Podcasts about hospitalized

Episode 212: Managing HFpEFHyo Mun and Jordan Redden (medical students) explain how to manage HFpEF with medications and touch some basics about nonpharmacologic treatments. Dr. Arreaza asks insightful questions to guide the discussion. Written by Hyo Mun, MSIV, American University of the Caribbean; and Jordan Redden, MSIV, Ross University School of Medicine. Comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Treatment of HFpEFArreaza: Mike, if you had to name the one therapy everyone with HFpEF should be on, what is it?Mike: That's easy! SGLT-2 inhibitors. This is the one slam-dunk we have in HFpEF. Empagliflozin (Jardiance) or dapagliflozin (Farxiga) should be started in essentially every patient with HFpEF, and it doesn't matter if they have diabetes or not.Jordan: And that's worth repeating, because people still think of these as “diabetes drugs.” They're not anymore. In HFpEF, SGLT-2 inhibitors reduce heart-failure hospitalizations, improve symptoms, improve quality of life, and even reduce cardiovascular death.Dr. Arreaza: They're also simple. Empagliflozin 10 mg daily or dapagliflozin 10 mg daily. No titration, no drama. The effectiveness of these meds was established around 2019 with DAPA-HF and later with DELIVER. These were trials thatdemonstrated that dapagliflozin reduces worsening heart failure and cardiovascular events across the full spectrum of heart failure, from reduced to preserved ejection fraction, independent of diabetes status.Mike: And the number needed to treat is about 28 to prevent one heart-failure hospitalization. That's excellent for a disease where we historically had almost nothing that worked.Jordan: They're also safe in chronic kidney disease down to an eGFR of about 25, which makes them even more useful in this population.Dr. Arreaza: Alright. We got SGLT-2 inhibitor, what's next?Mike: Volume management. Loop diuretics are still the backbone of symptom control in HFpEF. If the patient is volume overloaded, you diurese, and you diurese aggressively.Jordan: The goal is euvolemia. Dry weight, no edema, no orthopnea, no waking up gasping for air. A lot of these patients end up needing chronic oral loop diuretics to stay there.Dr. Arreaza: Something to remember: HFpEF patients don't tolerate congestion well, and being “a little wet” is not benign. Let's move into RAAS inhibition. Where do ARBs and ACE inhibitors fit in?Mike: Between ARBs and ACE inhibitors, ARBs are the winners in HFpEF. They actually reduce heart failure hospitalizations—drugs like candesartan, losartan, valsartan. ACE inhibitors? Not so much. They showed minimal benefit in older HFpEF patients, which is why we go with ARBs instead.Jordan: But a lot of clinicians get nervous about ACE inhibitors and ARBs because of kidney function, so it's worth talking through how these drugs actually work in the kidney.Dr. Arreaza: Yes, misunderstanding may lead to unnecessary drug discontinuation.Jordan: Under normal conditions, the afferent arteriole brings blood into the glomerulus, and the efferent arteriole is constricted by angiotensin II. That constriction keeps pressure high in the glomerulus and maintains filtration.Mike: Here's what happens with an ACE inhibitor: you block angiotensin II, the efferent arteriole relaxes, glomerular pressure drops, and GFR dips slightly. Creatinine bumps up a little, and that scares people, but that's actually the whole point—that's how you get kidney protection long-term.Jordan: High intraglomerular pressure causes hyperfiltration injury and scarring over time. Lowering that pressure protects the kidney long-term. The short-term GFR drop is the price you pay for long-term benefits.Dr. Arreaza: So let's talk about CKD, because this is where people panic.Mike: Right. ACE inhibitors and ARBs are not contraindicated in chronic kidney disease. In fact, they're recommended even in advanced stages. They reduce progression to kidney failure by about a third.Jordan: The key is how you use them. Start low. Check creatinine and potassium one to two weeks after starting, then periodically. A creatinine rise up to 30% from baseline is acceptable. That's not kidney injury, that's physiology.Dr. Arreaza: And what about potassium creeping up?Mike: You adjust the dose or add a potassium binder. You don't just automatically stop the drug.Dr. Arreaza: Now there is one absolute contraindication everyone needs to know about! (board exam test)Jordan: Bilateral renal artery stenosis. This is the big one. In these patients, the kidneys are completely dependent on angiotensin II–mediated efferent constriction to maintain GFR. Take that away, and GFR collapses.Mike: Creatinine can jump dramatically within days. If you see a creatinine rise of 20% or more shortly after starting an ACE inhibitor, you should be thinking about bilateral renal artery stenosis and stopping the drug immediately.Dr. Arreaza: After revascularization, though, many patients can tolerate ACE inhibitors again, so this isn't always permanent. What about cardiorenal syndrome? That's where things get uncomfortable.Mike: It is uncomfortable, but cardiorenal syndrome isn't a contraindication. These patients have severe heart failure and kidney disease, and their mortality is actually higher than patients with heart failure alone.Jordan: ACE inhibitors still reduce mortality and slow kidney disease progression in this group. Studies show that stopping ACE inhibitors during acute heart-failure admissions increases in-hospital mortality three- to four-fold.Dr. Arreaza: So we are cautious, but we don't avoid it.Mike: Exactly. Start low, titrate slowly, monitor labs closely, accept up to a 30% creatinine rise. You only stop if kidney function keeps worsening, or potassium gets dangerously high.Dr. Arreaza: Alright. Let's move on. What about mineralocorticoid receptor antagonists… MRA?Jordan: Spironolactone or eplerenone might reduce hospitalizations in HFpEF, but the data is mixed. This is more of a “select patients” situation.Mike: And you have to watch potassium and kidney function carefully, especially if they're already on an ACE inhibitor or ARB.Dr. Arreaza: What about sacubitril-valsartan, also known as Entresto®?Mike: Entresto may help patients with mildly reduced EF roughly in the 45 to 57% range. It's not first-line for HFpEF, but in select patients, it's reasonable.Dr. Arreaza: Now let's clarify one of the biggest sources of confusion: beta blockers.Jordan: Beta blockers are not a treatment for HFpEF itself. They're only indicated if the patient has another reason to be on them, like coronary disease or atrial fibrillation.Mike: And timing really matters here. You absolutely do not start beta blockers during acute decompensated heart failure. Their negative inotropic effects can make things worse when patients are volume overloaded.Jordan: But, and this is critical, you also don't stop them if the patient is already taking one. Abrupt withdrawal causes a sympathetic surge and dramatically increases mortality.Dr. Arreaza: If a patient is admitted on a beta blocker, what do we do?Mike: Continue it at the same dose or reduce it slightly if they're really unstable. Once they're euvolemic and stable, you can carefully titrate up.Jordan: And watch for chronotropic incompetence. HFpEF patients often rely on heart-rate response to exercise, and beta blockers can worsen exercise intolerance.Dr. Arreaza: Beyond medications, HFpEF is really about treating comorbidities. Aerobic activity can be an initial strategy to improve exercise intolerance and has evidence of improving aerobic function and quality of life. Sodium restriction: improves symptoms, does not decrease risk of death or hospitalizations.Mike: Hypertension control is huge. For diabetes, the SGLT-2 inhibitors will perform double duty. For obesity, weight loss improves symptoms, and GLP-1 agonists like semaglutide are absolute gamechangers.Jordan: Don't forget sleep apnea, atrial fibrillation, and lifestyle. Exercise improves the quality of life, even if it doesn't change hard outcomes. Lifestyle is the main treatment. Dr. Arreaza: And when should you refer to cardiology?Mike: You should refer when the diagnosis isn't clear; symptoms are not responding to treatment, difficult volume management, end-organ dysfunction, or if you are concerned about advanced heart failure.Dr. Arreaza: So, it has been a great discussion. What is the takeaway?Mike: HFpEF treatment isn't about one magic drug -- it's about volume control, SGLT2 inhibitors, smart use of RAAS blockade, and aggressive management of comorbidities.Jordan: And it's understanding the physiology, so you don't withhold life-saving therapies out of fear.Dr. Arreaza: Well said. If you found this helpful, share it with a friend or colleague and rate us wherever you listen. This is Dr. Arreaza, signing off.Jordan/Mike: Thanks! Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Barzin A, Barnhouse KK, Kane SF. Heart Failure With Preserved Ejection Fraction. Am Fam Physician. 2025;112(4):435-440.Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure. Circulation. 2022;145(18):e895-e1032.Kittleson MM, Panjrath GS, Amancherla K, et al. 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction. J Am Coll Cardiol. 2023;81(18):1835-1878.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.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.Pitt B, Pfeffer MA, Assmann SF, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370(15):1383-1392.Yusuf S, Pfeffer MA, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction. Lancet. 2003;362(9386):777-781.Solomon SD, McMurray JJV, Anand IS, et al. Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med. 2019;381(17):1609-1620.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.Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. 2022;28(3):583-590.Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from COVID-19. JAMA Cardiol. 2020;5(11):1265-1273.Basso C, Leone O, Rizzo S, et al. Pathological features of COVID-19-associated myocardial injury. Eur Heart J. 2020;41(39):3827-3835.Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601-615.Badve SV, Roberts MA, Hawley CM, et al. Effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in adults with estimated GFR less than 60 mL/min per 1.73 m². Ann Intern Med. 2024;177(8):953-963.Navis G, Faber HJ, de Zeeuw D, de Jong PE. ACE inhibitors and the kidney: a risk-benefit assessment. Drug Saf. 1996;15(3):200-211.Textor SC, Novick AC, Tarazi RC, et al. Critical perfusion pressure for renal function in patients with bilateral atherosclerotic renal vascular disease. Ann Intern Med. 1985;102(3):308-314.Hackam DG, Spence JD, Garg AX, Textor SC. Role of renin-angiotensin system blockade in atherosclerotic renal artery stenosis and renovascular hypertension. Hypertension. 2007;50(6):998-1003.Ronco C, Haapio M, House AA, et al. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52(19):1527-1539.Prins KW, Neill JM, Tyler JO, et al. Effects of beta-blocker withdrawal in acute decompensated heart failure. JACC Heart Fail. 2015;3(8):647-653.Jondeau G, Neuder Y, Eicher JC, et al. B-CONVINCED: Beta-blocker CONtinuation Vs. INterruption in patients with Congestive heart failure hospitalizED for a decompensation episode. Eur Heart J. 2009;30(18):2186-2192.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

As federal immigration enforcement efforts continue across California, families of detainees are struggling with a new problem. Many can't find loved ones who've been hospitalized after being detained by Immigration and Customs Enforcement. Guest: Claudia Boyd-Barrett, KFF Health News A federal judge blocked a California state law barring federal officers from wearing masks on Monday. But the ruling also handed the state a partial victory. Reporter: Marisa Lagos, KQED Learn more about your ad choices. Visit megaphone.fm/adchoices

The All Local Afternoon Update for Monday February 9th, 2026

Episode 211: Understanding HFpEF.  Hyo Mun and Jordan Redden (medical students) explain the pathophysiology of heart failure with preserved ejection fraction (HFpEF) and how it differentiates from HFrEF. Dr. Arreaza asks insightful questions and summarizes some key elements of HFpEF. Written by Hyo Mun, MS4, American University of the Caribbean; and Jordan Redden, MS4, Ross University School of Medicine. Comments and edits by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.What is EF? Just imagine, the heart is a pump, blood gets into the heart through the veins, the ventricles fill up and then squeeze the blood out. So, the percent of blood that is pumped out is the EF. Let's start at the beginning. What is HFpEF?Mike: HFpEF stands for heart failure with preserved ejection fraction. Basically, these patients squeeze normally—their ejection fraction is 50% or higher—but here's the thing: the heart can't relax and fill the way it should. The muscle gets stiff, almost like a thick leather boot that just won't stretch. And because the ventricle can't fill properly, pressure starts backing up into the lungs and the rest of the body. That's when patients start experiencing shortness of breath, leg swelling, fatigue—all those classic symptoms.Dr. Arreaza: And this is where people get fooled by the ejection fraction.Mike: Exactly. The ejectionfraction tells you total left ventricular emptying, not just forward flow.Jordan: The classic example is severe mitral regurgitation. You can eject 60% of your blood volume and still be in cardiogenic shock because most of that blood is leaking backward into the left atrium instead of going into the aorta. So, you get pulmonary edema, hypotension, fatigue, all with a “normal” EF. Which is honestly terrifying if you're over-relying on echo reports without thinking clinically.Dr. Arreaza: And in HFpEF, functional mitral regurgitation often shows up later in the disease. It's not usually the primary cause; it's more of a marker of advanced disease. Moderate to severe MR in HFpEF independently predicts worse outcomes, including a higher risk of mortality or heart failure hospitalization. So, let's contrast this with HFrEF. How are these two different?Mike: HFrEF—heart failure with reduced ejection fraction—is a pumping problem. The heart muscle is weak and can't contracteffectively. Ejection fraction drops below 40%, and this is your classic systolic dysfunction.Jordan: HFpEF, on the other hand, is diastolic dysfunction. The heart muscle is thick, fibrotic, and noncompliant. It squeezes fine, but it just doesn't relax, even though the EF looks reassuring on paper.Mike: I like to explain it this way: HFrEF is a weak heart that can't squeeze. HFpEF is a stiff heart that can't relax. Totally different problems.Dr. Arreaza: And then there's the gray zone: heart failure with mildly reduced EF, or HFmrEF. That's an EF between 41 and 49% with evidence of elevated filling pressures. It really shares the features of both worlds. So, what actually causes HFpEF versus HFrEF?Jordan: HFpEF is basically what happens when all the problems of modern living catch up with you. You've got chronic hypertension, obesity, diabetes, metabolic syndrome, aging, systemic inflammation—all of these things slowly remodel the heart over years. The muscle gets thick and stiff, and eventually the ventricle just loses its ability to relax. So, HFpEF is really a disease of metabolic dysfunction and chronic stress in the heart. Mike: HFrEF is more about direct injury. Think about myocardial infarctions, ischemic cardiomyopathy, viral myocarditis, alcohol toxicity, chemotherapy like doxorubicin, genetic cardiomyopathies, or chronic uncontrolled tachycardia. These insults actually damage or kill heart muscle cells, leading to a dilated, weak ventricle that can't pump effectively.Dr. Arreaza: So the short version: HFpEF is caused by chronic metabolic and hypertensive stress, while HFrEF is caused mainly by myocardial damage. A question we get a lot: does HFpEF eventually turn into HFrEF? What do you guys think?Mike: In most cases, no. HFpEF patients usually stay HFpEF throughout their disease course. They don't just “burn out” and turn into HFrEF.Jordan: They're generally separate disease entities with different pathophysiology. A patient with HFpEF can develop HFrEF if they have a big myocardial infarction or ongoing ischemia that damages the muscle, but that's not the natural progression.Mike: Interestingly though, the opposite can happen. Some HFrEF patients actually improve their ejection fraction with good medical therapy—that's called HF with improved EF—and it's a great sign that treatment is working.Dr. Arreaza: Another question. How do HFpEF and HFrEF compare to restrictive cardiomyopathy and constrictive pericarditis?Jordan: Clinically, they can all look very similar: dyspnea, edema, fatigue, but the underlying mechanisms are completely different.Mike: In HFpEF, the myocardium itself is stiff from hypertrophy and fibrosis. The problem is intrinsic to the heart muscle, and EF stays preserved. Echoshows diastolic dysfunction with elevated filling pressures.Jordan: In HFrEF, the myocardium is weak. The ventricle is often dilated and contracts poorly, with a reduced EF.Mike: Restrictive cardiomyopathy is different. Here, the myocardium gets infiltrated by abnormal stuff—amyloid, iron, sarcoid—and that makes it extremely stiff. It can look like HFpEF on the surface, but it's usually more severe. On Echo You'll see biatrial enlargement, small ventricles, and preserved EF. And importantly, it's a pathologic diagnosis, so you need advanced imaging or biopsy to confirm it.Jordan: Constrictive pericarditis is another mimic, but here the myocardium is usually normal. The problem is that the pericardium is thickened, calcified, and rigid. This will physically prevent the heart from being filled. Imaging shows pericardial thickening, septal bounce, and respiratory variation in flow, and cath shows equalization of diastolic pressures, which is the hallmark of constrictive pericarditis.Dr. Arreaza: So the takeaway is: HFpEF is a clinical syndrome driven by common metabolic and hypertensive causes, while restrictive and constrictive diseases are specific pathologic entities. If “HFpEF” is unusually severe or not responding to treatment, you need to think beyond HFpEF. Which type of heart failure is more common right now?Mike: Good question, the answer is: HFpEF. It now accounts for up to 60% of all heart failure cases, and it's still rising.Dr. Arreaza: Why is that?Jordan: Because people are living longer, gaining weight, and developing more metabolic syndrome. HFpEF thrives in older, or people with obesity, hypertension, or diabetes: basically, the modern American population. At the same time, better treatment of acute MIs means fewer people are developing HFrEF from massive heart attacks.Mike: HFpEF is the heart failure epidemic of the 21st century. It's honestly the cardiology equivalent of type 2 diabetes.Dr. Arreaza: Let's talk aboutCOVID-19. (2025 and still talking about it) Does it actually increase heart failure risk?Mike: Yes, absolutely. COVID increases both acute and long-term heart failure risk.Jordan: During acute infection, COVID can cause myocarditis, trigger massive inflammation, and precipitate acute decompensated heart failure, especially in patients with pre-existing disease. It also causes microthrombi, which can injure the myocardium.Mike: And after infection, even mild cases are linked to a significantly higher risk of developing new heart failure within the following year. Both HFpEF and HFrEF rates go up.Dr. Arreaza: I remember seeing this in 2021, we had a patient with acute COVID and HFrEF, her EF was about 10%, I lost contact with the patient and at the end I don't know what happened to her. What's the pathophysiology of COVID and heart failure?Mike: COVID causes direct viral injury through ACE2 receptors, triggers massive inflammation that damages the endothelium and heart muscle, leads to microvascular clotting and fibrosis—all mechanisms that promote HFpEF.Jordan: Add autonomic dysfunction, persistent low-grade inflammation, and worsening metabolic syndrome, and you've got a perfect storm for heart failure.Dr. Arreaza: Bottom line: COVID is a cardiovascular disease as much as a respiratory one. If someone had COVID and now has unexplained dyspnea or fatigue, think about heart failure. Get an echo, get a BNP, start treatment. Last big question: why did we have so many therapies for HFrEF but essentially none for HFpEF for years?Mike: HFrEF is mechanistically straightforward. You've got a weak heart with excessive neurohormonal activation going on — so you block RAAS, block the sympathetic system, drop the afterload. The drugs make sense.Jordan: HFpEF is messy. It's not one disease. It's stiffness, fibrosis, inflammation, microvascular dysfunction, metabolic disease, atrial fibrillation, all overlapping. One drug can't fix all of that.Mike: And some drugs that worked beautifully in HFrEF actually made HFpEF worse. Take Beta blockers, for example.  They slow heart rate, which is a problem because HFpEF patients rely on heart rate to maintain their cardiac output.Jordan: The breakthrough came with SGLT-2 inhibitors: diabetes drugs that unexpectedly addressed multiple HFpEF mechanisms at once: volume, metabolism, inflammation, and myocardial energetics.Dr. Arreaza: The miracle drug for HFpEF! Alright, let's wrap up.Mike: Bottom line: HFpEF is common, complex, and dangerous: even if the EF looks “normal.”Jordan: And if you're relying on ejection fraction alone, HFpEF will humble you every time.Dr. Arreaza: If you liked this episode, share it with a friend or a colleague and rate us wherever you listen. This is Dr. Arreaza, signing off.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Barzin A, Barnhouse KK, Kane SF. Heart Failure With Preserved Ejection Fraction. Am Fam Physician. 2025;112(4):435-440.Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure. Circulation. 2022;145(18):e895-e1032.Kittleson MM, Panjrath GS, Amancherla K, et al. 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction. J Am Coll Cardiol. 2023;81(18):1835-1878.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.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.Pitt B, Pfeffer MA, Assmann SF, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370(15):1383-1392.Yusuf S, Pfeffer MA, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction. Lancet. 2003;362(9386):777-781.Solomon SD, McMurray JJV, Anand IS, et al. Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med. 2019;381(17):1609-1620.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.Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. 2022;28(3):583-590.Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from COVID-19. JAMA Cardiol. 2020;5(11):1265-1273.Basso C, Leone O, Rizzo S, et al. Pathological features of COVID-19-associated myocardial injury. Eur Heart J. 2020;41(39):3827-3835.Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601-615.Badve SV, Roberts MA, Hawley CM, et al. Effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in adults with estimated GFR less than 60 mL/min per 1.73 m². Ann Intern Med. 2024;177(8):953-963.Navis G, Faber HJ, de Zeeuw D, de Jong PE. ACE inhibitors and the kidney: a risk-benefit assessment. Drug Saf. 1996;15(3):200-211.Textor SC, Novick AC, Tarazi RC, et al. Critical perfusion pressure for renal function in patients with bilateral atherosclerotic renal vascular disease. Ann Intern Med. 1985;102(3):308-314.Hackam DG, Spence JD, Garg AX, Textor SC. Role of renin-angiotensin system blockade in atherosclerotic renal artery stenosis and renovascular hypertension. Hypertension. 2007;50(6):998-1003.Ronco C, Haapio M, House AA, et al. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52(19):1527-1539.Prins KW, Neill JM, Tyler JO, et al. Effects of beta-blocker withdrawal in acute decompensated heart failure. JACC Heart Fail. 2015;3(8):647-653.Jondeau G, Neuder Y, Eicher JC, et al. B-CONVINCED: Beta-blocker CONtinuation Vs. INterruption in patients with Congestive heart failure hospitalizED for a decompensation episode. Eur Heart J. 2009;30(18):2186-2192.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

WDAY First News anchors Lisa Budeau, Scott Engen and Robert Poynter break down your regional news and weather for Tuesday, February 3. InForum Minute is produced by Forum Communications and brought to you by reporters from The Forum of Fargo-Moorhead and WDAY TV. Visit https://www.inforum.com/subscribe to subscribe.

In this episode: Former WWE star Braun Strowman hospitalized, Report on Rey Mysterio's condition following injury scare at WWE RAW, Triple H says that there are “a lot of surprises in store” for this Saturday's WWE Royal Rumble PLE, and Big E says “we were all robbed” of a Finn Balor babyface turn at WWE RAWKerr County Flood Relief Fund: https://cftexashillcountry.fcsuite.com/erp/donate/create/fund?funit_id=4201Support Katie: https://gofund.me/cb2cdcb5Support Eastern Kentucky: https://secure.kentucky.gov/formservices/Finance/emergencyrelief/American Red Cross: https://www.redcross.org/donate/cm/wlky32-pub.html/The Dream Center: https://www.ekdc.info/donateKCTCS Disaster Relief: https://kctcs.edu/disasterrelief.aspxUniversity of Kentucky Flood Relief: https://philanthropy.uky.edu/kentuckyfloodreliefIf you like what you hear on the podcast, consider helping me out a little bit financially at: https://www.patreon.com/jamminjon

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I spent last week in the hospital getting tests done after experiencing bad headaches. Everything came back clear, and I'm on the mend. While I was there, a line from Matthew McConaughey's book Greenlights kept coming to mind: "Can I live in a way that I look forward to looking back?" Sharing some thoughts on that experience and a few updates on what's coming up. EPISODE LINKS: Join the waitlist for You Are the Brand Academy » Greenlights (book) » CONNECT WITH ME Newsletter Instagram TikTok X (Twitter) LinkedIn Facebook

Hour 1 - Coach Self hospitalized in "an abundance of caution," but will miss away game in Colorado.

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Flu cases just hit a 30-year high with 11 million people sick, Ray J's hospitalized with pneumonia again, and the CDC just dropped new childhood vaccine guidelines. We're covering all of this on Dr. Frita LIVE! We'll get into why this flu season is worse than anything we've seen in decades, including what happened to 2-year-old Sara Lopez and what transverse myelitis actually does to the body. We're also clearing up pneumonia myths, talking through the new vaccine changes with RFK Jr. involved, and getting honest about Dr. Oz calling alcohol a "social lubricant" and Khloé Kardashian's kid-menu eating habits. Jump in with us live, ask your questions, and we'll figure out what all these headlines really mean for you and your family.This podcast is intended to be informational only.  It is not a medical consultation, nor is it personalized medical advice.  For medical advice, please consult your physician.#HealthHappyLifePodcast #DrFrita #DrFritaLIVE! #MedicalMondays #CelebrityHealthNews #MedicineInTheNewsHere are a few helpful resources to help on your journey to wellness:▶️ Subscribe so you will never miss a YouTube video.

Man tried to board a flight with his dead wife in a wheelchair. Chinese man hospitalized after putting a live leech inside his own body, and I won't say where. Study shows that Japanese people aren't having sex. // Weird AF News is the only daily weird news podcast in the world. Weird news 5 days/week and on Friday it's only Floridaman. SUPPORT by joining the Weird AF News Patreon http://patreon.com/weirdafnews - OR buy Jonesy a coffee at http://buymeacoffee.com/funnyjones Buy MERCH: https://weirdafnews.merchmake.com/ - Check out the official website https://WeirdAFnews.com and FOLLOW host Jonesy at http://instagram.com/funnyjones - wants Jonesy to come perform standup comedy in your city? Fill out the form: https://docs.google.com/forms/d/e/1FAIpQLSfvYbm8Wgz3Oc2KSDg0-C6EtSlx369bvi7xdUpx_7UNGA_fIw/viewform

The All Local Afternoon Update for Monday, January 12 2026

A former college football standout has been hospitalized due to severe burns. Correspondent Gethin Coolbaugh reports.

The CDC says Michigan is one of five states reporting very high levels of flu activity. Southeast Michigan has seen the most activity in the state. WWJ's Chris Fillar has your Wednesday, New Year's Eve, news briefs. (Photo credit: Getty Images)

It was two years into a vicious cycle of depression and Mike Doughty was falling apart. He was taking more Ambien than he had been prescribed, importing huge boxes of the stuff from India, waking up to find packs of cigarettes, candy wrappers, and pizza boxes with no memory of leaving his Memphis home to make such purchases. He was convinced something was deeply wrong with his heart even though every doctor said there wasn't. Finally, he checked into an in-patient facility that turned out to be wonderful and productive. Then he checked out. Then Mike, a recovering addict, started drinking heavily and smoking weed. Then he checked back in again. Mike Doughty is showing improvement now and talks about his treatment, his recovery, and touring again with his band Soul Coughing again 24 years after a bitter breakup.Thank you to all our listeners who support the show as monthly members of Maximum Fun.Check out our I'm Glad You're Here and Depresh Mode merchandise at the brand new merch website MaxFunStore.com!Hey, remember, you're part of Depresh Mode and we want to hear what you want to hear about. What guests and issues would you like to have covered in a future episode? Write us at depreshmode@maximumfun.org.Depresh Mode is on BlueSky, Instagram, Substack, and you can join our Preshies Facebook group. Help is available right away.The National Suicide Prevention Lifeline: 988 or 1-800-273-8255, 1-800-273-TALKCrisis Text Line: Text HOME to 741741.International suicide hotline numbers available here: https://www.opencounseling.com/suicide-hotlines

This is your All Local morning update for December 27, 2025.

ALSO: Overnight shootings on Indy's near east side leave 1 dead and 2 injured, woman fatally struck by SUV in hit and run crash, and Kountry Kitchen's 17th annual Christmas Giveback feeds thousands of families.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

An 18-year-old member of the South Oak Cliff football team was arrested early Sunday after accidentally shooting a teammate. In other news, more than 3 million package thefts with a value in excess of $159 million were reported in North Texas just this year. Dallas-Fort Worth ranked sixth among the 10 worst major metro areas for package theft; a man died during a house fire in Dallas' Singing Hills neighborhood Sunday. Firefighters responded around noon to reports of a fire at the one-story house in the 1200 block of Whispering Trail; and Anthony Davis had a dominant double-double of 35 points and 17 rebounds, but the Mavs lost 119-113 on Monday night. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Investigation underway into deputy-involved shooting in Imperial Beach, Teen hospitalized after being hit driver suspected of driving drunk in Imperial Beach, Rain expected for Christmas holiday

Anthony Joshua DESTROYS Jake Paul so bad, Paul gets HOSPITALIZED!

Hospitalized for months without knowing why and soon after changing her whole career, talk about a squiggle!Colleen and Kristine chat with Nicole Nell, also known as DJ Nicki Nell, who shares her journey from a professional dancer to a sought-after DJ and entrepreneur. Despite facing challenges like a severe illness and the COVID-19 pandemic, Nicole successfully pivoted her career, launching Visual Sound Productions which includes divisions for weddings, multimedia, AV production, and talent representation.DJ Nikki Nell: https://www.djnickinell.com/Follow Nikki: https://www.instagram.com/djnickinellStay in Touch with Your Hosts:Colleen on LinkedIn: https://www.linkedin.com/in/comara/Kristine on LinkedIn: https://www.linkedin.com/in/kristinethody/Subscribe wherever you get your podcasts for more conversations that transform career complexity into your competitive advantage!

Steelers TJ Watt HOSPITALIZED! Has surgery for COLLAPSED LUNG as Dry Needling treatment GOES BAD!

Join AST Nation and become a member today! https://www.youtube.com/@AllSteelersTalk/membership The Best Steelers Shirts On the Internet! https://blackandgoldapparel.myshopify.com/ Review Our Podcast (Please!): Spotify: https://open.spotify.com/show/4w67Psucw757d4pdH4jBDD?utm_medium=share&utm_source=linktree Apple: https://podcasts.apple.com/podcast/id1627248534?ign-itscg=30200&ign-itsct=lt_p Google: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vc3RlZWxlcnMtdG8tZ28 Everywhere else: https://linktr.ee/allsteelerstalk Follow Our Socials: TikTok: https://www.tiktok.com/@allsteelerstalk?lang=en Instagram: https://www.instagram.com/allsteelerstalk/ Twitter: https://twitter.com/AllSteelersFN Facebook: https://www.facebook.com/AllSteelers Learn more about your ad choices. Visit megaphone.fm/adchoices

Post-Gazette Steelers insiders Gerry Dulac and Ray Fittipaldo report from Thursday's practice at the team's facility ahead of its NFL Week 15 matchup with the Miami Dolphins on Monday Night Football. They start by breaking down the news that star outside linebacker T.J. Watt was in the hospital Thursday while being evaluated for a lung condition. While Watt's availability and status are up in the air, what will the Steelers defense look like if he can't go? Are Nick Herbig and Alex Highsmith prepared to step into that role? What about rookie Jack Sawyer? Who can help fill gaps as the Steelers prepare to face De'Von Achane and the strong Dolphins run game? What's with this streak of facing some of the NFL's best rushing attacks? And what is Derrick Harmon's status, as he revealed Thursday he's dealing with the same knee that caused him to miss games early in the season but a different injury? Our duo answers those questions and more. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

An NFL star has been hospitalized after experiencing an unexpected health issue. Correspondent Gethin Coolbaugh reports.

0:00 Intro 0:09 Divorce 6:15 Cut off 11:46 Suspicious cash Learn more about your ad choices. Visit megaphone.fm/adchoices

In which we talk Khloe Kardashian mold exposure, Rosalia's Southwest Airlines ventures, forgotten memories from Rihanna's 777 tour, Mad Men's 4K restoration errors, Sabrina Carpenter Trump songs, and Lily Allen's USB butt plugs. JOIN US ON PATREON BONUS EPISODES + TV TALK EVERY WEEK About Eating For Free: Hosted by journalists Joan Summers and Matthew Lawson, Eating For Free is a weekly podcast that explores gossip and power in the pop culture landscape: Where it comes from, who wields it, and who suffers at the hands of it. Find out the stories behind the stories, as together they look beyond the headlines of troublesome YouTubers or scandal-ridden A-Listers, and delve deep into the inner workings of Hollywood's favorite pastime. The truth, they've found, is definitely stranger than any gossip. You can also find us on our website, Twitter, and Instagram. Any personal, business, or general inquires can be sent to eatingforfreepodcast@gmail.com  Joan Summers' Twitter, Instagram Matthew Lawson's Twitter, Instagram

We have a listener that specifically scheduled surgery to avoid family over the holidays....whoa.  Also - how naughty has your elf on the shelf been already? Lotsa laughs today!

The All Local Afternoon Update for Friday, November 28th 2025

This week we’ve seen some pretty frightening headlines about food allergies and food contamination. Microbiologist Michael Robach (yes, Amy’s Dad) sits down with T.J. and Amy to talk about how a common tick bite led to a meat allergy that killed a New Jersey man. It’s important information everyone should hear. Then we dive into the massive baby formula recall that sickened 23 infants with Botulism. We talk about what botulism is, how it enters the food chain and what every parent needs to know. See omnystudio.com/listener for privacy information.

This week we’ve seen some pretty frightening headlines about food allergies and food contamination. Microbiologist Michael Robach (yes, Amy’s Dad) sits down with T.J. and Amy to talk about how a common tick bite led to a meat allergy that killed a New Jersey man. It’s important information everyone should hear. Then we dive into the massive baby formula recall that sickened 23 infants with Botulism. We talk about what botulism is, how it enters the food chain and what every parent needs to know. See omnystudio.com/listener for privacy information.

This week we’ve seen some pretty frightening headlines about food allergies and food contamination. Microbiologist Michael Robach (yes, Amy’s Dad) sits down with T.J. and Amy to talk about how a common tick bite led to a meat allergy that killed a New Jersey man. It’s important information everyone should hear. Then we dive into the massive baby formula recall that sickened 23 infants with Botulism. We talk about what botulism is, how it enters the food chain and what every parent needs to know. See omnystudio.com/listener for privacy information.

This week we’ve seen some pretty frightening headlines about food allergies and food contamination. Microbiologist Michael Robach (yes, Amy’s Dad) sits down with T.J. and Amy to talk about how a common tick bite led to a meat allergy that killed a New Jersey man. It’s important information everyone should hear. Then we dive into the massive baby formula recall that sickened 23 infants with Botulism. We talk about what botulism is, how it enters the food chain and what every parent needs to know. See omnystudio.com/listener for privacy information.

11.13.2025 #RolandMartinUnfiltered: Longest Shutdown In History Ends, DOJ Tries To Block Calif. Map, Rev. Jesse Jackson Hospitalized LIVE from the Butterfield Bermuda Championship. I'll show you my conversation with PGA golfer Chase Johnson later in the show. Here's what else is coming up on Roland Martin Unfiltered, streaming live on the Black Star Network. The longest government shutdown in history is over. Congresswoman Lauren Underwood will explain why we should expect everything to snap back to normal. In the nation's redistricting battle, Trump's DOJ is taking legal steps to block California's new congressional map, voted on by the people. Illinois is up next in the redistricting fight. State Senator Willie Preston will explain why he is more interested in protecting Black voters than in Democratic redistricting efforts. A federal judge heard arguments to disqualify interim U.S. Attorney Lindsey Halligan in the cases against former FBI Director James Comey and New York Attorney General Letitia James. They say she is improperly in her position as interim U.S. attorney for the Eastern District of Virginia. The Reverend Jesse Jackson is in a Chicago hospital under observation for a neurodegenerative condition. If you're not into baking but still need to bring a dessert to this year's holiday gathering, we've got just the thing for you. We have the perfect sweet treat to tell you about in tonight's Black Star Network Marketplace Segment. #BlackStarNetwork partner: Fanbasehttps://www.startengine.com/offering/fanbase This Reg A+ offering is made available through StartEngine Primary, LLC, member FINRA/SIPC. This investment is speculative, illiquid, and involves a high degree of risk, including the possible loss of your entire investment. You should read the Offering Circular (https://bit.ly/3VDPKjD) and Risks (https://bit.ly/3ZQzHl0) related to this offering before investing. Download the Black Star Network app at http://www.blackstarnetwork.com! We're on iOS, AppleTV, Android, AndroidTV, Roku, FireTV, XBox and SamsungTV. The #BlackStarNetwork is a news reporting platform covered under Copyright Disclaimer Under Section 107 of the Copyright Act 1976, allowance is made for "fair use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research.See omnystudio.com/listener for privacy information.

Rev. Jesse Jackson has been hospitalized for progressive supranuclear palsy. A.I. got a man wrongly arrested at a casino. New Arizona Democrat scorches Mike Johnson in first speech after she's finally sworn in. Host: Dr. Rashad Richey (@IndisputableTYT) Co-Host: Tehran Von Ghasri (@IAmTehran) *** SUBSCRIBE on ⁠⁠⁠YOUTUBE⁠⁠⁠  ☞ ⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/IndisputableTYT⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ FOLLOW US ON: ⁠⁠⁠FACEBOOK⁠⁠⁠  ☞ ⁠⁠⁠  ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/IndisputableTYT⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠TWITTER⁠⁠⁠  ☞     ⁠⁠⁠  ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.twitter.com/IndisputableTYT⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠INSTAGRAM⁠⁠⁠ ☞ ⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/IndisputableTYT⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit podcastchoices.com/adchoices

AP correspondent Karen Chammas reports on the health of the Reverend Jesse Jackson.

Robach and Holmes cover the latest news headlines and entertainment updates and give perspective on current events in their daily “Morning Run.”See omnystudio.com/listener for privacy information.

Robach and Holmes cover the latest news headlines and entertainment updates and give perspective on current events in their daily “Morning Run.”See omnystudio.com/listener for privacy information.

Robach and Holmes cover the latest news headlines and entertainment updates and give perspective on current events in their daily “Morning Run.”See omnystudio.com/listener for privacy information.

The longest shutdown in US history is officially over. Meanwhile, food stamp benefits and air travel may take a while to go back to normal. A House vote on releasing the full Epstein case files has been promised for next week. A British journalist detained by ICE for more than two weeks has returned to the UK. Plus, civil rights leader Jesse Jackson has been hospitalized. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Da Brat and the rest of the team celebrated Rickey Smiley’s 36 years in comedy, reflecting on milestones from opening for Martin Lawrence to his long-running radio legacy. The show also addressed community news, including updates on the shutdown resolution and Reverend Jesse Jackson’s hospitalization, with listeners encouraged to keep him lifted in prayer. See omnystudio.com/listener for privacy information.

The Rickey Smiley Morning Show kicked off with a major announcement that had music lovers buzzing. Questlove revealed a posthumous D’Angelo album is officially on the way, describing the sound as “yesterday but for the future,” and hinting at an intimate look behind the scenes of the late neo-soul icon’s creative world. From there, the crew dove straight into a spicy debate after NBA legend Jason Williams suggested Megan Thee Stallion might be distracting Klay Thompson from performing at his best, which sparked a playful but heated back-and-forth about relationships, superstition, and whether love can really affect an athlete’s game. The episode balanced that drama with heartfelt moments as the team celebrated Rickey Smiley’s 36 years in comedy, reflecting on milestones from opening for Martin Lawrence to his long-running radio legacy. The show also addressed community news, including updates on the shutdown resolution and Reverend Jesse Jackson’s hospitalization, with listeners encouraged to keep him lifted in prayer. Website: https://www.urban1podcasts.com/rickey-smiley-morning-show See omnystudio.com/listener for privacy information.

See omnystudio.com/listener for privacy information.

Robach and Holmes cover the latest news headlines and entertainment updates and give perspective on current events in their daily “Morning Run.”See omnystudio.com/listener for privacy information.

AP correspondent Donna Warder reports on an ammonia gas leak in Oklahoma.

AP correspondent Donna Warder reports on a toxic gas leak in Oklahoma.

Dr. Jennifer McNeely stops by the show to discuss her new article Medication for Opioid Use Disorder for Hospitalized Patients at Six New York City Public Hospitals with an Addiction Consult Service.   Article Link: Medication for Opioid Use Disorder for Hospitalized Patients at Six New York City Public Hospitals with an Addiction Consult Service

The final victim of the Annunciation Catholic Church and School shooting in Minneapolis was discharged from the hospital Thursday. 12-year-old Sophia Forchas was shot on August 27th in the mass shooting that left two dead and thirty injured. A Twin Cities man is the first defendant to plead guilty in a scheme to defraud a Medicaid housing assistance program.This is an MPR News Evening update, hosted by Emily Bright. Theme music is by Gary Meister.  Subscribe on Apple Podcasts, Spotify, YouTube or RSS.