the goal of euvolemia is step one. Additionally, underlying contributory conditions (eg. pulmonary HTN, HFrEF, atrial fibrillation) should be addressed, if appropriate, and then TR severity reassessed. The choice between T-TEER and TTVR hinges on anatomy, RV function, pulmonary hypertension, and the ability to tolerate anticoagulation. T-TEER is generally first line in atrial functional TR with appropriate anatomy, in patients with poor RV function who cannot tolerate a sudden increase in RV afterload, or in patients who cannot tolerate the necessary anticoagulation with TTVR. TTVR is preferred with wide coaptation gaps and CIED-related TR. This is a team sport. Multidisciplinary discussions utilizing imaging (TTE/TEE, CT), risk scores (TRI-SCORE or TRIO), patient preference, and prior institutional experience are essential for the effective treatment of severe TR. Notes: What is the clinical importance of tricuspid regurgitation? TR is very common with approximately 4% of people over 75 having moderate or greater severity. TR (even mild) is associated with increased mortality. Those outcomes worsen as the TR severity worsens, and this phenomenon is independent of the mechanism of regurgitation. What is unique about the tricuspid valve compared to the other cardiac valves? It is at an anterior location which allows it to be imaged well with transthoracic echocardiography It is the largest valve and composed generally of 3 leaflets (but very often can have 4+ leaflets). Importantly, the RV is compliant and changes size and shape readily based on loading conditions. The TV annulus similarly changes size and shape based on hemodynamic conditions such as preload. What is a good framework for approaching the causes of tricuspid regurgitation? Determine the presence and define the severity of TR. Using TTE, we want to measure the right atrial size, the RV size, and any other concomitant valvular lesions.  Use TTE (2D and 3D) to characterize leaflet anatomy and characteristics. Subtypes of TR mechanisms (many times etiology is mixed). Primary: primary leaflet abnormality, occurs in ~10% of cases. Look for prolapse, flail, endocarditis, etc. Secondary/functional: leaflets normal but surrounding structures are abnormal. Atrial: RA and tricuspid annular dilation but normal RV size/shape, and can be related to arrhythmias like atrial fibrillation. Ventricular: RV dilated and/or dysfunctional with leaflet tethering. Can be related to pulmonary hypertension or primary RV disease. Cardiac implantable electronic device (CIED): Related to device (usually pacemakers or ICD) interaction with TV leaflets. Includes perforation, entanglement in subvalvular apparatus, impingement, etc. 3D TTE particularly helpful to evaluate How do we grade TR severity? It is very important to grade the severity of TR, and this is generally done with echocardiography. There are both quantitative and qualitative methods which use Doppler and various equations to estimate TR severity. Current recommendations have expanded TR severity beyond mild/moderate/severe to include “massive” and “torrential” categories. The most important parameters measured/calculated are vena contracta width, regurgitant volume, regurgitant fraction, and effective regurgitant orifice area. Helpful qualitative metrics include hepatic venous flow reversal. When should additional studies beyond transthoracic echocardiography, such as transesophageal echocardiography (TEE), cardiac computed tomography (CT), and cardiac magnetic resonance imaging (MRI) be pursued? TEE is particularly helpful if TTE views are poor. Since TEE is used during transcatheter intervention, a pre-procedure TEE to define anatomy, determine procedure candidacy, and plan for the procedure is critical.  CT is also helpful for procedure planning and has particular strengths in defining annulus size and geometry. A CT is required prior to transcatheter tricuspid valve replacement (TTVR). MRI is helpful for measuring RV volumes and function, but is not generally used to assess TR severity.  What is the approach to the treatment for severe tricuspid regurgitation? The first step is to try to determine the etiology. For secondary TR, treating the underlying condition is indicated. For example, pulmonary vasodilators for pulmonary HTN or guideline therapy for heart failure with reduced ejection fraction. Diuretics are the mainstay for treatment, with the goal to obtain euvolemia. This may require inpatient admission to optimize volume status and medication regimen. Once reversible etiologies are addressed, if the patient is still symptomatic from TR, additional therapies can be considered. What is the role of right heart catheterizations (RHC) in patients with severe TR? RHC is very helpful for many reasons. We use it in TR to help determine volume status, cardiac output, and RV function. Additionally, identifying and characterizing pulmonary hypertension (with pulmonary artery pressures and calculating pulmonary vascular resistance) is an important factor when choosing future therapies.  With severe tricuspid regurgitation, when should we refer for intervention (either with surgery or transcatheter repair or replacement)? Once reversible etiologies are addressed and euvolemia has been achieved, if the patient is still symptomatic from TR despite aggressive medical optimization, additional therapies can be considered. Once euvolemic, a repeat TTE should be ordered to reassess the severity of the TR. Use calculators (for example, either the TRI-SCORE or TRIO score) to predict operative mortality for isolated TR surgery. What are our transcatheter treatment options in severe tricuspid regurgitation, and how do we choose between them? The primary approved transcatheter treatment options for severe TR include transcatheter tricuspid edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR), of which the Edwards EVOQUE valve is the only one currently approved by the FDA. There are other TTVR device under investigation. These decisions should be made with a multi-disciplinary team including representation from cardiac imaging, interventional cardiology, and cardiothoracic surgery. Factors that go into the decision between T-TEER and TTVR include anatomy (annulus width, coaptation gap, leaflet length), RV reserve, pulmonary hypertension presence, ability to tolerate anticoagulation, patient preference, and institutional experience.  T-TEER is generally the first line with atrial functional and suitable anatomy. It is successful at reducing TR but does not generally eliminate it.  TTVR with EVOQUE is preferred in certain anatomic considerations like a large coaptation gap or when there is CIED-related TR (as this was excluded in T-TEER trials). Patients must be suitable for anticoagulation to receive TTVR as there is risk of leaflet thrombosis without it. If moderate/severe pulmonary hypertension is present, or there is poor RV function, TTVR may be avoided as the sudden elimination of TR causes a sudden increase in RV afterload which may not be tolerated. What is the role in advanced metrics for evaluating RV function? Advanced metrics like RV/PA coupling are under investigation but have not made it into the guidelines. The clinical utility is not yet known.  Assessing the RV function is important as stated above. Dr. Mankad prefers using 3D TTE to calculate an RVEF, or tracking RV longitudinal free wall strain. If you do encounter CIED-related TR, how do you treat it? Evaluate with TTE or TEE. 3D is very helpful to identify relative anatomy and leaflet-device interactions. There is no clear consensus about treatment if CIED-related TR is the primary mechanism of severe TR. If recently implanted, repositioning may be a valid option, but requires discussions with multiple teams including electrophysiology, advanced cardiac imaging, CT surgery, and interventional cardiology. References O’Gara PT, Lindenfeld J, Hahn RT, et al. 10 Issues for the Clinician in Tricuspid Regurgitation Evaluation and Management: 2025 ACC Expert Consensus Decision Pathway. J Am Coll Cardiol. 2025;S0735-1097(25)07047-0. O’Gara PT, Little SH, Badhwar V, et al. Operator and Institutional Recommendations and Requirements for Tricuspid Interventions: 2026 ACC/AHA/ASE/HRS/STS Expert Consensus Systems of Care Document. J Am Coll Cardiol. 2026;S0735-1097(26)05481-1. Hahn RT. Tricuspid Regurgitation. N Engl J Med. 2023;388(20):1876-1891. Davidson LJ, Tang GHL, Ho EC, et al. The Tricuspid Valve: A Review of Pathology, Imaging, and Current Treatment Options: A Scientific Statement From the American Heart Association. Circulation. 2024;149(22):e1223-e1238.

In this segment, we discussed the recent American Heart Association guidance on LDL cholesterol and the sobering estimate that only about one in three adults has their cholesterol adequately managed. For patients with risk factors for cardiovascular disease, the LDL target is now 55 mg/dL or lower — a number that is all too often overlooked when lab results are reviewed. The result is that many people are walking around with elevated LDL cholesterol, unaware that they are at meaningful risk for serious cardiovascular events including heart attack, stroke, and heart failure.The call to action for listeners is straightforward: log into your hospital or clinic patient portal, pull up your most recent lipid panel, and confirm that your LDL cholesterol is in range. Diet and exercise absolutely play a role in improving LDL, but lifestyle change alone is frequently not enough — particularly for patients with diabetes, hypertension, obesity, or fatty liver disease. In these cases, statin therapy is often the necessary next step, and it should not be viewed as a failure of lifestyle effort but as appropriate risk reduction.We also covered two additional recommendations. First, the AHA now advises a one-time measurement of lipoprotein(a). An elevated Lp(a) signals a substantially higher cardiovascular risk, and because the level is genetically determined, it typically will not improve with diet or exercise — making it essential information for guiding how aggressively other risk factors are treated. Second, a coronary calcium scan can bring your individual risk into sharp focus. A positive calcium score is a clear indication that aggressive intervention is warranted. Taken together, these three steps — knowing your LDL, checking your Lp(a) once, and considering a calcium score — give you and your clinician a far more complete picture of your true cardiovascular risk.How To Reach Dr. Joe Galati and his Team:For an on-line consultation or press inquiries, contact Teresa Reyes at 713-794-0700Dr. Galati's Newsletter Sign-UpLiver Specialists of TexasGet a Copy of Dr. Galati's BookDr. Galati on FacebookMessage Dr. Galati and his team Hosted on Acast. See acast.com/privacy for more information.

OPENER: Stephen A Smith DESTROYS WNBA After HIDING BRITTNEY GRINER'S DIRTY SECRET! Defend Sophie Cunningham! - 5:11 Brandon Gill Gets Witness To Admit Who DEI Punishes - 5:13 “I went to court to argue what a woman is” — Sall Grover at ARC 2026 -1:00 Jason Arday Whistleblower: ‘People Knew The Truth And Covered It Up' - 4:00 Quick, easy, worthless: Students let AI do the thinking | Principia Scientific, Intl. - Text It's Time to Save America - 10:00   HEALTH NEWS Arginine Supplement May Strengthen Immune Response to Cancer and Viral Infections Yeast food supplement helps immune cells fight cancer more effectively Physical activity linked to lower stroke and death risk in adults with atrial fibrillation Phthalates may contribute to high blood pressure in pregnant women Daily Collagen Supplement Alters Bone-Related Blood Markers in Female Runners, Study Says Arginine Supplement May Strengthen Immune Response to Cancer and Viral Infections Rockefeller University, August 10, 2026 (Natural News) A study published in the journal Cell reports that arginine, an amino acid found in protein-rich foods and produced by the body, may help the immune system recognize and respond to cancer and viral infections. The research found that low arginine levels were linked to reduced production of MHC-1, a protein that displays abnormal cellular signals to T cells, according to the report. In mouse models, arginine-rich diets were associated with fewer colon tumors and milder influenza and SARS-CoV-2 infections, the researchers reported. The findings add to prior work linking declining immune function to cancer progression. When arginine is scarce, cells struggle to produce MHC-1 proteins, which appear on the surfaces of cells throughout the body and display foreign or abnormal proteins to T cells. Researchers repeated the dietary studies using mouse models of influenza and SARS-CoV-2, conditions previously associated with unusual levels of different amino acids. One of the most dramatic patterns to emerge was that arginine was the most depleted amino acid in all of these diseases. Not only did mice with an arginine-rich diet have milder symptoms from viral infections, giving the mice arginine after influenza infection improved their outcomes too. Yeast food supplement helps immune cells fight cancer more effectively Trinity College Dublin & University College Dublin, July 9 2026 Researchers from Trinity College Dublin (TCD) and University College Dublin (UCD) have shown for the first time that a food supplement made from yeast helps the body to make stronger immune cells that can fight cancer. The research teams found that adding a yeast-based supplement to the food of obese laboratory mice changes how their immune cells grow and help to make better cancer‑fighting cells. Mice were fed a standard or high fat diet supplemented with yeast beta-glucan for 4-12 weeks and then their immune system was challenged by different types of cancer cells (colorectal, skin and breast cancer). The study also tested whether yeast supplementation could overcome immune dysfunction caused by obesity and whether protective effects persist after weight loss. Crucially, this dietary intervention restores anti-tumor innate immunity in obese mice and reverses long-term immune memory defects that persist even after weight loss, a major unmet clinical challenge. Physical activity linked to lower stroke and death risk in adults with atrial fibrillation Arctic University of Norway, August 5 2026 (News-Medical) Being physically active was linked to a lower risk of stroke and death for adults with atrial fibrillation, or AFib, according to new, independent research published in the Journal of the American Heart Association. AFib is a quivering or irregular heartbeat that occurs in the heart's upper chamber known as the atria. According to the American Heart Association, it can lead to blood clots, stroke and other heart-related conditions. The prevalence of AFib in the U.S. was estimated at 4.48% of the adult U.S. population. The study tracked more than 87,000 adults in Norway for about 15 years, capturing information about AFib, stroke and death from national health registries. What did the analysis find? Compared to adults who were inactive, adults with a low, moderate or high level of physical activity had a 9%, 19% and 18% lower risk of stroke, respectively. Having a low, moderate or high level of physical activity was associated with an 11%, 18% and 22% lower risk of death from any cause, respectively. For people with AFib, staying active was tied to living an average of 0.5 to 1.2 years longer compared to those who were inactive Phthalates may contribute to high blood pressure in pregnant women Harvard School of Public Health, August 10 2026 (News-Medical) Phthalates, which are chemicals found in plastics, personal care products and hundreds of other consumer goods, may contribute to high blood pressure in pregnant women, according to a study published in the Journal of the Endocrine Society. The researchers measured phthalate exposure and blood pressure in 338 pregnant women at three points during pregnancy. They analyzed whether higher levels of these chemicals-individually and in combination-were linked to higher blood pressure or an increased risk of pregnancy-related high blood pressure disorders. The authors found that pregnant women with higher urine concentrations of fragrance-associated phthalates and those in personal care products had higher systolic and diastolic blood pressure markers of an increased risk of hypertensive disorders of pregnancy. About 13% of participants in the study developed a pregnancy-related high blood pressure disorder. Women with higher levels of certain phthalates, especially those found in personal care products, tended to have higher blood pressure later in pregnancy. Daily Collagen Supplement Alters Bone-Related Blood Markers in Female Runners, Study Says Fitchburg State University, University of Connecticut & Mayo Clinic, August 4 2026 (Natural News) A four-week randomized, double-blind, placebo-controlled trial found that female distance runners who took 20 grams of collagen peptides per day showed an approximately 5.1 percent rise in P1NP over four weeks, a blood marker of bone formation, while the placebo group showed no such change, according to a study published in Frontiers in Nutrition. The collagen group also showed a drop in IL-6, an inflammatory protein linked to bone breakdown, while placebo levels held steady or rose, the study reported. The trial included 22 female runners ages 18 to 35 who ran at least 35 miles per week, and no adverse effects were reported. Collagen is the most common and abundant protein in the body, accounting for about 30 percent of total protein content and providing structural support to bones, tendons, ligaments, and other connective tissues, according to published research.       Discussion about this episode

Cette semaine : MINI-SÉRIE épisode 2, je décortique l'activité physique, le deuxième des huit facteurs identifiés par l'American Heart Association pour prévenir les maladies cardiovasculaires. Je vous explique pourquoi connaître les recommandations ne suffit pas, ce que l'autonomie, la compétence et l'affiliation viennent y jouer, et quoi faire concrètement pour les appliquer jour après jour.Formation gratuite : https://www.skool.com/labdelaconstance/aboutEn savoir plus sur notre offre :https://equipeevo.com/evo360Références : Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. The American psychologist, 55(1), 68–78. https://doi.org/10.1037//0003-066x.55.1.68Ryan, R. M., & Deci, E. L. (2017). Self-determination theory: Basic psychological needs in motivation, development, and wellness. The Guilford Press. https://doi.org/10.1521/978.14625/28806Status of Cardiovascular Health in US Adults and Children Using the American Heart Association's New “Life's Essential 8” Metrics: Prevalence Estimates From the National Health and Nutrition Examination Survey (NHANES), 2013 Through 2018https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8

CardioNerds (Dr. Apoorva Gangavelli, Dr. Rebecca Garber, and Dr. Tina Reddy), discuss pre-pregnancy risk stratification and counseling with Dr. Katy Young across a range of risks.  This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. This discussion was planned in collaboration with the Mayo Clinic Cardiovascular Board Review Course. Audio editing by CardioNerds intern, Dr. Patrick Pekyi-Boateng. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Notes:  Why is pregnancy considered a “physiologic stress test,” and why does risk extend beyond delivery? Blood volume, heart rate, and cardiac output rise while systemic vascular resistance falls, peaking in the late second/early third trimester; underlying (even undiagnosed) heart disease can be unmasked or worsened. Postpartum (“fourth trimester”) is a high-risk period, not a safe zone – fluid shifts, rising SVR, and bleeding risk can precipitate decompensation in patients with heart failure, pulmonary hypertension, valvular disease, or aortopathy. Adverse pregnancy outcomes (hypertensive disorders, gestational diabetes, preterm birth, fetal growth restriction, peripartum cardiomyopathy) are markers of future cardiovascular risk and warrant long-term preventive follow-up. What is the practical framework for approaching pre-pregnancy cardiovascular risk? Four broad categories: (1) patients who may need cardiac screening before pregnancy, (2) patients needing risk-factor/medication optimization, (3) known cardiovascular disease where pregnancy is reasonable with structured risk stratification, and (4) high-risk disease where pregnancy may need to be delayed, modified by intervention, or discouraged. Testing should be targeted, not blanket – reserved for symptoms, abnormal exam, concerning family history, or reduced functional capacity. How is risk stratified in patients with known cardiovascular disease? Use a combination of tools per 2025 ESC guidelines: mWHO 2.0 (broad maternal risk category), CARPREG II (additional predictors of maternal cardiac events), and ZAHARA (useful in congenital heart disease). Key lesion-specific factors: aortic size/growth, valve severity, ventricular function, symptoms, blood pressure, and family history of dissection. Translate risk into practical terms for patients rather than leading with a numerical score. Which cardiovascular medications require review before conception? ACE inhibitors, ARBs, and ARNIs should be transitioned off before pregnancy; statins, MRAs, and SGLT2 inhibitors also need review. DOACs are contraindicated in pregnancy and lactation; mechanical valve anticoagulation requires individualized shared decision-making, as no strategy is risk-free for mother and fetus. Medication changes are best made proactively, before conception, rather than reactively. This is not an exhaustive list! The medication list needs to be reviewed carefully. Which conditions carry high or prohibitive risk in pregnancy? Pulmonary arterial hypertension, Eisenmenger syndrome, severe ventricular dysfunction, prior peripartum cardiomyopathy with residual LV dysfunction, severe left-sided obstructive valve disease (e.g., severe mitral stenosis), mechanical valves, significant aortopathy, cyanotic congenital heart disease, and Fontan physiology. Common theme: limited cardiovascular reserve and high risk of decompensation, thrombosis, arrhythmia, heart failure, aortic dissection, or death. These patients need expert multidisciplinary evaluation before pregnancy. Severe mitral stenosis is poorly tolerated because tachycardia shortens diastolic filling time and raises left atrial pressure, risking pulmonary edema and decompensation. When should genetic testing or counseling be offered? Consider when a diagnosis may be inherited or affect the patient, pregnancy, or family members: inherited cardiomyopathies, aortopathies, channelopathies, select congenital heart disease, and some pulmonary hypertension syndromes. Recurrence risk of congenital heart disease in offspring is roughly 6-10% when the mother has CHD; fetal echocardiography should be offered. How should contraception be approached in high-risk cardiac patients? Frame contraception as part of the cardiac care and reproductive safety plan to prevent unplanned high-risk pregnancy. Long-acting reversible contraception is often preferred; progestin-only methods are generally safer than estrogen-containing options with thrombosis risk, pulmonary hypertension, or mechanical valves. What are key delivery-planning considerations for cardiac patients? Vaginal delivery is preferred unless there is an obstetric indication for cesarean or a specific cardiac reason (e.g., unstable maternal status, therapeutic INR) to avoid labor. Planning should address delivery location, anesthesia involvement, telemetry needs, fluid management, and postpartum monitoring, clearly communicated across the multidisciplinary team in advance. How should clinicians counsel patients when pregnancy is discouraged but strongly desired? Acknowledge the patient’s goals and the emotional weight of the conversation; separate the goal (family building) from the timeline (safety now vs. after optimization). If pregnancy remains prohibitively risky, discuss alternatives for family building and ensure adequate patient support. What are the key gaps and future directions in cardio-obstetric risk stratification? Current risk tools (mWHO, CARPREG II, ZAHARA) provide common language but do not fully capture functional status, prior pregnancy history, or how risk evolves over time. Future direction: individualized, dynamic risk prediction incorporating imaging, biomarkers, exercise capacity, and social drivers of health, with better long-term links between pregnancy complications and cardiovascular prevention. References 1. European Society of Cardiology. 2025 ESC Guidelines for the management of cardiovascular disease and pregnancy. 2. Mehta LS, et al. Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association. Circulation. 2020;141:e884-e903. PMID: 32362133. doi:https://doi.org/10.1161/CIR.0000000000000772 3. ACOG Practice Bulletin No. 212. Pregnancy and Heart Disease. Obstet Gynecol. 2019;133(5):e320-e356. PMID: 31022123. doi:https://doi.org/10.1097/AOG.0000000000003243

This week, I reviewed the cyclosporiasis outbreak a little more; not much has changed. I’m waiting to hear a friend’s experience with treatment. Then, I got into how much caffeine is enough, or too much? According to the American Heart Association, 400 mg is fine for most people! It’s NOT fine for me. I’d be […]

In the fourth installment of our church security series, Lloyd discusses the importance of training and the different kinds of training your church security team should partake of and how to role-play emergency situations inside your church worship space. Support the Show  Armed Lutheran Radio is a listener-supported podcast. If you value the information and entertainment we provide, consider supporting the show by joining our membership site, The Reformation Gun Club! http://www.ReformationGunClub.com  Links of Interest American Red Cross - https://www.redcross.org/take-a-class/cpr/cpr-training American Heart Association- https://cpr.heart.org/ SABRE Personal Safety Training - https://www.sabrered.com/personal-safety-training AVADE Pepper Spray Training - https://avadetraining.com/product/avade-pepper-spray-defense-e-learning-course/ USCCA Free Guide - https://www.usconcealedcarry.com/uscca-info/guide/protecting-house-of-worship-guide/ Sheepdog Church Security - https://sheepdogchurchsecurity.net/ Gatekeepers - https://gatekeeperstx.com/ NOCSSM 2026 Conference - https://gatekeeperstx.com/nocssm-conference/ Buy Duty to Defend, Volume 2 on Amazon – https://amzn.to/3D3frE5 Prayer of the Week Grant, O Lord, we implore You, that the course of this world may be so peaceably ordered by Your governance, that Your Church may joyfully serve You in all godly quietness; through Jesus Christ, Your Son, our Lord. Amen. Get in Touch Visit our Feedback Page - https://armedlutheranradio.libsyn.com/contact Please tell your friends about us, leave an iTunes review, and like us on Facebook Join our Facebook group - https://www.facebook.com/groups/fansofarmedlutheranradio Subscribe to us and follow us on Youtube - https://www.youtube.com/armedlutheran Check Out More at our Website- http://www.armedlutheran.us Original Music by Reformer  https://www.youtube.com/ReformerBand   

Send us Fan Mail"It is probably nothing."The swelling is probably the third trimester. The breathlessness is probably the stairs. The ache in your calf is probably that run you should not have done. And most of the time, all of that is exactly right.Most of the time is doing a lot of work in that sentence.Dr. Rachel Rosovsky is a hematologist at Massachusetts General Hospital, where she has spent twenty years on blood clots, and she co-authored the first ever AHA/ACC guideline on acute pulmonary embolism. The American Heart Association reached out about this one, and I said yes immediately, because this is the conversation I do not think most of us have ever actually had.

Join Dr. Martin in today's episode of The Doctor Is In Podcast.  

Family, friends and world leaders gathered for ceremonies in the nation's capital to celebrate the life of late Sen. Lindsey Graham — the farewells continue in his home state of South Carolina. TODAY shines a light on new high blood pressure guidelines from the American Heart Association, including a cardiovascular disease risk calculator tool and easy lifestyle changes to improve health outcomes. Tom Holland confirms his marriage to Zendaya after getting grilled by elementary school students on “Celebrity Substitute.” Plus, Macaulay Culkin eyes a return to the holiday silver screen after pitching a “Home Alone” reboot to Disney. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

How many grams of protein do you need to be healthy? What about fiber? Supplements? It feels like we're changing our diets daily to adhere to constantly shifting recommendations and none of it is really working to optimize our health. Christopher Gardner, Professor of Medicine in Nutrition Science at Stanford University, and featured advisor on the Netflix show, “You Are What You Eat: A Twin Experiment”, joins us today to talk about how the industry is stacked against us and why the solution to our diet woes is as simple as beans, peas, and lentils. For more than 30 years Christopher Gardner, PhD, has studied what to consume and to avoid for optimal health, and how best to motivate individuals to achieve healthy dietary behaviors. He recently completed a two-year term serving on the US Dietary Guidelines Advisory Committee and is the past chair of the American Heart Association's Nutrition Committee. He has conducted and published dozens of human nutrition intervention trials, including trials of Mediterranean, Ketogenic, Vegan, Low-Fat and Low-Carb diets and their effects on cardiometabolic health. Some of his current interests include Stealth Nutrition, Unapologetic Deliciousness and Institutional Food Settings. He is currently working on personalized nutrition explorations with several colleagues, with particular focus on the gut microbiome.

Play 16:28 30:46 Mute Settings On this episode of The Community Cast, Carissa sits down with Ashley Deeb, Marketing Manager at Mainely Tubs, to discuss the growth of Maine's employee-owned hot tub, swim spa, and sauna company. Ashley shares how Mainely Tubs has expanded across New England, the benefits of employee ownership, and how her team helps customers create spaces for relaxation, wellness, and connection at home. Beyond her professional role, Ashley opens up about her personal journey as a heart disease survivor and how that experience inspired her commitment to community service through the American Heart Association and Make-A-Wish Maine. From leadership and volunteerism to resilience and purpose, this conversation highlights the power of giving back and the impact one person can have on the lives of others.

Investigators are trying to piece together what happened in a Michigan home that led to 47-year-old Kris Karolkiewicz shooting and killing his six children, his wife and then himself after setting the family home on fire. We know Kris recently lost his job as a Vice President with the American Heart Association, but it’s still unclear if that played a role in the unthinkable tragedy. Investigators say they found his licensed firearm near his body, and the rest of the family members shot to death in their bedrooms. While police confirmed he did not leave behind a note, investigators have seized what they call “a lot of documentation” from the home.See omnystudio.com/listener for privacy information.

Investigators are trying to piece together what happened in a Michigan home that led to 47-year-old Kris Karolkiewicz shooting and killing his six children, his wife and then himself after setting the family home on fire. We know Kris recently lost his job as a Vice President with the American Heart Association, but it’s still unclear if that played a role in the unthinkable tragedy. Investigators say they found his licensed firearm near his body, and the rest of the family members shot to death in their bedrooms. While police confirmed he did not leave behind a note, investigators have seized what they call “a lot of documentation” from the home.See omnystudio.com/listener for privacy information.

Investigators are trying to piece together what happened in a Michigan home that led to 47-year-old Kris Karolkiewicz shooting and killing his six children, his wife and then himself after setting the family home on fire. We know Kris recently lost his job as a Vice President with the American Heart Association, but it’s still unclear if that played a role in the unthinkable tragedy. Investigators say they found his licensed firearm near his body, and the rest of the family members shot to death in their bedrooms. While police confirmed he did not leave behind a note, investigators have seized what they call “a lot of documentation” from the home.See omnystudio.com/listener for privacy information.

Investigators are trying to piece together what happened in a Michigan home that led to 47-year-old Kris Karolkiewicz shooting and killing his six children, his wife and then himself after setting the family home on fire. We know Kris recently lost his job as a Vice President with the American Heart Association, but it’s still unclear if that played a role in the unthinkable tragedy. Investigators say they found his licensed firearm near his body, and the rest of the family members shot to death in their bedrooms. While police confirmed he did not leave behind a note, investigators have seized what they call “a lot of documentation” from the home.See omnystudio.com/listener for privacy information.

This week's supplement spotlight—spermidine; American Heart Association does a 180° on coffee; How accurate are health tracker wearables for sleep, blood pressure, heart rate? A skin disorder practically no one has heard of is often confused for skin cancer; Vitamin D—what forms and what dosages are optimal? Popular sugar substitutes may be worse for the brain than natural sugar.

In this episode of *Pediatric Critical Care Insights*, Dr. Monica Gray and Dr. Pradip Kamat chat about how capnography, specifically end-tidal CO2 monitoring, is used in the pediatric ICU. They walk through a real-life case of a 9-year-old with respiratory failure from influenza A, showing how ETCO2 monitoring helps confirm endotracheal tube placement, guides ventilation, spots cardiac arrest, and even helps assess the quality of CPR. Along the way, they break down how to interpret capnography waveforms, discuss different types of devices, and explain the key physiological concepts. The episode is packed with practical, bedside tips for intensivists caring for critically ill kids.Show Highlights:Importance of capnography (end-tidal CO2 monitoring) in the pediatric intensive care unit (PICU)Clinical case study of a 9-year-old boy with respiratory failure due to influenza AUse of capnography for confirming endotracheal tube placement and assessing ventilation statusDetection of cardiac arrest and guidance for CPR quality through ETCO2 monitoringOverview of capnography physics and physiology, including terminology distinctionsTypes of capnography: mainstream vs. sidestream, and their applications in pediatric patientsAssumptions for accurate ETCO2 approximation of arterial CO2 and conditions affecting this relationshipAnalysis of capnography waveform phases and their clinical significancePrognostic value of ETCO2 during cardiac arrest and its correlation with patient outcomesPractical applications of ETCO2 monitoring in critical care, focusing on airway, breathing, and circulation managementReferences:Noninvasive respiratory monitoring and assessment of gas exchange. David F. Butler; Kenneth A. Schenkman. Fuhrman and Zimmerman's Pediatric Critical Care, 43, 483-491.e3Humphreys S, Schibler A, von Ungern-Sternberg BS. Carbon dioxide monitoring in children—A narrative review of physiology, value, and pitfalls in clinical practice. Pediatr Anaesth. 2021;31:839–845. https://doi.org/10.1111/pan.14208Lasa JJ, Dhillon GS, Duff JP, et al. Part 8: Pediatric Advanced Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics. 2026;157(1):e2025074351O'Flaherty. Capnography: principles and practice. London: BMJ Publishing Group; 1994.Aminiahidashti H, Shafiee S, Zamani Kiasari A, Sazgar M. Applications of End-Tidal Carbon Dioxide (ETCO2) Monitoring in Emergency Department; a Narrative Review. Emerg (Tehran). 2018;6(1):e5. Epub 2018 Jan 15. PMID: 29503830; PMCID: PMC5827051.

Public Health is about more than hospitals and healthcare; it's also about the policies that help people live healthier lives every day.This week on the Conduit Street Podcast, Michael Sanderson and Karrington Anderson are joined by Laura Hale, State Government Relations Director for the American Heart Association, to discuss how counties can help improve community health through smart public policy.Laura shares practical examples of how counties are working with the AHA to make a difference, from expanding access to nutritious school meals and reducing youth exposure to tobacco to helping families make more informed dining choices through informed dining initiatives. She also explains how local governments can use partnerships, policy, and local authority to create healthier communities across Maryland. Plus, you'll hear one surprising statistic that may change the way you think about sugary drinks: the average child consumes the equivalent of a bathtub full each year.Tune in to hear this timely conversation on how thoughtful local policy can improve public health, one school meal, one community partnership, and one informed decision at a time.Follow us on Socials!MACo on TwitterMACo on FacebookLearn More: Why Give | American Heart Association

Ryan and Dana talk with Dr. Joe Galati, host of the Dr. Joe Galati Podcast on iHeartRadio, about new American Heart Association guidance suggesting that drinking up to five cups of coffee a day may be safe for many adults.

Ryan and Dana talk with Dr. Joe Galati, host of the Dr. Joe Galati Podcast on iHeartRadio, about new American Heart Association guidance suggesting that drinking up to five cups of coffee a day may be safe for many adults.See omnystudio.com/listener for privacy information.

In this episode, Scott Becker discusses new findings from the American Heart Association suggesting that drinking up to five cups of coffee a day may support heart health and reduce stroke risk.

CardioNerds (Drs. Apoorva Gangavelli, Jenna Skowronski, and Hannah Every) discuss the continuum of prevention and heart failure with Drs. Anu Lala and Martha Gulati. Grounded in a clinical case of a 55-year-old woman with uncontrolled hypertension, type 2 diabetes, and obesity who is on the trajectory toward heart failure, this episode unpacks a paradigm-shifting framework from a joint HFSA/ASPC Scientific Statement. The discussion explores how prevention should not be siloed from heart failure management but rather integrated across a patient’s lifespan—from primary prevention in at-risk individuals, to secondary prevention in those with established heart failure, to tertiary prevention in patients with advanced therapies such as LVADs and heart transplantation. The experts highlight the importance of aggressive risk factor management, biomarker-guided screening, the AHA’s Life’s Essential 8, and the need for multidisciplinary collaboration and systems-level change to shift heart failure care from reactive to proactive. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Systemic inflammatory diseases are associated with an elevated CVD risk that has significant implications for early detection, risk Heart failure prevention is a continuum, not a checkpoint. Prevention applies at every stage—from at-risk (Stage A) through advanced/post-transplant care—and every clinical encounter is an opportunity to intervene. The AHA’s Life’s Essential 8 (diet, physical activity, nicotine exposure, sleep, BMI, blood lipids, blood glucose, blood pressure) forms the foundation at every stage. Hypertension carries the highest population-attributable risk for heart failure of any modifiable risk factor. In the Framingham Heart Study, 91% of patients with newly diagnosed HF had pre-existing hypertension. The SPRINT trial demonstrated a 38% reduction in HF incidence with intensive blood pressure targets (30 ng/L or NT-proBNP >125 ng/L) identify individuals at heightened risk for progression to symptomatic HF. The ACC/AHA/HFSA guidelines give a Class IIa recommendation for natriuretic peptide screening in at-risk patients. Urine albumin-to-creatinine ratio (UACR) is an underutilized screening tool that provides additional insight into CKM risk. The heart failure label does not close the prevention window—it accentuates it. Secondary prevention through GDMT optimization (quadruple therapy in HFrEF) and continued risk factor management remains critical. Tertiary prevention extends to post-LVAD and post-transplant patients, where hypertension, diabetes, obesity, and CKD management remain essential to long-term outcomes. Show notes For a comprehensive review, please review the full HFSA/ASPC Joint Scientific Statement: Lala A, Beavers C, Blumer V, et al. The Continuum of Prevention and Heart Failure in Cardiovascular Medicine. J Card Fail. 2026;32:75-105. doi:10.1016/j.cardfail.2025.06.013 1. What is the “continuum of prevention” framework, and how does it differ from traditional approaches to heart failure prevention? Historically, prevention and heart failure management have been treated as separate disciplines—primary prevention handled by preventive cardiologists and treatment managed by heart failure specialists. This joint HFSA/ASPC Scientific Statement reframes prevention as a dynamic, continuous process that spans a patient’s entire lifespan, regardless of HF stage or ejection fraction. The framework maps onto the ACC/AHA HF staging system: Primary prevention targets Stage A (“at risk”) and Stage B (“pre-HF”) patients to reduce the burden of incident HF. Secondary prevention targets Stage C (symptomatic) and Stage D (advanced) patients to reduce the impact of established HF through GDMT optimization and ongoing risk factor management. Tertiary prevention encompasses risk factor management in patients with LVADs or heart transplants—populations where hypertension, diabetes, and obesity still drive outcomes. The Central Figure of the statement illustrates that Life’s Essential 8 (blood pressure and lipid control, diabetes management, exercise, sleep, smoking cessation, weight management, and diet/nutrition counseling) forms the foundation at every stage, with pharmacologic and device-based therapies layered on top as disease progresses (Figure) 2. How do traditional risk factors drive heart failure, and what should clinicians prioritize? Hypertension carries the greatest population-attributable risk for HF. In the Framingham Heart Study (N=5,143), HTN was associated with a 2- to 3-fold increased risk of HF, with a population-attributable risk of 39% in men and 59% in women. The SPRINT trial showed a 38% reduction in HF incidence and 25% reduction in the primary composite outcome with intensive BP targets (30 ng/L or NT-proBNP >125 ng/L) are associated with heightened risk for progression to symptomatic HF. In the ARIC study, incorporating NT-proBNP reclassified 20% of older adults without HF into Stage B. Factors that affect interpretation include age, sex, obesity (lower values), and CKD (higher values). High-sensitivity cardiac troponin (hs-cTn): Concentrations above the 99th percentile are now included in the definition of Stage B HF. Troponin testing may complement natriuretic peptides, particularly when BNP/NT-proBNP values are ambiguous. Risk scores: The PCP-HF equation predicts 10-year HF risk using traditional risk factors plus QRS duration. The AHA PREVENT score incorporates HF risk calculation and includes markers of kidney function (albuminuria, eGFR), though it may underestimate risk in men and Black adults. The CKM syndrome staging framework (Stages 0–4) provides a holistic approach to assessing systemic cardiovascular-kidney-metabolic risk. 4. What are the key nontraditional risk factors and cross-cutting themes in heart failure prevention? Genetics: Pathogenic cardiomyopathy variants exist in ~1 in 200 individuals in the general population. The HFSA and ACMG recommend cascade testing to identify at-risk family members. Polygenic risk scores for dilated cardiomyopathy show a 3.8-fold risk for DCM in the top 10th percentile compared with the median. Sex-specific considerations: Women have 2.8 times the odds of developing HFpEF, while men have similarly increased odds of HFrEF. A complete obstetric/gynecologic history is essential—preeclampsia is associated with a 4-fold increased risk of HF. Peripartum cardiomyopathy requires intentional screening in high-risk populations. Cardiotoxic exposures: Clinicians should be aware of medications that cause direct myocardial toxicity (e.g., anthracyclines, trastuzumab, tyrosine kinase inhibitors). A team-based approach with pharmacists can help optimize medication selection and risk factor modification. Social determinants of health: Environmental exposures (air pollution, arsenic, lead, cadmium), food insecurity, financial instability, and limited healthcare access contribute to HF risk and progression. Equity-focused, risk-based prevention strategies are needed. Psychological health: Depression is common in HF and independently associated with worse outcomes. Screening with brief questionnaires (e.g., PHQ-2) is recommended. Meditation, spirituality, and holistic wellness approaches remain underutilized. 5. What systems-level and policy changes are needed to move the needle on heart failure prevention? Multidisciplinary HF prevention clinics that bring together preventive cardiologists, HF specialists, endocrinologists, nephrologists, dietitians, pharmacists, exercise physiologists, and genetic counselors are advocated by the statement. EHR-embedded risk stratification could proactively flag patients on a trajectory toward HF—analogous to sepsis alerts or fall risk flags—enabling earlier intervention, particularly for patients who may not reach a cardiologist. Cardiac rehabilitation remains underutilized, particularly in HFrEF (Class 2b recommendation) and HFpEF (not yet covered by Medicare). The HF-ACTION trial showed quality-of-life benefits, and the REHAB-HF trial showed particular benefit in older patients with HFpEF. Policy priorities include expanding insurance coverage for preventive screening and novel therapies (SGLT2i, GLP-1 RAs, nsMRAs), reducing clinical inertia through team-based care models with closer follow-up intervals, and ensuring equitable access to evidence-based therapies across diverse populations. Digital health and AI hold promise for personalized risk prediction, remote monitoring (e.g., wearable devices, implantable PA pressure monitors), and virtual cardiac rehabilitation to overcome access barriers. Figure  Lala A, Beavers C, Blumer V, et al. The continuum of prevention and heart failure in cardiovascular medicine: a joint scientific statement from the Heart Failure Society of America and the American Society for Preventive Cardiology. J Card Fail. 2026;32(1):75-105. doi:10.1016/j.cardfail.2025.06.013) References Key references are bolded. Lala A, Beavers C, Blumer V, et al. The continuum of prevention and heart failure in cardiovascular medicine: a joint scientific statement from the Heart Failure Society of America and the American Society for Preventive Cardiology. J Card Fail. 2026;32(1):75-105. doi:10.1016/j.cardfail.2025.06.013 Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063 Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life’s Essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation. 2022;146(5):e18-e43. doi:10.1161/CIR.0000000000001078 SPRINT Research Group, Wright JT Jr, Williamson JD, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103-2116. doi:10.1056/NEJMoa1511939 Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA. 1996;275(20):1557-1562. doi:10.1001/jama.1996.03530440037034 Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288(23):2981-2997. doi:10.1001/jama.288.23.2981 Yusuf S, Sleight P, Pogue J, et al. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000;342(3):145-153. doi:10.1056/NEJM200001203420301 Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373(22):2117-2128. doi:10.1056/NEJMoa1504720 Anker SD, Butler J, Filippatos G, et al. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021;385(16):1451-1461. doi:10.1056/NEJMoa2107038 Solomon SD, McMurray JJV, Claggett B, et al. Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2022;387(12):1089-1098. doi:10.1056/NEJMoa2206286 Filippatos G, Anker SD, Agarwal R, et al. Finerenone reduces risk of incident heart failure in patients with chronic kidney disease and type 2 diabetes: analyses from the FIGARO-DKD trial. Circulation. 2022;145(6):437-447. doi:10.1161/CIRCULATIONAHA.121.057983 Solomon SD, McMurray JJV, Vaduganathan M, et al. Finerenone in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2024;391(16):1475-1485. doi:10.1056/NEJMoa2407107 Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221-2232. doi:10.1056/NEJMoa2307563 Deanfield J, Verma S, Scirica BM, et al. Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial. Lancet. 2024;404(10454):773-786. doi:10.1016/S0140-6736(24)01498-3  Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389(12):1069-1084. doi:10.1056/NEJMoa2306963 Ndumele CE, Neeland IJ, Tuttle KR, et al. A synopsis of the evidence for the science and clinical management of cardiovascular-kidney-metabolic (CKM) syndrome: a scientific statement from the American Heart Association. Circulation. 2023;148(20):1636-1664. doi:10.1161/CIR.0000000000001175 Khan SS, Matsushita K, Sang Y, et al. Development and validation of the American Heart Association’s PREVENT equations. Circulation. 2024;149(6):430-449. doi:10.1161/CIRCULATIONAHA.123.067626 Khan SS, Ning H, Shah SJ, et al. 10-year risk equations for incident heart failure in the general population. J Am Coll Cardiol. 2019;73(19):2388-2397. doi:10.1016/j.jacc.2019.02.057 Bozkurt B, Fonarow GC, Goldberg LR, et al. Cardiac rehabilitation for patients with heart failure: JACC expert panel. J Am Coll Cardiol. 2021;77(11):1454-1469. doi:10.1016/j.jacc.2021.01.030 Packer M. Leptin-aldosterone-neprilysin axis: identification of its distinctive role in the pathogenesis of the three phenotypes of heart failure in people with obesity. Circulation. 2018;137(15):1614-1631. doi:10.1161/CIRCULATIONAHA.117.032474 Lala A, Tayal U, Hamo CE, et al. Sex differences in heart failure. J Card Fail. 2022;28(3):477-498. doi:10.1016/j.cardfail.2021.10.006 Bozkurt B, Coats AJS, Tsutsui H, et al. Universal definition and classification of heart failure. Eur J Heart Fail. 2021;23(3):352-380. doi:10.1002/ejhf.2115 Hershberger RE, Givertz MM, Ho CY, et al. Genetic evaluation of cardiomyopathy—a Heart Failure Society of America practice guideline. J Card Fail. 2018;24(5):281-302. doi:10.1016/j.cardfail.2018.03.004 Levine GN, Cohen BE, Commodore-Mensah Y, et al. Psychological health, well-being, and the mind-heart-body connection: a scientific statement from the American Heart Association. Circulation. 2021;143(10):e763-e783. doi:10.1161/CIR.0000000000000947 Ezekowitz JA, Colin-Ramirez E, Ross H, et al. Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial. Lancet. 2022;399(10333):1391-1400. doi:10.1016/S0140-6736(22)00369-5

Discover Lafayette welcomes Katie Ferguson, whose remarkable story is one of resilience, advocacy, and choosing purpose in the face of life’s most unexpected challenges. A Lafayette native, communications professional, and passionate community advocate, Katie has lived through two extraordinary journeys. First, she became the long term caregiver for an Army veteran whose life changed forever after a catastrophic spinal cord injury. Years later, while feeling completely healthy, a free heart screening uncovered a life threatening ascending aortic aneurysm caused by an undiagnosed congenital heart defect, leading to open heart surgery that ultimately saved her life. Katie approaches both experiences with remarkable clarity and compassion. As she explains, “Nothing happens without having purpose. When something happens to me, chances are it’s happening to someone else. And if I can shine a light on what they’re going through, if I’m able to help ease anyone’s journey, it’s worth it.” That philosophy has shaped her work as an Elizabeth Dole Foundation Fellow, where she advocates for military and veteran caregivers across the country, and as a spokesperson for heart health awareness through the American Heart Association’s Go Red for Women initiative. Katie’s caregiving journey began in 2010 under circumstances she never could have imagined. She and Army officer Barry were casually dating and, by her own admission, were “kind of looking like we were going to break up” as he prepared to retire from military service and move overseas to launch a business. The day after signing his retirement paperwork, Barry suffered a devastating spinal cord injury after slipping from a rope swing into a sandbank, shattering his cervical spine and becoming immediately quadriplegic. Katie recalls receiving a call from a mutual friend before joining his family in the intensive care unit, beginning what she describes as “many, many waits in ICU rooms and hospital rooms and not knowing.” Rather than walking away from an uncertain future, Katie leaned in. “I loved him,” she says simply. As Barry progressed through months of rehabilitation in New Orleans, Lafayette, and Atlanta, the two began dating in earnest while he was still hospitalized. They eventually married, allowing Katie to become his full time paid caregiver after leaving her successful public relations career. “I gave up my career because this was much more important. This was all encompassing.” Her description of caregiving offers a rare, honest glimpse into the invisible work performed by millions of family caregivers every day. “You are literally trying to plan two steps ahead,” she explains, describing everything from helping with showers and medications to waking every three or four hours throughout the night to reposition Barry and prevent pressure sores. While the physical demands were immense, Katie says the mental burden proved even greater. “You don’t think about it when you’re going through it. You’re trying to survive. This is the hand you’re dealt, and you don’t have a choice in the matter. You put your head down and you make it work.” One of the most compelling parts of Katie’s story is that caregiving did not end when her marriage did. Although she and Barry divorced after twelve years, she remains his primary caregiver outside of the hours covered by home health services. She still helps several times each week and is often the first call when emergencies arise at night or on weekends. As she explains, “Whenever his breathing changes, I know what that means. Whenever his eye movement starts moving around, I know what those eye movements mean. Why would I not help somebody if I have the tools to make someone’s life a little bit better?” Katie also shares invaluable advice for caregivers navigating military systems and government bureaucracy. Persistence, she says, is essential. After spending two and a half years successfully appealing a Department of Defense financial decision, she learned that “everything has steps and you just have to go through the steps.” Perhaps more importantly, “You have to know the right question to ask… nobody will just volunteer the information to you. But if you go in and you say, ‘I need this particular form,’ or ‘I need help with this thing,’ they open up doors.” Her work with the Elizabeth Dole Foundation has given Katie an even broader perspective on military caregiving. She notes that seventy five percent of caregivers are not spouses, reminding us that caregiving is defined not by legal status but by love, compassion, and responsibility. She also highlights the foundation’s Hidden Heroes initiative, which recognizes caregivers serving behind the scenes, and the Hidden Helpers program, which acknowledges children who quietly shoulder caregiving responsibilities within military families. Katie’s second life changing chapter began almost by accident. Feeling “100% healthy” and completely without symptoms, she attended a free cardiovascular screening during Women’s Health Month because heart disease ran in her family. A routine calcium score CT scan revealed no plaque buildup, but it did reveal something far more dangerous: an enlarged ascending aorta. “I felt fine. I went to the surgeon, to my open heart surgery, completely asymptomatic.” Initially, like many people would, Katie delayed following up. Three months later, additional imaging confirmed a life threatening ascending aortic aneurysm. Doctors monitored it for nearly a year before recommending surgery. During the operation in January 2023, surgeons discovered an undiagnosed congenital bicuspid aortic valve, a birth defect in which the heart valve has only two leaflets instead of three. They replaced it with a mechanical valve while repairing the aneurysm. Today, Katie says the gentle clicking of that valve, once unsettling, has become reassuring. “It’s more calming to me now… I kind of use it to lull me to sleep.” Throughout the conversation, Katie passionately advocates for preventive health care. She emphasizes that heart disease remains the leading killer of women, noting that one in three women will die from cardiovascular disease, compared with one in twelve from cancer. Her own experience illustrates why proactive screening matters. Had she ignored that free test, doctors estimated she likely would not have survived another five years. Looking back, she reflects, “Had I not been proactive, I’d be gone.” Katie also discusses how women’s heart attack symptoms often differ dramatically from men’s, frequently resembling flu symptoms, indigestion, jaw pain, reflux, or unexplained fatigue rather than the classic crushing chest pain. She praises the work of Go Red for Women, not only for raising awareness but also for funding research and local initiatives such as CPR education, blood pressure screening stations, and food security programs throughout Acadiana. Perhaps the most meaningful takeaway from this conversation is Katie’s conviction that advocacy begins with caring for yourself. Years spent advocating for someone else taught her to ask questions, seek second and third opinions, and never hesitate to pursue answers. “I’m no good if I’m not here,” she says. “I have to advocate for myself so I can be here physically present to help.” When asked what she would tell caregivers, Katie offers wisdom born from experience. Learn to ask for help. Accept support when it comes. And if someone you know is caregiving, do not wait for them to ask. Simple gestures, whether bringing a meal or rolling a neighbor’s trash cans to the curb, can lighten an overwhelming mental load. Katie Ferguson’s story reminds us that resilience is not simply surviving hardship. It is choosing, again and again, to use our experiences to lift others. Whether advocating for military caregivers, encouraging women to take charge of their heart health, or simply sharing practical advice with someone facing an uncertain diagnosis, Katie continues to transform personal adversity into hope for others.

Rep. Sarah Crawford stops by the podcast for a second visit and discusses serving two terms in the House after a biennium in the Senate.  Click here to listen to her first visit in 2022.   The Wake County Democrat also talks about her relationships with her Republican colleagues and how those friendships here get a law enforcement bill through the North Carolina House, navigating difficult conversations, and earning support from members on both sides of the aisle. Crawford also reflects candidly on the political realities of bipartisan work. While reaching across the aisle can produce real results for constituents, she acknowledges that it isn't always celebrated within her own party.  Plus, Skye and Brian unpack the week of political news, including next week's session, fundraising, short session numbers, and more.   The Do Politics Better podcast is sponsored by New Frame, the NC Travel Industry Association, the American Heart Association, the NC Pork Council, the NC Realtors, Heal the System NC, and the NC Healthcare Association.

In this episode, Scott Becker discusses new findings from the American Heart Association suggesting that drinking up to five cups of coffee a day may support heart health and reduce stroke risk.

What if one of the most important healthcare partners in your community isn't a clinic or hospital—but your local library?In this episode of the California State Rural Health Association Podcast, Lisa Lindsay, Library Programs Consultant with the California State Library, shares how rural libraries are evolving into trusted community health hubs. Drawing on more than 20 years of experience in public libraries, Lisa reveals how libraries are helping bridge healthcare gaps through innovative partnerships, trusted relationships, and creative programming that reaches people where they already feel comfortable.From telehealth access and blood pressure monitor lending programs to emergency preparedness, literacy services, nutrition education, and health resource fairs, Lisa demonstrates how libraries are addressing the social drivers of health in ways many healthcare organizations have yet to discover. She also shares inspiring examples from rural and tribal communities across California, highlighting how collaboration between libraries, public health agencies, nonprofits, and healthcare providers is creating healthier, more connected communities.Whether you're a rural healthcare leader, public health professional, librarian, or community advocate, this conversation will challenge the way you think about community partnerships—and reveal why libraries may be one of healthcare's most underutilized assets.In this episode, you'll learn:Why libraries have become trusted access points for health information and services.How rural libraries are expanding access through telehealth, health screenings, and wellness programming.The impact of the Rural Health Connections Project across California.How partnerships with organizations like the American Heart Association are improving cardiovascular health through the Libraries with Heart initiative.Practical ideas for healthcare organizations looking to collaborate with local libraries to better serve rural communities.Healthcare doesn't only happen in hospitals and clinics—it happens wherever people gather, learn, and trust. This episode offers a fresh perspective on building healthier rural communities through unexpected partnerships.Listen now to discover why the future of rural health may begin with a library card.Connect with Lisa Lindsay:LinkedInResourcesRural Health Connections Project (California)Libraries with Heart (American Heart Association partnership)California State Library (Library Programs & Rural Initiatives)The CSRHA has been a go-to resource for rural healthcare and community leaders since 1995. The CSRHA brings an accumulation of actionable insights to the next generation of rural healthcare leaders. For more behind the scenes of this podcast follow @CSRHApodcast on Twitter or @csrha.advocate on Facebook.If you enjoy This Is Rural Health, we could use your support! Please consider leaving a 5-star rating and review, and share it with someone who needs to hear this!Learn more about the CSRHA at csrha.org.

July 22, 2026: Your daily rundown of health and wellness news, in under 5 minutes. Today's top stories: Garmin launches CIRQA Smart Band, a screenless, subscription-free wearable, as hardware becomes table stakes and data interpretation becomes the real battleground Kalshi partners with AppliedXL to launch prediction markets forecasting clinical trial outcomes and FDA decisions, making drug development probabilities tradable American Heart Association guidance finds up to 400mg of caffeine daily is safe for most adults and may reduce heart disease risk, while warning on energy shots More from Fitt: Fitt Insider breaks down the convergence of fitness, wellness, and healthcare — and what it means for business, culture, and capital. Subscribe to our newsletter → insider.fitt.co/subscribe  Work with our recruiting firm → https://talent.fitt.co/ Follow us on Instagram → https://www.instagram.com/fittinsider/ Follow us on LinkedIn → linkedin.com/company/fittinsider  Reach out → insider@fitt.co 

Dave Rubin of "The Rubin Report" gives a first look at the stories you need to know to start your day, including President Donald Trump rejecting New York City Mayor Zohran Mamdani's threat to arrest Israeli Prime Minister Benjamin Netanyahu over the International Criminal Court's warrant, declaring America will protect its closest ally; a suspect in custody after an incendiary device attack outside a federal immigration building in Manhattan, where authorities say anti-ICE materials, a manifesto, and pellet guns were recovered; and a new American Heart Association study finding that drinking up to five cups of black coffee a day is safe for most adults and may reduce the risk of heart disease, stroke, type 2 diabetes, and other cardiovascular conditions; and much more.

P.M. Edition for July 20. The Magnificent Seven have dominated the stock market for years. But now, as markets reporter Hannah Erin Lang discusses, there are signs that everyday investors are buying fewer shares of the megacap tech companies as they look to find the next big AI stock. Plus, a judge puts a temporary restraining order on the $81 billion merger of Paramount and Warner Bros. Discovery. And how much coffee should you drink for a healthy heart? A new scientific statement from the American Heart Association has the answer… and it may be more than you think. Alex Ossola hosts. Sign up for the WSJ's free What's News newsletter. Learn more about your ad choices. Visit megaphone.fm/adchoices

Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/20-07-2026Nesta segunda-feira, o boletim analisa descobertas em biologia molecular de plataformas genéticas, a intersecção de fatores em cardio-oncologia e o planejamento estratégico de saúde frente a riscos ambientais. Abordamos o estudo publicado na Nature Biotechnology revelando que a resposta gerada por tecnologias de RNAm segue múltiplos caminhos no organismo, evidenciando o papel ativo das células musculares na apresentação de antígenos ao sistema de defesa. Detalhamos o alerta da American Heart Association direcionado a mulheres idosas, apontando que a fibrilação atrial e neoplasias mamárias compartilham fatores basais comuns como processos inflamatórios crônicos e distúrbios metabólicos. Por fim, trazemos no Radar a apresentação do plano AdaptaSUS no Congresso do Conasems, uma iniciativa do Ministério da Saúde para estruturar a resiliência de serviços públicos e o alerta precoce diante de oscilações ambientais extremas. Afya News. Informação médica confiável e atualizada no seu tempo.

From organizing as a teenage Republican to managing campaigns out of his college dorm room, serving in elected office, and building a career in government relations, Zach Almond has always known politics was where he belonged. Today, he's living that dream as Executive Director of the North Carolina Republican Party. Zach joins us to discuss his journey, what he's learned along the way, and why he's more optimistic about the 2026 midterm elections than many political prognosticators. Plus, Skye and Brian break down North Carolina's #2 business ranking, the latest fundraising numbers, budget schedule rumors, new polling, #TOTW, and much more. The Do Politics Better podcast is sponsored by New Frame, the NC Travel Industry Association, the American Heart Association, the NC Pork Council, the NC Realtors, Heal the System NC, and the NC Healthcare Association.

Resources for the Community:___________________________________________________________________Linktree Our Favorite ThingsNeed help appealing your GLP-1 dials? www.FindHonestCare.com/KimFind Your US Representatives https://www.usa.gov/elected-officials ______________________________________________________________________"Both Our Advice and our Guest Expert insights don't replace your own care team. Always talk to a doctor who can review your personal records and labs to make the safest choices for you."How GLP-1s Broke Diet CultureFor decades, we believed weight gain and weight loss were mostly about willpower, calories, and exercise. Today, we're learning there's much more happening beneath the surface. The biology that drives hunger, metabolism, weight gain, and long-term health is far more complex than we once understood.In this episode, Dr. Chiadi Ndumele, preventive cardiologist at Johns Hopkins Medicine and a leader with the American Heart Association, explains why GLP-1 medications work, how weight, metabolism, and chronic disease are connected, and why the first-ever Cardiovascular-Kidney-Metabolic (CKM) Clinical Practice Guideline represents a major shift in how we understand and treat weight-related disease. You'll also hear a powerful patient story that shows why this new understanding is giving hope to millions.In this episode:Why GLP-1 medications work when diets often don't.What really drives weight gain, weight loss, and long-term weight management.How metabolism, hormones, genetics, and overall health work together.Why understanding your body can help you advocate for the quality care you deserve.GuestDr. Chiadi NdumelePreventive Cardiologist, Johns Hopkins MedicineChair, 2026 American Heart Association/American College of Cardiology Cardiovascular-Kidney-Metabolic (CKM) Clinical Practice GuidelineResourcesAmerican Heart Association: New Cardiovascular-Kidney-Metabolic (CKM) Clinical Practice Guidelinehttps://www.heart.org/en/news/2026/06/09/new-ckm-guideline-urges-early-weight-talks-to-prevent-health-risksProfessional Heart Daily: 2026 Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndromehttps://professional.heart.org/en/science-news/2026-guideline-for-the-prevention-detection-evaluation-and-management-of-ckm-syndromeAmerican Heart Association News Release: First-Ever Clinical Practice Guideline for Cardiovascular-Kidney-Metabolic Syndromehttps://newsroom.heart.org/news/first-ever-guideline-on-cardiovascular-kidney-metabolic-syndrome-issued______________________________________________________________________Join this channel to get access to perks:   / @theplussidez______________________________________________________________________#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy #ObesityCare #PatientAdvocate #GLP1Community #RealGLP1StoriesSend us Fan Mail!Use Honest Care to Appeal GLP-1 Denials. Go to HonestCare.com/Kim  Honest Care can Appeal GLP-1 Denials. Go to FindHonestCare.com/Kim Support the showKim Carlos, Executive Producer TikTokInstagram Kat Carter,  Producer TikTokInstagram 

Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/14-07-2026Nesta terça-feira, o boletim analisa debates regulatórios sobre o manejo farmacológico em saúde mental, benefícios vasculares de análogos hormonais e a reorganização de fluxos de trabalho. Abordamos a mobilização federal nos Estados Unidos para estruturar diretrizes clínicas voltadas à desprescrição segura e gradual de moduladores de serotonina, distinguindo reações de descontinuação do retorno de quadros clínicos prévios. Detalhamos o estudo observacional destacado pela American Heart Association sugerindo que os agonistas de GLP-1 podem reduzir significativamente o risco de desfechos vasculares graves e internações em pacientes com distúrbios metabólicos e arteriais periféricos. Por fim, trazemos no Radar o relatório do McKinsey Health Institute sobre o papel da inteligência artificial em reduzir a carga administrativa e a documentação burocrática, devolvendo o tempo do médico para o cuidado direto. Afya News. Informação médica confiável e atualizada no seu tempo.

Dr. St-Onge is the founding Director of the Center of Excellence for Sleep & Circadian Research at Columbia University Irving Medical Center. The overall focus of her research program is the study of the impact of lifestyle, specifically sleep and diet, on cardiometabolic health. Dr. St-Onge has been NIH-funded since 2008, conducting innovative, cutting-edge clinical research combining her expertise on sleep, nutrition, and energy balance regulation to address questions related to the role of circadian rhythms, including sleep duration and timing as well as meal timing and eating patterns, on cardiometabolic risk. Dr. St-Onge was Center Director for the American Heart Association funded Go Red for Women Strategically Focused Research Center, aimed at determining the causality of the relation between sleep and cardiovascular disease and the specific role that sleep plays in the health of women throughout the life cycle. She is a pioneer in this field, having chaired the first scientific statements endorsed by the AHA on sleep and cardiometabolic health as well as meal timing and frequency and cardiovascular disease risk prevention. More recently, she chaired a follow-up scientific statement highlighting the role of multidimensional sleep health for cardiometabolic health. She is a Fulbright Scholar, and the recipient of an NHLBI Outstanding Investigator Award from the National Institutes of Health. Dr. St-Onge has authored over 200 peer-reviewed publications and is author of Eat Better, Sleep Better: 75 recipes and a 28-day meal plan that unlock the food-sleep connection.Support the show

Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/13-07-2026Nesta segunda-feira, o boletim analisa o desenvolvimento acelerado de soluções biológicas, os impactos das oscilações climáticas no sistema circulatório e o panorama epidemiológico sazonal. Abordamos a autorização no Reino Unido para o início dos ensaios clínicos de um imunizante desenvolvido pela Universidade de Oxford em apenas oito semanas contra uma variante emergente rara na África. Detalhamos o alerta da American Heart Association sobre como a exposição ao estresse térmico extremo sobrecarrega o organismo, exigindo monitoramento preventivo rigoroso em pacientes com insuficiência cardíaca e hipertensão. Por fim, trazemos no Radar o posicionamento da OPAS sobre a simultaneidade de múltiplos patógenos respiratórios sazonais no hemisfério sul e a urgência de impulsionar as coberturas vacinais. Afya News. Informação médica confiável e atualizada no seu tempo.

CardioNerds co-chairs Dr. Dinu Balanescu and Dr. Billy Joe Mullinax, along with FIT lead Dr. Shiavax Rao, discuss the evolving landscape of randomized controlled trials in pulmonary embolism with Dr. Jay Giri, interventional cardiologist, Associate Professor of Medicine, and Director of the Cardiovascular Catheterization Laboratories at the Hospital of the University of Pennsylvania. This episode examines the historical evidence behind systemic thrombolysis, the emergence of catheter-directed therapies and mechanical thrombectomy, and the landmark RCTs – STORM-PE, PEERLESS, HI-PEITHO, and PEERLESS II – that are reshaping intermediate-risk PE management. The discussion highlights challenges in PE trial design, the critical importance of clinical deterioration as an endpoint, and why this era represents an unprecedented wave of evidence generation in PE. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Dr. Dinu Balanescu and Dr. Billy-Joe Mullinax are Co-chairs for the CardioNerds PE Series, developed in collaboration with the PERT Consortium.   Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Pulmonary Embolism PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls: Systemic thrombolysis in intermediate-risk PE reduces hemodynamic decompensation but at the cost of ~1.5–2% intracranial hemorrhage risk – a near-zero net benefit that has driven the search for safer catheter-based alternatives. “Focus on clinical deterioration, not mortality” – Due to crossover design in contemporary PE RCTs, control-arm patients who decompensate are rescued with advanced therapies, biasing mortality toward the null. Clinical deterioration is the most informative endpoint to watch in HI-PEITHO, PRAGUE-26, and PEERLESS II. HI-PEITHO is the first large RCT to demonstrate that catheter-directed fibrinolysis plus anticoagulation significantly reduces the composite of PE-related death, cardiorespiratory decompensation, or PE recurrence versus anticoagulation alone (RR 0.39; 95% CI 0.20–0.77; P=0.005), with no intracranial hemorrhage in either arm. The four major upcoming/recently reported PE RCTs (HI-PEITHO, PRAGUE-26, PEERLESS II, PE-TRACT) enroll progressively different risk populations – from the most enriched (HI-PEITHO) to the most permissive (PE-TRACT, which includes intermediate-low risk patients) – enabling a nuanced understanding of which patients benefit most from intervention. PE device clearance follows a fundamentally different FDA pathway than structural heart devices (single-arm safety/efficacy studies vs. mandated RCTs), yet market forces and clinical need have ultimately driven industry and government to sponsor large-scale RCTs – a lesson in how evidence development can evolve organically alongside regulatory frameworks. Notes: Notes drafted by Dr. Shiavax Rao. Question #1: What is the current evidence behind advanced PE therapies? Systemic thrombolysis: Sixteen RCTs over 40 years (1972–2014) enrolling nearly 2,000 patients have studied systemic thrombolysis in intermediate-risk PE. The landmark PEITHO trial (n=1,006) showed that tenecteplase reduced the composite of death or hemodynamic collapse (2.6% vs. 5.6%; P=0.015), driven primarily by reduced hemodynamic decompensation (1.6% vs. 5.0%; P=0.002). However, this came at the cost of increased major bleeding (6.3% vs. 1.5%; P

This week we're joined by Kendra Cunningham and Kayla Messana, sisters and co-hosts of the podcast Flatlined and Fine, and their stories are almost impossible to believe. Kayla was 31, healthy, three kids, husband just back from deployment, when she woke him up with agonal breathing in the middle of the night. He dragged her to the floor, did CPR for 10 minutes, and she was shocked twice by an AED before going on to have cardiac arrest approximately eight more times in the next 24 hours. Four years later, she's been shocked by her ICD three additional times and still has no clear diagnosis. Then, a few years after Kayla's event, Kendra had her own cardiac arrest while awake and feeding her newborn twins, told her husband she was about to faint, and was gone within seconds, saved by a man whose only CPR training was a few American Heart Association videos he'd watched before their first child was born. Kristin and I swap notes with them on everything: what it's like to wake up in an ICU with no memory of what happened, how you explain cardiac arrest to kids who are five, six, and eight years old, the psychological weight of an idiopathic diagnosis that gives you no answers and no closure, and the very real experience of being a 31-year-old in a cardiology waiting room surrounded by people forty years older than you. We also get into the insurance disaster of a $15,000 whole exome sequencing test that Blue Cross Anthem denied, why Kendra couldn't pick up her newborn twins for months after her ICD surgery, and why I was cleared to perform eye surgery but not allowed to drive for six months. I also get publicly shamed for not having plugged in my ICD data transmitter in two years. It's earned. Takeaways: Cardiac arrest in young, healthy adults often has no identifiable cause. CPR saves lives even when the person doing it is terrified and untrained. The co-survivor experience is its own separate, underserved story. Young cardiac arrest survivors often get inadequate guidance from the healthcare system. Being shocked by an ICD is traumatic and disruptive in ways that don't get talked about enough. — Want more Kendra Cunningham and Kayla Messana? @flatlined.and.fine on Instagram Flatlined and Fine on Spotify: https://open.spotify.com/show/2nRXIK5OvgAv2CXKvCwrQu?si=eHV4s_CZTQyLAXLvf7A14A&nd=1&dlsi=359ec698e7c64c90 To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information. Head to http://www.cozyearth.com and use my code KNOCKKNOCK for an exclusive 20% off. Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

North Carolina lawmakers finally reached a budget agreement, a bipartisan one at that, and Skye and Brian break down what made it into the spending plan and what's next in the legislative session. Also, Rep. Phil Shepard (R-Onslow) reflects on his 15 years in the legislature, the evolution of North Carolina politics in his region, and the lessons he's learned.  The Do Politics Better podcast is sponsored by New Frame, the NC Travel Industry Association, the American Heart Association, the NC Pork Council, the NC Realtors, Heal the System NC, and the NC Healthcare Association.

Episode 2821 - Vinnie Tortorich and Chris Shaffer discuss marketing ploys by Big Food, poorly done food studies, and that exercise is king. https://vinnietortorich.com/2026/07/exercise-is-king-episode-2821 PLEASE SUPPORT OUR SPONSORS Pure Vitamin Club Pure Coffee Club NSNG® Foods VILLA CAPPELLI EAT HAPPY KITCHEN YOU CAN WATCH THIS EPISODE ON YOUTUBE - @FitnessConfidential Podcast Vinnie's workout videos are available to purchase! Choose from a 2-day, 4-day, or 6-day workout–or buy all three at a discount! TO PURCHASE VINNIE'S WORKOUT VIDEOS, CLICK THIS LINK: https://vinnietortorich.com/workout Exercise is King Vinnie tells a story of "who is influencing whom?" (3:00) We can all do better, encourage each other, and be an example. The American Journal of Public Health recently published an article that highlights the connections between the marketing approaches of Big Food and Big Tobacco. (13:00) Lunchables are marketed as having a good amount of protein; however, the breakdown shows otherwise. (19:00) Big Food's entire goal is to get you addicted to their products. (28:00) You can find a book focusing on this topic in Vinnie's Book Club on his Amazon page. The book is "Salt, Sugar, Fat" by Michael Moss: https://www.amazon.com/dp/B07DF5QS3H?linkCode=ssc&tag=vinnitorto-20&creativeASIN=B07DF5QS3H&asc_item-id=amzn1.ideas.DLRU885XQ4BV&ref_=cm_sw_r_cp_ud_aipsfshop_aipsfvinnietortorich_109ME21EYG8380MBNX34_asin It appears that the American Heart Association finally agrees with what Vinnie has been saying for years: exercise is a poor way to lose weight. (43:00) Exercise is king for health and longevity! However, you need to eat real food, too. Another epidemiological study on meat consumption; however, it compares processed meats (like salami, pepperoni) to white meat, such as chicken (not processed). The comparison is off, so the outcome is off. (50:00) For a recent study on drinking tea, the article included all kinds of caveats, but the article about meat did not. Update on the PVC Magnesium product. (1:05:30) Anna's products are now linked to PureVitamin Club's website. Look under the "Food and Snacks" section to purchase them there, too. https://purevitaminclub.com/collections/food-and-snacks Vinnie hopes to add other products as well, all of which will be health-related. The NSNG® VIP GROUP IS NOW CLOSED AGAIN AS OF SUNDAY, MARCH 15TH Anna's next cookbook, Eat Happy Cocktail Hour, is filled with cocktails, mocktails, and appetizers and is available for pre-order right now. If you pre-order, you'll get bonus goodies! You can preorder from a wide variety of booksellers at https://eathappycocktailhour.com/ Save your receipt from wherever you preorder, you'll need it for your bonuses! Physical Release Date is October 2026 You can book a consultation with Vinnie to get guidance on your goals. https://vinnietortorich.com/phone-consultation-2/ More News Serena has added some of her clothing suggestions and beauty product suggestions to Vinnie's Amazon Recommended Products link. Self Care, Beauty, and Grooming Products that Actually Work! https://www.amazon.com/shop/vinnietortorich/list/3GPVU29UHHPMY?ref_=aipsflist Don't forget to check out Serena Scott Thomas on Days of Our Lives on the Peacock channel. "Dirty Keto" is available on Amazon! You can purchase or rent it here.https://amzn.to/4d9agj1 Please make sure to watch, rate, and review it! Eat Happy Italian, Anna's second cookbook, is available! You can go to https://eathappyitalian.com You can order it from Vinnie's Book Club. https://amzn.to/3ucIXm Anna's recipes are in her cookbooks, on her website, and on Substack —they will spice up your day! https://annavocino.substack.com/ PURCHASE DIRTY KETO (2024) The documentary launched in August 2024! Order it TODAY! This is Vinnie's fourth documentary in just over five years. Visit my new Documentaries HQ to find my films everywhere: https://vinnietortorich.com/documentaries Then, please share my fact-based, health-focused documentary series with your friends and family. Additionally, the more views it receives, the better it ranks, so please watch it again with a new friend! REVIEWS: Please submit your REVIEW after you watch my films. Your positive REVIEW does matter! PURCHASE BEYOND IMPOSSIBLE (2022) Visit my new Documentaries HQ to find my films everywhere: https://vinnietortorich.com/documentaries FAT: A DOCUMENTARY 2 (2021) Visit my new Documentaries HQ to find my films everywhere: https://vinnietortorich.com/documentaries FAT: A DOCUMENTARY (2019) Visit my new Documentaries HQ to find my films everywhere: https://vinnietortorich.com/documentaries

Rapid advances in acute ischemic stroke care have expanded treatment windows and improved patient outcomes through thrombolysis, mechanical thrombectomy, and optimized antithrombotic strategies. This episode highlights evolving approaches to patient selection, the growing role of tenecteplase, and the importance of team-based systems of care in delivering timely, effective treatment. In this episode, Casey S. Albin, MD, FAAN, speaks with Christopher R. Leon Guerrero, MD, author of the article "Thrombolysis, Thrombectomy, and Antithrombotic Therapy for Acute Ischemic Stroke" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Leon Guerrero is an associate professor of neurology and the adult neurology residency program director at Atrium Health Carolinas Medical Center in Charlotte, North Carolina, where he also serves as outpatient stroke director. Additional Resources Read the article: Thrombolysis, Thrombectomy, and Antithrombotic Therapy for Acute Ischemic Stroke Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin Full episode transcript available here Dr Albin: In stroke care, every minute kills nearly two million neurons. But today, we're going to unpack all the details about the latest treatments that can give those neurons back.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Albin: Hello and welcome. This is Dr. Casey Albin. Today, I'm interviewing Dr. Christopher Leon-Guerrero about his article on Thrombolysis, Thrombectomy, and Antithrombotic Therapy for Acute Ischemic Stroke. This article appears in the April 2026 Continuum issue on cerebrovascular disease. Welcome to the podcast. I always like to start by just having you introduce yourself so our listeners know a little bit about you.  Dr Leon-Guerrero: Thanks for the introduction, Dr. Albin. Really glad to be here today. My name is Chris Leon-Guerrero. I'm a vascular neurologist at Atrium Health in Charlotte, North Carolina, at Carolinas Medical Center. I'm an associate professor in the Department of Neurology. I serve as our Neurology Residency Program Director, and I also wear the hat of an outpatient stroke director in our clinics.  Dr Albin: So, you are wearing a lot of hats and balancing a lot of things, and it's a really exciting time to be talking about this. For our listeners, we are recording this right after the launch of the American Heart Association, American Stroke Association just released their new guidelines on acute ischemic care. So, no better time to kind of dive into some of this. And really, when I think about acute ischemic stroke care, it's dramatically transformed in the last two to three decades. I mean, from lengthening time windows for IV thrombolysis to expanded thrombectomy eligibility, this is really, I think, some of the most exciting stuff in neurology. And your article did a fantastic job of distilling those rapid advancements and clarifying some of the evidence behind some of these new evolving treatment selections and imaging modalities, and it's exciting. So, let's just start with thrombolysis. Where are we now with IV thrombolytics and the time windows there?  Dr Leon-Guerrero: So, a lot has changed in the last decade, since that initial trial with NINDS, nearly thirty years ago. We're still giving intravenous thrombolysis in the traditional time window up to 4.5 hours, and really emphasizing we should be selecting patients for treatment early and quickly as possible. In most of those cases, a non-con head CT is sufficient to rule out bleeding and initiate treatment as quickly as possible. Where things have gotten really exciting is using advanced neuroimaging to help select patients beyond that traditional 4.5 hour window, and we're able to treat patients even up to twenty-four hours from symptom onset.  Dr Albin: Which is really exciting. It has really totally shifted the paradigm here. You know, I think most listeners are going to be pretty familiar with three to four and a half hours. Like, that's sort of our standard. What can you tell us about some of the advanced imaging we're using for that later selection period?  Dr Leon-Guerrero: It's around the principle of you want to be able to, uh, rescue significant salvageable tissue without a lot of core. So, this large profusion deficit and small core is really how you're trying to select out these patients. And two types of modalities are used. One is going to be MRI, and a lot of those imaging protocols, you know, are outlined in the WAKE UP trial and basically are looking for patients with DWI hyperintense lesions and FLAIR negative lesions to suggest that patients in an early time window that's treatable for thrombolysis. And then in the other category, we'll be using profusion imaging, whether that's CT profusion or MR profusion, to look for patients with large salvageable tissue.  Dr Albin: Yeah. And I think that this has been one of the things that, to me, has been really impactful is I think when WAKE UP came out, it was exciting. It was fun to sort of think about, "Hey, we're going to be able to use MRI." But MRI can be very challenging to get acutely, especially in community centers where they don't have the capabilities to get someone from the emergency department into an MRI rapidly enough to make thrombolysis decisions. So, to see some of that expand to CT profusion has been really exciting. How are you going about sort of counseling patients or thinking about their risk when you're using some of those, like, advanced imaging techniques?  Dr Leon-Guerrero: Yeah. I think it's similar to the conversations we've had with patients even within the traditional 4.5 hour window. The risk for intravenous thrombolysis is hemorrhage, and counseling patients on the, you know, the risk and benefits of hemorrhage and the potential clinical benefit of receiving thrombolytics is important. And then providing patients with that information to make an informed decision, so that they can make the best decision for their own care.  Dr Albin: Totally. And it's, again, time sensitive, but trying to give families enough information and enough time to sort of process those, especially when it's a little bit beyond the standard that we're so used to consenting for. The other big area that's really changed is that tenecteplase has become the star of the show. It's really gained momentum, so what should clinicians understand about this?  Dr Leon-Guerrero: Yeah. There's been an explosion of data over the last decade on tenecteplase supporting its use for clinical practice. You know, there was recent updates even from the neurology journal with a large meta-analysis with all of the data showing good clinical outcomes and perhaps even lower risk of bleeding. And so, I think you're seeing a lot of centers across the country switching from alteplase to tenecteplase. There's some practical advantages. So tenecteplase is a one-time bolus dose. And then biologically, it seems to have better fibrin specificity, longer half-life, which may ultimately make it a more attractive drug and may make it even more effective. But I think the practical aspects of tenecteplase are not to be understated. I think there's a lot of advantages for speed and efficiency and for centers to make that switch.  Dr Albin: Yeah. I remember when our health system made the pivot from alteplase to tenecteplase. Like any changes, that obviously created some adjustments with the new workflow. But, the fact that this could be given just as a one-time dose and not with the "we got to calculate the bolus, and now we got to get the infusion on board," like really simplified workflow. So, I think that's been pragmatically one of the nicest things we've done in stroke care. Really exciting.  Dr Leon-Guerrero: Yeah. And, you know, it's a doable thing. I think you have to be, very deliberate about it at whatever center you're at to make sure that all stakeholders are aware of that change. I think that's helpful to get everybody involved and have a lot of planning to avoid wrong dosing errors or inadvertently dosing as alteplase versus tenecteplase. But it's certainly doable, and I think in the long term, centers that have switched have been pretty satisfied with tenecteplase.  Dr Albin: And you know, initially when this came out, there really was sort of a debate about, is it gonna be 0.25? Was it gonna be 0.4? Where have we landed with that debate?  Dr Leon-Guerrero: So, I think we found the correct dose is 0.25 milligrams per kilogram is the recommended dose with a max out of 25 milligrams. There's some within the American Heart Association guidelines that were just published. They mentioned even tier dosing based on 10 kilograms, so intervals. So, that may be an easier way for centers to do it. But that cap out dose of 25 milligrams at 0.25 milligrams per kilogram, I think, is the sweet spot.  Dr Albin: Yeah. That's great, and I think that that has helped, you know, say, "This is what we're doing. There's not a debate that's happening anymore." And that really just got codified in the new ASA guidelines, so really exciting there. So, there is a lot of guidance for these patients, but I think one of the things that your article really tackled is the fact that there are some special populations, where we really still don't have a lot of guidance. And so, I think just to kind of distill those for the listeners, thinking about our pregnant patients, thinking about children, how are we approaching thrombolysis decisions in these special populations?  Dr Leon-Guerrero: These are always tough cases. For example, for pregnant women, they've often been excluded in the thrombolytic trials. But there's still evidence. You know, there's some inference based on the evidence we do have, and there's a lot of registry and case reports suggesting potential safe treatment for pregnant women. And I think when you're approaching those cases, again, it's gonna be patient-centered and really should be multidisciplinary. These are the types of cases you really need to lean on your maternal fetal medicine colleagues, your high-risk OBGYNs, your obstetricians to help with that decision-making. And I think, a multidisciplinary approach is the way to go for these cases. It's the same thing with the pediatric population. We had some data. There was one trial, randomized control trial, called TIPS trial that looked at using intravenous alteplase for acute ischemic stroke in patients under the age of 18. It had difficulty with enrollment. But I think most experts would argue that patients with pediatric stroke should be considered for intravenous thrombolysis if appropriate. Again, same thing. You want to make it a multidisciplinary approach, really getting your pediatric neurologists, your pediatricians involved early to make the best decision for the patient.  Dr Albin: Yeah. That's just really an important takeaway, just thinking about this as a multidisciplinary decision, because there are going to be other stakeholders to the patient's care who may have some different information than what we as neurologists are bringing to the approach. And obviously, our perspective really matters. But trying to work in everyone's unique vantage point of the patient really helps to make the most effective decision. When we talk about acute ischemic stroke care, I really don't think that you could do justice to the topic without pivoting to mechanical thrombectomy, which, you know, as we think about how the medical field as a whole, not just neurology, how the medical field has evolved. I mean, there's probably no bigger impact than mechanical thrombectomy has made in terms of reducing not just morbidity, but mortality from stroke. I mean both. So, thrombectomy has been around for a while, but just walk our listeners through what's the core that we for sure know that these are the patients that this works for?  Dr Leon-Guerrero: The types of patients we should be selecting for intervention are patients with large vessel occlusions. And those initial trials that were published in 2015 really demonstrated that this is a quite an effective treatment for patients with large vessel occlusion ischemic strokes in the anterior circulation. When that smattering of publications occurred in 2015, the general consensus, we should be treating all patients up to six hours from symptom onset if they do have a large vessel occlusion. And then, Dr. Albin, as you know, the, the windows continue to expand. So, we were using advanced neuroimaging with MR selection and perfusion selection based on DAWN and DEFUSE 3 trial protocols to select patients all the way out to the 24 window, and it's even expanded beyond that over the last few years.  Dr Albin: I think that when we think about trials that really, totally, changed the game, when we think about DAWN and DEFUSE 3, and we switched from that time-based window to more of that, like we talked about for thrombolysis, that tissue-based clock and, like, looking at what is salvageable and where can we make an impact on salvageable tissue, truly moved the needle in terms of just bringing this therapy for people who, you know, it's hard to get in within six hours. When we moved the needle to 24, it made a huge difference. But people were still coming in with a lot of ischemic damage already done, and they would have traditionally been excluded from being enrolled in thrombectomy trials. But that's changing too. So where are we there?  Dr Leon-Guerrero: Yeah. I think there were lessons learned from DEFUSE and DAWN that we were probably over-selecting. Perhaps too stringent. You know, we had number needed to treat in the range of two to three for good outcome based on those trials. And so, I think those were lessons learned to move forward, and we, and, and people started looking at large core infarctions. And in the last few years, we've seen a multitude of randomized control trials examining large core infarctions. These are patients with ASPECT scores all the way down to zeros. A lot of the trials relied on three to six as their score, but there was at least one large core study that looked at ASPECT scores down to zero to two, and all of these studies showing benefit.  Dr Albin: Yeah. And we've really moved into if there's some tissue to spare there, probably getting clot out really makes a big difference in impact. You know, it was really surprising to me as a neurointensivist looking at these trials, that the trials had such low rates of hemorrhage, and pretty low rates of dramatic cerebral edema after thrombectomy. I don't know that we've seen all of that in sort of real world applications, but again, we are still seeing some of these patients come in, that really would've been devastated having some amount of functional recovery regained, which is incredible. In terms of another patient population that I think gives a lot of people pause or stickiness, is those basilar artery occlusions, right? Another large vessel, but one that we've had a little bit harder of a time enrolling in trials and having well-selected trials. Where are we now on whether or not basilar artery occlusion should go to mechanical thrombectomy?  Dr Leon-Guerrero: So, a lot of excitement in this area, too. There's at least two studies that were published in the last five years that were showing benefit in doing thrombectomy for patients with basilar artery occlusion up to 24 hours, and these were patients with moderate to severe deficits with NIH Stroke Scale scores greater than 10. And then making sure that they don't have large core, so using a newer scoring algorithm on the CAT scan called PC ASPECT, so basically a posterior circulation ASPECT score, to kind of make sure that patients don't have large core infarctions that are being considered for thrombectomy. All of those things collectively in those two recent studies, the ATTENTION trial and the BAOCHI trial, I think is what ended up making those studies positive, is that we were selecting the right types of patients, uh, without large core, early core, and patients with moderate to severe deficits that made the difference from previous trials.  Dr Albin: Yeah. I think that that's so important. Those trials to me, and like how long it took to get those enrolled, really emphasized to me that there really was a selection bias. Like, we believed this worked, which made it hard to then do a trial. But I'm so glad to hear that we have the data now to support moving forward in a more rigorous way.  Dr Leon-Guerrero: You're absolutely right. I think that was some of the challenges with the initial trials. In fact, the authors had commented on that. There's a lot of difficulties with lack of clinical equipoise, or experts wanting to take these patients anyways out of clinical trial and treat them, and so that's always been an issue. And then, you know, we all remember basilar artery occlusion cases. They can be severe, devastating cases in our career, but the reality is they're not that common. So, if you look at large vessel occlusions, they only account for about 10%, and if you look at all stroke patients presenting to most centers, they represent about 1% of cases. So really hard clinical trials to do just because there's thankfully not a lot of patients walking around with basilar artery occlusions, but certainly makes for challenges when you're trying to conduct randomized controlled trials on this subset of patients.  Dr Albin: Absolutely. But we did it, and I think that, like, really if, if the listeners take nothing else, it's that the field of vascular neurology is really moving forward with evidence-based, doing very rigorously controlled clinical trials, which is, I think, is what makes this field so exciting. Finally, closing out, cause we could talk all day, but we don't have all day. You know, it seems to me that more and more we are just using dual antiplatelet therapy all the time. And maybe that is, uh, a little bit of a hyperbole, cause I don't think it's all the time, but let's walk through— when is there good evidence for dual antiplatelet therapy?  Dr Leon-Guerrero: Yeah. So, there's strong evidence for early initiation of dual antiplatelet therapy or DAPT in patients with minor stroke or high-risk TIAs, and it's been studied using both clopidogrel as an add-on to aspirin and ticagrelor. Both seem like they're viable options in patients. I think one of the key things is the duration of therapy. So, in these cases with minor stroke and high-risk TIAs, we really should be confining the treatment of early DAPT for 21 days. The risk profile changes, so the risk of recurrent stroke starts to decline with time, and that risk of hemorrhage complications increases with time. And so that sweet spot of 21 days, or even some centers will do 30 days for just practical purposes, you know, really is what we should be doing in most of those cases. Other instances where DAPT can be considered, is in patients with intracranial atherosclerosis that's symptomatic, extrapolating from the SAMMPRIS trial that in the, in the medical management arm alone, used dual antiplatelet therapy with aspirin and clopidogrel for up to 90 days. So, you'll see that as well in clinical practice. Some people will opt for a 90-day duration for those patients with symptomatic intracranial atherosclerosis and stroke.  Dr Albin: Just so I emphasize, this is not set it and forget it. You can stay on DAPT forever. It is you're going to have a definitive time course, 21 days, 90 days. We have directed instructions where we're doing more benefit than harm because of that risk of hemorrhage.  Dr Leon-Guerrero: That's correct. In most cases, we really should be confining the duration of DAPT either to 21 days or 90 days. This is a challenging clinical practice. Centers really have been making an emphasis on stroke follow-up, so making sure these patients get appropriate and timely stroke follow-up to address these issues and to make sure that DAPT is discontinued if appropriate.  Dr Albin: Yeah. I love that, and I want to pull on that a little bit because you as someone who is helping direct a stroke center– A lot of this really does rely on systems of care. When we think about early lysis decisions or mechanical thrombectomy, it's how do we get the patient to one of those capable centers as quickly as possible? And then on the back end, when you're discharging a patient, how do you make sure that they are getting follow-up, making sure that they're getting their Holter monitor if they need it? You know, all the stuff that goes into kind of figuring out, why did the stroke happen? What are some of the things that you, in your role, are really excited about, that will move the needle over the next five or 10 years?  Dr Leon-Guerrero: Yeah. I think a lot of centers are doing it just like we're doing it. It really has to be a team-based approach, and you really want to reach the patient where they are in terms of the continuum of care. And so making sure if it's the in the field that you've reached out to your EMS and first responders to make sure they understand triage protocols to get patients where they need to be, to get the acute treatments that they need for the type of stroke that they're presenting with, to the actual centers that you work at, making sure your whole team, nurses, emergency physicians, APPs that are involved in care are all aware of the stroke protocols and how we're selecting these patients, making sure that your imaging protocols are up to date, and so that it's seamless when patients come in, that we're not adding on perfusion if we should have gotten that up front– We already know, have made decisions before that patient gets there. And then thinking about the patient after that hospital stay, I think, is critical. We really want to reduce their risk of recurrence, making sure that we're leveraging transitions of care, getting those patients seen in our stroke clinics for follow-up, and then make sure we're passing that baton to the long term. All of their long-term comorbidities that may be increasing their risk of stroke are managed and reduced as best as possible.  Dr Albin: From the Continuum journal to the continuum of stroke care.  Dr Leon-Guerrero: That's right.  Dr Albin: I mean, we have it all. I think that that really is so important. I'll just close with what's one thing that is your favorite part about being a vascular neurologist?  Dr Leon-Guerrero: I think it's what attracted to me to this field. As a medical student at that time, all we had was intravenous thrombolysis, and there was so much promise. There was so much promise that there was going to be widespread advancements in acute stroke, and here we are. There's been a tremendous amount of advancements and improvements for patients. I'm really excited to see what unfolds in the next few years, and I'm really excited that we've been able to increase the number of patients we're able to treat with acute ischemic stroke. I hope that we continue to expand the time window, the inclusion criteria, all of those things that we can treat more stroke patients effectively.  Dr Albin: It is really a very exciting time to be a vascular neurologist. Again, today, I've been interviewing Dr. Christopher Leon-Guerrero about his article on Thrombolysis, Thrombectomy, and Antithrombotic Therapy for Acute Ischemic Stroke. This article appears in the April 2026 Continuum issue on cerebrovascular disease. Be sure to check out Continuum Audio episodes from this and other issues, and thank you again, Dr. Leon Guerrero and our listeners for joining today.  Dr Leon-Guerrero: Thanks for having me.  Dr Monteith: This is Dr. Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

This week on Do Politics Better, Brian Lewis and Skye David sit down with North Carolina Department of Natural and Cultural Resources Secretary Pam Cashwell to discuss her remarkable career in public service and her department's leadership role in commemorating America's 250th anniversary. Secretary Cashwell made history as the first Native American to serve in a North Carolina Governor's Cabinet. Throughout her career, she has been guided by a commitment to public service, holding leadership positions in civil rights enforcement, litigation, public safety, and state government. She reflects on the experiences that shaped her, the mentors who influenced her path, and why she believes public service remains one of the most meaningful ways to make a difference in people's lives. The conversation also explores North Carolina's plans for America 250, the nationwide commemoration of the 250th anniversary of the signing of the Declaration of Independence. As the state agency charged with preserving North Carolina's history, culture, and natural heritage, the Department of Natural and Cultural Resources is leading efforts to ensure communities across the state have opportunities to celebrate, learn, and reflect on the nation's founding and the many stories that have shaped North Carolina over the past two and a half centuries. Plus, Brian and Skye unpack another busy week in North Carolina politics. They provide the latest updates on state budget negotiations, veto override efforts at the General Assembly, and legislation that is moving—or waiting in the queue—as lawmakers race toward key deadlines. They also discuss the Carolina Hurricanes' visit to the legislature, reflect on the life and legacy of a former state senator following his passing, and cover a variety of other political developments from around the state. The Do Politics Better podcast is sponsored by New Frame, the NC Travel Industry Association, the American Heart Association, the NC Pork Council, the NC Realtors, Heal the System NC, and the NC Healthcare Association.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-490 Overview: In the US, maternal morbidity and mortality rates are among the highest in the western world, and stroke is one of the leading causes—responsible for 1 of 12 maternal deaths. This rate is estimated to be much higher in high-risk pregnancies. Join us as we discuss a recent study examining rates of maternal stroke in which 1 in 4 women with stroke experienced a missed diagnostic opportunity and hear what these findings mean for your practice. Episode resource links: Haghighi N, Bourscheid RM, Shang C, et al. Identifying missed diagnostic opportunities in maternal stroke. Stroke. 2026;57(2). doi:10.1161/STROKEAHA.125.052995 Chen Y, Shiels MS, Uribe-Leitz T, et al. 2025. Pregnancy-Related Deaths in the US, 2018-2022. JAMA Network Open.  Lappen JR, Pettker CM, Louis JM. 2021. American Journal of Obstetrics and Gynecology. Society for Maternal-Fetal Medicine Consult Series #54: Assessing the Risk of Maternal morbidity and Mortality. American Journal of Obstetrics and Gynecology. Miller EC, Bello NA, Chen PR, et al 2026. Prevention and Treatment of Maternal Stroke in Pregnancy and Postpartum: A Scientific Statement from the American Heart Association. Stroke.  Bushnell C, Kernan WN, Sharrief AZ, et al. 2024. Guideline for the Primary Prevention of Stroke: A Guideline from the American Heart Association/¬American Stroke Association. Stroke.  Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Sometimes V-fib doesn't respond to the shock at all. Sometimes it converts and comes right back. Those are two completely different problems.In this episode, Sarah breaks down the science behind why defibrillation fails, how to recognize the difference between refractory and recurrent V-fib, and respond when shocks aren't working. You'll learn how to start approaching the electrical storm at the bedside — that means understanding transthoracic impedance, optimizing your pad placement, and knowing when to reach for double sequential defibrillation.Topics discussed in this episode:Refractory vs. recurrent V-fibThe physiology of ventricular fibrillation and re-entry tachycardiasMisconceptions about defibrillationTransthoracic impedance and how to reduce itAnterior-lateral vs. anterior-posterior pad placementDouble sequential defibrillation: evidence and objectionsKey findings from the DOSE VF trialAmerican Heart Association. (2025). 2025 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation.Cheskes, S., Dorian, P., Feldman, M., McLeod, S., Scales, D. C., Pinto, R., Turner, L., Morrison, L. J., Drennan, I. R., & Verbeek, P. R. (2020). Double sequential external defibrillation for refractory ventricular fibrillation: The DOSE VF pilot randomized controlled trial. Resuscitation, 150, 178–184. https://doi.org/10.1016/j.resuscitation.2020.02.010D. Hasegawa, A. Sharma, Y. I. Lee, & R. Sato. (2023). A systematic review and meta-analysis of esmolol for refractory ventricular fibrillation and pulseless ventricular tachycardia. Chest, 164(4 Suppl.), A1568. https://doi.org/10.1016/j.chest.2023.07.1077International Liaison Committee on Resuscitation. (2025). 2025 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR).Mentioned in this episode:CONNECT