Podcasts about American Heart Association

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.

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.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 

Anthropic treft een schikking van 1,5 miljard dollar, nadat het bedrijf miljoenen boeken zonder toestemming gebruikte om AI-modellen te trainen. Uit onderzoek van techredacteur Niels Kooloos blijkt dat ook bekende Nederlandse titels, zoals ‘Het diner’ van Herman Koch en ‘De ontdekking van de hemel’, in de gebruikte databanken voorkomen, waardoor Nederlandse auteurs via het Amerikaanse systeem aanspraak kunnen maken op een vergoeding. Minister van Justitie en Veiligheid David van Weel voert de druk op om topcrimineel Jos Leijdekkers, alias Bolle Jos, uitgeleverd te krijgen uit Sierra Leone. Samen met Ghana en Liberia werkt Nederland aan een regionale coalitie tegen cocaïnesmokkel, met scanners op luchthavens en een permanent secretariaat, maar volgens Afrika-correspondent Sophie van Leeuwen staan corruptie en lokale belangen in de weg bij een snelle uitlevering. Goed nieuws voor alle koffie liefhebbers. Uit nieuw onderzoek van de American Heart Association blijkt namelijk dat 400 milligram cafeïne per dag - zo'n 5 kopjes per dag - goed voor je is. De wetenschappers leggen zelfs een verband tussen cafeïne en een betere gezondheid van het hart Deze omschrijving is met AI gemaakt en gecontroleerd door een BNR-redacteur. Over deze podcast BNR Nieuws Vandaag is de podcast met daarin BNR Ochtendnieuws en BNR Avondnieuws. Je krijgt ’s ochtends vroeg en aan het einde van de werkdag in 20 minuten het belangrijkste nieuws van de dag. Abonneer je via bnr.nl/podcast/bnrnieuwsvandaag, de BNR-app, Spotify en Apple Podcasts. Of luister elke dag live via bnr.nl/live.See omnystudio.com/listener for privacy information.

Digital Content Editor, Barbara Friedman, shared her top three stories trending online. Views and News with Clarence Ford is the mid-morning show on CapeTalk. This 3-hour long programme shares and reflects a broad array of perspectives. It is inspirational, passionate and positive. Host Clarence Ford’s gentle curiosity and dapper demeanour leave listeners feeling motivated and empowered. Known for his love of jazz and golf, Clarrie covers a range of themes including relationships, heritage and philosophy. Popular segments include Barbs’ Wire at 9:30am (Mon-Thurs) and The Naked Scientist at 9:30 on Fridays. Thank you for listening to a podcast from Views & News with Clarence Ford Listen live on Primedia+ weekdays between 09:00 and 12:00 (SA Time) to Views and News with Clarence Ford broadcast on CapeTalk https://buff.ly/NnFM3Nk For more from the show go to https://buff.ly/erjiQj2 or find all the catch-up podcasts here https://buff.ly/BdpaXRn Subscribe to the CapeTalk Daily and Weekly Newsletters https://buff.ly/sbvVZD5 Follow us on social media: CapeTalk on Facebook: https://www.facebook.com/CapeTalk CapeTalk on TikTok: https://www.tiktok.com/@capetalk CapeTalk on Instagram: https://www.instagram.com/ CapeTalk on X: https://x.com/CapeTalk CapeTalk on YouTube: https://www.youtube.com/@CapeTalk567See omnystudio.com/listener for privacy information.

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.

Dr. Chris Labos, cardiologist with a degree in epidemiology and a regular contributor on CJAD 800. He joins Sue Smith, in for Aaron Rand.

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.

Ep 279 Why is Rick Rubin Selling Athletic Nicotine? Kitty wants to know. Why is nicotine suddenly being marketed as a wellness product? In this episode, Kitty O'Compost turns her satirical eye toward the rise of “athletic nicotine,” a new generation of premium nicotine pouches aimed at runners, creatives, executives, and health-conscious high performers. Using Rick Rubin's podcast sponsorship as a starting point, Kitty explores how a highly addictive substance is being wrapped in the language of mindfulness, optimization, and intentional living. With humor, skepticism, and a trip through the False Consensus Detector, Kitty examines the growing effort to separate nicotine from its tobacco past and position it alongside coffee, supplements, and other performance tools. Along the way, she asks whether beautiful branding can obscure biological reality and whether a wellness halo can transform public perception without changing the underlying molecule. Avis closes the episode with a personal reflection on his admiration for Rick Rubin's work and his repeated requests that Rubin reconsider promoting athletic nicotine to his audience. Listen for the peace. Referenced Materials & Studies: Corporate Strategy: Magazine, "How This Founder Changed Minds Instead of Pushing Sales" by Christopher Cason (April 2026). Link to Inc. Article Cardiovascular Risks:The American Heart Association (AHA) Policy Statement, "Impact of Smokeless Oral Nicotine Products on Cardiovascular Disease: Implications for Policy, Prevention, and Treatment" (Published in Circulation). This study tracks the adverse effects of oral pouches on cardiovascular biomarkers and the specific dangers of synthetic nicotine. https://pubmed.ncbi.nlm.nih.gov/39624904/ Excerpt: “Abstract. Smokeless oral nicotine products are addictive, and their use has potential adverse effects on some but not all biomarkers of cardiovascular risk. The use of some types of these products, for instance, is associated with an increased mortality risk in those with ischemic heart or cerebrovascular disease. Similarly, smokeless tobacco has the potential to increase the risk of oral cancer, but the risks depend on the chemical composition of the product. The market of smokeless oral nicotine products has transformed since the last American Heart Association smokeless tobacco policy statement. Several varieties of tobacco-free oral nicotine products-including oral nicotine pouches; nontherapeutic nicotine gums, lozenges, and tablets; and nicotine gummies-have rapidly proliferated. The sales of oral nicotine pouches, in particular, have increased substantially; however, no data are available on their cardiovascular or health risks. In addition, synthetic (compared with tobacco-derived) nicotine has been used in some brands of oral nicotine products, but its cardiovascular and health effects have been inadequately studied. Robust public policy levers are identified to support ending addiction to all commercial tobacco products. Critical components and policy initiatives include clinicians emphasizing the prevention of tobacco product initiation and supporting cessation with established pharmacological and behavioral tobacco dependence treatment therapies as primary goals for achieving an end to commercial tobacco and nicotine addiction.” Public Health Data:The Centers for Disease Control and Prevention (CDC) Fact Sheet on Oral Nicotine Pouches, highlighting rapid dependency loops, systemic toxicity, and the acceleration of youth addiction through modern marketing. Excerpts: “There are no safe tobacco products, including nicotine pouches. This is especially true for youth, young adults, and women who are pregnant.” “More research is needed to better understand the short- and long-term health effects of using nicotine pouches.” Join the Community / Get the Books:AvisKalfsbeek.com  

Welcome to the Plant-Based Canada Podcast! In today's episode, we're joined by Dr. Vasanti Malik to discuss sustainable, healthy diets and environmental impacts. Dr. Vasanti Malik is an Associate Professor in the Department of Nutritional Sciences at the University of Toronto and holds a Tier 2 Canada Research Chair in Nutrition and Chronic Disease Prevention. She also serves as an adjunct faculty member at the Harvard T.H. Chan School of Public Health. Dr. Malik earned her MSc in Nutritional Sciences from the University of Toronto and a dual doctorate in Nutrition and Epidemiology from Harvard, where she also completed postdoctoral training.Her research focuses on dietary and lifestyle determinants of obesity and cardiometabolic diseases across diverse populations and life stages, with additional expertise in environmental sustainability and food systems. Using epidemiological studies, clinical trials, and evidence synthesis, she has published more than 150 peer-reviewed papers that have informed dietary guidelines and health policy internationally. Dr. Malik has contributed to expert advisory initiatives with organizations including World Health Organization and American Heart Association, and collaborates on global nutrition and chronic disease prevention research in Canada, the United States, and internationally.WebsiteDr. Vasanti Malik: https://nutrisci.med.utoronto.ca/faculty/vasanti-malikResources:TOsustain: https://utsc.utoronto.ca/foodandfarm/tosustainTMU Urban Farm: https://www.torontomu.ca/sciencerendezvous/activity-booths/urbanfarm/Lancet Planetary Health Abstract: https://pubmed.ncbi.nlm.nih.gov/38632913/ Diabetes & Community Gardens: https://healthypopulationsnetwork.utoronto.ca/news/catalyst-grants-fund-projects-aimed-reducing-type-2-diabetes-risk-peel-region Plant-Based Canada's Socials:Instagram  (@plantbasedcanadaorg)Facebook (Plant-Based Canada, https://m.facebook.com/plantbasedcanadaorg/)Website  (https://www.plantbasedcanada.org/)X / Twitter @PBC_orgBonus PromotionCheck out University of Guelph's online Plant-Based Nutrition Certificate. Each 4-week course will guide you through essential plant-based topics including nutritional benefits, disease prevention, and environmental impacts. You can also customize your learning with unique courses such as Plant-Based Diets for Athletes and Implementing a Plant-Based Diet at Home. As the first university-level plant-based certificate in Canada, you'll explore current research, learn from leading industry experts, and join a community of like-minded people. Use our exclusive discount code PBC2026 to save 10% on all Plant-Based Nutrition Certificate courses. uoguel.ph/pbn.Thank you for tuning in! Make sure to subscribe to the Plant-Based Canada Podcast so you get notified when new episodes are published. This episode was hosted by Stephanie Nishi RD, PhD.Support the show

This week, how workplace wellness can boost our energy and focus, the best ways to store and cook with olive oil, and how a quick brain type test may reveal how our mind works when it comes to weight loss. Plus, where to learn life-saving CPR skills and simple mood boosters to lift our spirits naturally.  Hear practical habit-building tips (cue, craving, response, reward) and everyday swaps to improve health, plus buying and storage advice for extra virgin olive oil — why darker bottles, cool cupboards, and mindful cooking matter. Learn about CPR and AED training, the American Heart Association's Nation of Lifesavers effort, and pick up simple workplace-wellness and instant mood-boosting strategies to fight fatigue and burnout.

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.

Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/23-06-2026Nesta terça-feira, analisamos a importância do vínculo na pediatria, um alerta cardiovascular sobre os cigarros eletrônicos e o papel da ancestralidade na oncologia de precisão. Discutimos um estudo nacional que comprova como a falta de um médico de atenção primária de referência aumenta a dependência das crianças pelo pronto-socorro como principal porta de entrada no sistema de saúde. Detalhamos a pesquisa apresentada na American Heart Association revelando que aditivos sintéticos com efeito "ice" em vapes provocam arritmias e estresse celular cardíaco. Por fim, no Radar, abordamos um estudo brasileiro com mais de mil pacientes com câncer de pulmão que mapeou a influência das mutações no gene TP53. Afya News. Informação médica confiável e atualizada no seu tempo.

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.

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

NC Family Policy Council Lobbyist Jere Royall sits down for a fascinating conversation about politics, family, and the power of relationships in #ncpol. Jere is the son of the late Sen. Ken Royall, one of the most influential figures in modern North Carolina political history when he became both the Senate Majority Leader and Appropriations Chairman decades ago. Gov. Jim Hunt described the Durham legislator as "a master of the legislative process" who helped shape state policy from education and economic development to mental health reform and hospitals. Despite growing up in a household led by a Democratic political giant, Jere charted a different path. He became a lobbyist and advocate for many of the social and family policy causes most closely associated with North Carolina conservatives and the Republican Party.  Jere reflects on lessons learned from his father, the values that shaped his own political worldview, and how respect, trust, and personal relationships still matter in a highly polarized political environment. Plus, Skye and Brian break down the latest political news, including budget news, political news, an election bill, a rumor, the Canes win, 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.

Many people worry about memory loss and cognitive decline as they age. In this episode of Health Matters, host Courtney Allison speaks with Dr. Matthew Fink, neurologist-in-chief at NewYork-Presbyterian and Weill Cornell Medicine, about how lifestyle choices—especially diet—can help protect the brain. Dr. Fink explains the MIND diet, a combination of the Mediterranean and DASH diets, which emphasizes whole foods like leafy greens, berries, fish, nuts, and olive oil while limiting salt, sugar, and ultra-processed foods. He breaks down how key nutrients such as B vitamins and antioxidants support brain metabolism, reduce inflammation, and may slow the aging process. The conversation also highlights the brain's high energy demands and why proper nutrition is essential for cognitive function. Dr. Fink shares research showing that healthy lifestyle interventions can significantly lower the risk of dementia and discusses the broader benefits of the MIND diet for heart health and stroke prevention. Finally, Dr. Fink outlines additional habits that support brain health, including regular physical activity, quality sleep, and social connection, emphasizing that even small, gradual changes can lead to meaningful long-term benefits.   Chapters 00:00 – Why Brain Health Is in Your Control How lifestyle choices can reduce dementia risk and why prevention starts early 03:00 – What Is the MIND Diet? Key components of the Mediterranean and DASH diets and how they support the brain 06:00 – Brain-Boosting Nutrients and Foods to Avoid The role of B vitamins, antioxidants, and which foods increase risk 10:30 – Beyond Diet: Exercise, Sleep, and Daily Habits How movement, rest, and social connection contribute to cognitive health     Key Topics Covered MIND diet overview Mediterranean diet and DASH diet Brain metabolism and energy use B vitamins and brain health Antioxidants and inflammation Foods that support cognitive function Foods to limit (salt, sugar, processed foods) Dementia and Alzheimer's prevention Stroke and heart disease connection Exercise and brain function Sleep and cognitive health Lifestyle changes for healthy aging   Takeaway Message You have more control over your brain health than you might think. By focusing on whole, nutrient-rich foods, limiting processed options, staying active, and getting enough sleep, you can significantly reduce your risk of cognitive decline and support a healthier brain as you age.   Doctor Bios Matthew E. Fink, MDis currently the Louis and Gertrude Feil Professor and chair of the Department of Neurology at Weill Cornell Medicine, and neurologist-in-chief at NewYork Presbyterian/Weill Cornell Medical Center.  In addition, he is chief of the Division of Stroke and Critical Care Neurology at NewYork-Presbyterian/Weill Cornell Medical Center, and vice chair of the medical board. Dr. Fink attended college at the University of Pennsylvania, medical school at the University of Pittsburgh, and served as resident and chief resident in internal medicine at the Boston City Hospital. He came to New York and trained in neurology at the Neurological Institute of NewYork-Presbyterian/Columbia University Irving Medical Center, and served as chief resident under Dr. Lewis P. Rowland. Subsequently, he joined the faculty of Columbia University and became the founding director of the Neurology-Neurosurgery Intensive Care Unit at NewYork-Presbyterian and was appointed associate professor of clinical neurology and neurosurgery while at Columbia. Dr. Fink was a founding member and chair of the critical care section of the American Academy of Neurology, and the research section for neurocritical care of the World Federation of Neurology. He is board-certified in internal medicine, neurology, critical care medicine, vascular neurology, and neurocritical care.  He has been elected as a Fellow of the American Neurological Association, the American Academy of Neurology, and the Stroke Council of the American Heart Association. Throughout his career, Dr. Fink has been involved in the education and training of students, residents and fellows in the field of stroke and critical care neurology, as well as an active participant in clinical research within this field. He is a leader in this new specialty, has lectured widely, and has published many research and clinical articles in the field of stroke and critical care. In addition, he currently serves as editor of the monthly publication, NEUROLOGY ALERT, and is a past-president of the New York State Neurological Society.

Are eggs bad for you because they may raise cholesterol?It's one of the most common nutrition questions in cardiology, and one of the most misunderstood. The reality is that raising cholesterol and harming your health aren't always the same thing, and when it comes to eggs, the data tells a much more nuanced and reassuring story than most people have been led to believe.In this conversation, Dr. Bret Scher walks through the science of eggs, cholesterol, and cardiovascular risk, cutting through decades of nutritional confusion to help you understand what it actually means for your individual dietary choices.You'll learn:Why the original "eggs cause heart disease" logic doesn't hold up under scientific scrutinyWhat happens to LDL and HDL when most people eat whole eggsWho the "egg hyper responders" are and what genetics has to do with itWhy hazard ratios in observational egg studies are often clinically unhelpfulWhat the American Heart Association now says about eggs and cardiovascular riskWhy eggs are one of the most nutrient dense whole foods availableHow to think about egg quality, quantity, and individual responseThe takeaway: eggs can be part of a healthy whole foods dietary pattern for most people. Context, metabolic health, and the totality of your diet often matter far more than any single food.

Primary stroke prevention is a critical opportunity for neurologists, with most stroke risk driven by modifiable factors such as hypertension and lifestyle behaviors. This episode highlights practical tools and strategies, including Life's Essential 8 and contemporary risk calculators, while also exploring evolving approaches to shared decision making and secondary prevention. In this episode, Katie Grouse, MD, FAAN, speaks with Mitchell S. Elkind, MD, MS, FAAN, author of the article "Stroke Prevention" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California, San Francisco in San Francisco, California. Dr. Elkind is the Chief Science Officer for Brain Health and Stroke at the American Heart Association in Dallas, Texas, and a professor of neurology and epidemiology at Columbia University in New York, New York. Additional Resources Read the article: Stroke Prevention 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 Guest: @MitchElkind Full episode transcript available here Dr Grouse: Neurologists have generally been more involved in secondary stroke prevention, but primary stroke prevention is increasingly recognized as an important topic of discussion for neurologists. Today, I have the opportunity to interview Dr. Mitchell Elkind, who wrote the article on stroke prevention in the newest Continuum issue on cerebrovascular disease.  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 Grouse: This is Dr. Katie Grouse. Today, I'm interviewing Dr. Mitchell Elkind about his article on stroke prevention. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Welcome to the podcast, and please introduce yourself to the audience.  Dr Elkind: Thank you so much, Katie. So, my name is Mitch Elkind, and I'm the Chief Science Officer for Brain Health and Stroke at the American Heart Association and a stroke neurologist by background.  Dr Grouse: Well, I just want to start by saying that I really enjoyed reading this article. I think this is just a really wonderful article I recommend strongly. Such a high yield, an important topic for a lot of us who see patients who are interested in learning about their stroke risks or need help with, uh, stroke prevention after having a stroke. So, I wanted to start. What's changed in the last couple of years? You know, what are some big highlights that you really want to stress that are different from maybe the last time we reviewed this topic?  Dr Elkind: Sure. Well, there's been a lot of development in the field of secondary stroke prevention, for one thing. But even beyond that, I think we increasingly appreciate how important it is to control what we call the social drivers of health on the earlier side, primordial or primary prevention. And that has been a big advance, I'd say. And I would also say, I think it's really important for neurologists to understand some of those questions about primordial and primary prevention. You know, we tend to get involved with patients after they've had a stroke or maybe a TIA, some kind of event. But sometimes we find people who are following for, you know, non-stroke related conditions who have risk factors also. And we can really play an important role in identifying those risk factors and helping to prevent a first stroke or vascular event as well. So, I think it's real important for us to be doctors even before we're neurologists. So, you know, Katie, about ninety percent of stroke risk is modifiable, so we can do a great job as neurologists in preventing stroke. And one of the most important things that we can do is to identify and treat high blood pressure. And recently, actually, the American Heart Association, American College of Cardiology guidelines on the management of hypertension have said that treatment of high blood pressure not only prevents stroke, but it can also help to prevent cognitive decline and dementia. And this is the first time that we've had a class of recommendation one and level of evidence A, the highest level of recommendation we give for the use of blood pressure treatment to prevent dementia. And that's largely based on the results of some large trials that have come out recently showing that you can prevent dementia with blood pressure control. So that's a really exciting link, I think, between cardiovascular risk factor control and subsequent brain health. It just illustrates the role that neurologists can play in, so many conditions outside of stroke as well.  Dr Grouse: That's a really great point, and I want to get a little more into the idea of primordial stroke prevention. Can you tell us a little bit more about what that might be?  Dr Elkind: So primordial prevention refers to addressing how we can prevent risk factors from occurring in the first place, and how can we improve the environments in which people live. You know, we know that only about twenty percent of health outcomes is dependent on what happens between the patient and their doctor in the office. About eighty percent of it is due to what happens in the environments in which we live, work, pray, and play. And so that's what we mean when we refer to the social drivers of health. What is the neighborhood like where somebody lives? Do they have access to healthy food? Do they have places where they can go to exercise? Is there air pollution in the area that may affect their health? You know, one really interesting fact that's become apparent in the last few years is that air pollution is a major risk factor for stroke. Something like a sixth of all strokes can be attributed to the quality of air. And so, what are the things we can do at the broader public policy, community level to reduce the risk of risk factors like high blood pressure and diabetes even before somebody has an event that brings them to the attention of the doctor? So that's what we're thinking about with regard to primordial prevention. It's the earliest stage in prevention.  Dr Grouse: And that's really fascinating. You know, I think an area that we haven't, as neurologists, really put a lot of our time thinking about, but clearly a very important thing. I really appreciated reading your article about how you incorporated the fact that, you know, a lot of these risk factors overlap very, very closely with all the risk factors for various types of cardiovascular events. And I would imagine that the work you've done as the Chief Clinical Science Officer for the American Heart Association has informed a lot of the way you've thought about-Trying to bring all these risks together and think a little bit more holistically about the whole thing. Could you tell us a little bit more about that and the work that you've done on the American Heart Association's Life's Essential 8 score?  Dr Elkind: Sure. I can't take credit for it. It's really work that was done by others at the Heart Association, particularly a cardiologist and epidemiologist named Don Lloyd-Jones. But many other volunteers participated. Life's Essential 8 is our approach to primary stroke prevention and cardiovascular prevention more broadly. We say Life's Essential 8 because it includes four health behaviors and four health factors that people can observe to reduce their risk of cardiovascular disease. The four factors are kind of things like know your numbers, your blood pressure, your blood sugar, your body mass index, right, which is a combination of weight and height, and your cholesterol level. So, know those numbers and keep them within the recommended ranges, and talk to your doctor if they're not. And then four lifestyle behaviors. So, one of them is to eat a healthy diet, and typically that means the Mediterranean diet. It means getting regular exercise, and we recommend 150 minutes a week of moderate to vigorous physical activity. Of course, it means abstinence from smoking or other tobacco products. And the last one, the eighth one, which I was so excited about when we added this, is sleep, recommending at least seven hours of sleep a night. So, I was really excited about this because we used to talk about Life's Simple 7, and then the last iteration of our recommendations included this recommendation for adequate sleep because of the mounting evidence of the importance of sleep to cardiovascular health. But sleep is really a brain function, right? And so, it was really the first, in a way, specific brain function that was added to our recommendations. So that's Life's Essential 8. People can read about it online at heart.org and recommend it to your patients as a simple way for people to understand the best approach to reducing their risk of cardiovascular disease, including stroke.  Dr Grouse: I checked it out myself after reading the article. It's very accessible to patients. It's a great education tool. And they can, you know, see their own score and use that in their own way to, to think about what their risks are and how they can help mitigate and then rescore themselves down the line. There's also, though, on the kind of more the clinician side, the PREVENT calculator as well. Could you tell us a little bit more about how we could use that in approaching this patient population?  Dr Elkind: Yeah. So, I think of Life's Essential 8 as being a patient-focused tool that people can use. PREVENT is really more for clinicians. Anybody can look it up online and enter your data into it. There's a risk calculator online. But the basic idea behind PREVENT and other similar risk calculators is that it's a way to estimate somebody's risk of having a cardiovascular event like stroke or a heart attack or even heart failure by entering information about your health. And we used to think, we used to use something called the ASCVD, atherosclerotic cardiovascular disease risk calculator, or the Framingham score. Framingham Heart Score, for example, was another one. PREVENT is the latest version, and it has several advantages over those earlier types of risk predictors. For one thing, it predicts risk at younger ages as well. It goes down to age 30. It predicts risk over a longer duration of time, so over 30, 10 or 30 years. It eliminates the use of race as an item to put into the calculator and substitutes for that socioeconomic status, so it's not a race base, but a measure of social disadvantage. And it also includes kidney elements, kidney measures. It includes renal function, for example, that weren't included in prior measures, and it can also be used to predict heart failure, which was not part of the original calculators. Another major advantage of the PREVENT study is that it was based on real-world data from about three million patients, many, many more than the 50,000 or so that the earlier risk calculators were based on. So, it has a much more robust data set and therefore allows a bit more precision in the ability to predict future risk of events. And typically, primary care doctors would enter their patient's data, calculate a risk, and then based on the results of the risk calculator, they can make recommendations about what type of medications a person should take or what other strategies they could use to reduce their risk. And so that's the role that PREVENT plays, is really being focused more for the clinician than the patient.  Dr Grouse: Really great tool for us to be aware of. You earlier alluded to the fact that neurologists are in the situation where we sometimes are helping patients with this primary prevention. But you also make a case for why it's in the patient's best interest for us to be involved in, in these conversations when we can, when we have the opportunity. Can you tell us more about that?  Dr Elkind: Shared decision-making is really important because we know that people aren't going to lead the healthiest possible lives if they're not invested in their care. And so, a doctor telling somebody what to do if the patient doesn't want to do it is gonna have limited benefit.So we emphasize the importance of shared decision-making as much as possible. And I think that where this comes up a lot is actually in the situation of, for example, atrial fibrillation, where patients will often be put on a blood thinner. And many people are fearful of blood thinners. They worry about the risk of bleeding. Maybe they know a relative who's had a bleeding complication from a blood thinner, and so they may be disinclined to try it. And so, it's really important to have these discussions about the risks and the benefits of medication and engage the patient in thinking about this. And there are even tools and visual aids that people can look to to help explain some of these complicated concepts to patients. So, these are the kinds of things that reflect implementation science as a way to improve adherence. We know what works in a clinical trial setting often, but the challenge is translating that into the real world and getting our patients to use the medications that we believe scientifically have been shown to be of benefit. I've actually been surprised sometimes at conversations I've had with people, in some cases, healthcare professionals who resist going on blood thinners because of their fear of the complications. And I feel like the evidence is there. Why don't they believe me? And that's why it's really important to have the conversation. Even our peers and colleagues can sometimes question the evidence, and it's important for us to be aware of that.  Dr Grouse: Absolutely. I think that sounds very reasonable to me, and hopefully these tools will help us with making some of these decisions with our patients. Now, turning our attention a little bit to secondary prevention. So, you know, someone's already had a stroke or a TIA, sort of thinking about what we can do to optimize their risk factors for further strokes. You know, I think there has been some changes that have happened, I think, in the last few years that might be affecting some of the decisions we're making and some of the advice we're giving our patients. I wanted to talk a little bit about GLP-1 receptor agonist medications. Is the data there to support use of this either in secondary prevention or even in primary prevention in the case of stroke?  Dr Elkind: There is evidence that supports the use of GLP-1s for stroke prevention. We need more data, though. We need trials that focus only on patients with stroke, for example, there have been studies in patients with cardiovascular disease broadly that include stroke patients. But if you look at the subcategory just of stroke patients alone, the data in that subgroup alone don't always show a benefit. And so, we need more data that's focused on stroke patients alone. So, I think the data are continuing to emerge, but we need more still.  Dr Grouse: Is there any development in the thought about whether we should be putting patients on antiplatelet therapies for incidental, incidentally identified strokes? For instance, if you got an MRI for migraine or for other reasons and you found one, no history of any stroke-like symptoms. Should we be putting these patients on aspirin or any other types of therapies?  Dr Elkind: That's a really great question. And again, it's an area where there's some controversy and really, there's really no definitive data that would support using antiplatelet therapy in people with incidentally discovered infarcts or what we call, you know, whispering strokes or silent strokes. Many stroke neurologists will use antiplatelet agents. This is one of those areas where it's so important to identify the risk factors. As we were saying before, patients who have other neurological disorders like migraine or epilepsy may turn out to have cardiovascular risk factors like diabetes and high blood pressure. That's why it's so important for neurologists to be able to treat those patients or refer them to specialists who can. Patients who have incidentally discovered lesions similarly are a group where we should be looking for risk factors. So, I don't think of it only in terms of do we put them on an antiplatelet or not, but really more holistically, can we identify their other risk factors and address those? Should the patient's information be entered into a risk calculator like PREVENT, for example, so that we can come up with a more global or holistic measure of their cardiovascular risk and address that as appropriate? Because if they are at risk for stroke, they're also at risk for cardiac events, including heart attack, heart failure, sudden cardiac arrest, and so forth. So, I think of it as a, as a great kind of teachable moment or an opportunity to catch somebody and bring them into the healthcare system more broadly and address those other potential risk factors.  Dr Grouse: Speaking of, of risk factors that we often like to think about and work up when possible, in cases where it seems certainly possible the patient had an embolic stroke, but perhaps we've done a few weeks or four weeks of cardiac monitoring, have not found any evidence of atrial fibrillation. What's new and what's the current recommendations for doing further monitoring when there's high suspicion for cardioembolic stroke?  Dr Elkind: This is a really active area of investigation, and guidelines suggest that we should do some cardiac monitoring for atrial fibrillation after an unexplained stroke, but it's not clear how much we should do. Studies generally show that the longer you follow somebody on a cardiac monitor after stroke, the more likely you are to detect atrial fibrillation. It could be as high as thirty percent after a few years. And that's great. And if you detect atrial fibrillation, people usually end up being recommended for a blood thinner. But how extensively we should monitor remains unknown. And I think a lot of the investigation recently has been around the question of, are there other ways to get that information rather than waiting six months or a year for the person to develop atrial fibrillation?It's a little bit funny logically to think a person has a stroke today, a year later you discover atrial fibrillation on the monitor, and you say, "Oh, now I know what caused your stroke a year ago." Right? The temporality, the causality perhaps is off in that case. And so, wouldn't it be better if we could tell what somebody's risk of having another cardioembolic stroke is, or the likelihood that they have atrial fibrillation is at the time that you first see them for the stroke, you know, in the hospital, for example. And so, there's some really new technologies that have evolved like AI or artificial intelligence interpretation of EKGs that can give a really good indication of which people are gonna go on to develop atrial fibrillation. And so, I think we need some more trials in that area to demonstrate that we can detect the risk of AFib and treat that even before it appears on one of those delayed monitors. That's an area that I think is very exciting right now. There's also a further question with regard to how to treat these patients, which is that sometimes atrial fibrillation is a consequence of the stroke itself. So, we can think about what people call known AF, meaning atrial fibrillation that's known about before the stroke even occurs, versus AF that's detected after a stroke, or AF-DAS, people will say. Those may have very different implications for the risk of recurrence and what the person's cardiovascular status is. So, I think what we've learned over the last few years is that atrial fibrillation, it used to be like the slam dunk for a stroke neurologist. It was the easy thing. You know, you had a stroke, you have AFib, you should be on a blood thinner. Now we know that there's lots of different kinds of AFib. There's AFib before stroke, there's AFib after stroke, there's burden of atrial fibrillation. So, some people may have 30 seconds of AFib, some people may have several hours, some people may be in it continuously. It comes and goes, and that can make it challenging to manage. So, we have a lot more work to do to understand this problem better.  Dr Grouse: That also gets me into some other interesting areas that I think there's still some question, you know, how aggressive should you be? How often is it a case of is this correlated or is this causative? For instance, when a patent foramen ovale is, is discovered in patients with cryptogenic stroke. Are there any tools or new developments to help us understand whether these PFOs should be closed in these cases?  Dr Elkind: PFO and stroke is a great story that's been going on for decades. And again, we've made tremendous progress in the last several years. So, it's true that about 20% or so of people have a PFO, and because of that, it can be really hard to say with any certainty whether an individual patient sitting in front of you, that the PFO was the cause of their stroke. Rarely we can have a really high degree of certainty. You know, if somebody has, uh, a DVT, for example, and shortly after that maybe they have pulmonary embolism and then a stroke, and we can say, "Oh, clearly this was a paradoxical embolism," went to the lungs and then some crossed over and went to the brain. That happens really infrequently. Most of the time you're faced with a patient who has a PFO and a stroke, and they may have some other risk factors. There are some tools that we can use to help figure out the likelihood that a PFO is related to a stroke. One of those is called the ROPE score or the risk of paradoxical embolism score that was developed by David Thaler and, uh, David Kent from Tufts and a group of other investigators as well. That score allows one to say what the likelihood is that the PFO was causative of the stroke, and it's based on a person's risk factors such that the younger you are, the more likely it is the PFO caused the stroke. And the absence of risk factors make it more likely that the PFO caused the stroke. So, the higher your ROPE score indicating the fewer other reasons you have a stroke, the more likely the PFO is to be causative. So that can be helpful in identifying patients who may have had a stroke due to their PFO. There are other features that are identified in something called the PASCAL score, which is a way of assessing the degree of shunting and whether or not there's an atrial septal aneurysm that can be used as additional factors that lead to the likelihood that a PFO was causative rather than just incidental. So, by putting this kind of information together, we can kind of do precision neurology or precision prevention by identifying which patients with a PFO are really the ones we need to worry about and do procedures like closure.  Dr Grouse: I look forward to hearing more and learning more as more advances are made in these areas. Dr Elkind: Thank you.   Dr Grouse: And thank you so much for joining us today to talk about your article.   Dr Elkind: Oh, I appreciate it. Thank you for giving me the opportunity. I really enjoyed it.  Dr Grouse: Again, today I've been interviewing Dr. Mitchell Elkind about his article on stroke prevention. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today.  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.

Click to Text Thoughts on Today's EpisodeWhen a friend described drooping eyes, slurred words, and fuzzy thinking at brunch — and then brushed it off as anxiety — I knew something wasn't right. That conversation sparked this important Common Sense episode on recognizing the warning signs of stroke, TIA, and heart attacks, and why acting fast can make all the difference. I hope this episode gives you a little more confidence and a little less hesitation if you ever need it. Share it with someone you love. It might matter more than you know.In This Episode:Why women are more likely to dismiss their symptoms — and the cost of waitingThe FAST acronym for stroke and TIA: F — Face droopingA — Arm weaknessS — Speech difficultyT — Time to call 911What a TIA (transient ischemic attack) is and why feeling better doesn't mean you're in the clearAdditional stroke warning signs beyond FASTHow heart attacks present differently in women — including jaw pain, back pain, nausea, fatigue, and shortness of breath with no chest pain at allWhy you should call 911 instead of driving yourselfA personal reflection on loss and the what-ifs we carryEpisodes Discussed:500th Episode: ​5 Uncomfortable Lessons from 500 Episodes​For more information on heart attacks and stroke visit:American Heart Association — heart.org — covers both heart attack and stroke, very thorough, well-organized for general audiencesAmerican Stroke Association — stroke.org — technically a division of AHA but has its own dedicated stroke content including FAST informationMy latest recommended ways to nourish and move your body, mind and spirit: Nourished Notes Bi-Weekly Newsletter30+ Non-Gym Ways to Improve Your Health (free download)Connect with Amy: GracedHealth.com Instagram: @GracedHealthYouTube: @AmyConnell

865. The USDA unveiled the 2025–2030 Dietary Guidelines for Americans, and the "Inverted Pyramid" has been sparking a lot of discussion. After a decade of MyPlate, why is the government returning to a pyramid visual—and why is it upside down?In this episode, Monica breaks down the major shifts in the new US guidance, including:The protein pivot: Why protein is taking center stage and what it means for your health.The plant-based omission: Why beans and legumes were left out of the new visuals despite the scientific evidence.The global gap: How the new US pyramid compares to the UK's Eatwell Guide and Canada's food plate.AHA vs. USDA: Why the American Heart Association is issuing its own "course correction" on salt and saturated fat.This episode will help you navigate these changes without losing sight of common-sense nutrition.Nutrition Diva is a Quick and Dirty Tips podcast, hosted by Monica Reinegal.New to Nutrition Diva? Check out our special Spotify playlist for a collection of the best episodes curated by our team and Monica herself! We've also curated some great playlists on specific episode topics including Staying Strong as We Age, Diabetes, Weight Loss That Lasts and Gut Health! Also, find a playlist of our bone health series, Stronger Bones at Every Age. Have a question for Nutrition Diva? Email: nutrition@quickanddirtytips.comFind Monica at wellnessworkshere.comDiscover more from Nutrition Diva:Facebook LinkedInNewsletterTranscripts available at QuickandDirtyTips.com. Hosted on Acast. See acast.com/privacy for more information.