Podcasts about Hypertension

Today, two conversations highlight how policy shapes public health, both in communities and on Capitol Hill.  First, Beth Giambrone, Senior Analyst for State Health Policy at ASTHO, explains how states are rethinking their approach to hypertension. From telehealth and remote blood pressure monitoring to expanded insurance coverage, policymakers are leveraging new technology to improve heart health across the lifespan. Later, Jeffrey Ekoma, ASTHO's Senior Director of Government Affairs, shares what's top of mind in Washington in preparing for ASTHO's upcoming Hill Day, from FY26 and FY27 appropriations to protecting public health infrastructure funding, navigating grant terminations. Jeffrey outlines key advocacy priorities, including sustained federal investment, workforce stability, and emerging issues such as vaccines, preparedness, and federal leadership transitions.Preventing Hypertension Through State Policy Efforts | ASTHOLeadership Power Hour: Your Launchpad for Impact | ASTHOFour Ways Public Health Agencies Are Strengthening Grants Management | ASTHO

Pregnancy over 40 is often surrounded by fear, but the real story is more nuanced than most women are told.In Part 2 of our Over 40 series, we break down what actually matters when considering pregnancy later in life, including medical risks, lifestyle factors, birth decisions, and even the surprising benefits of having babies in your 40s.If you've been labeled “advanced maternal age,” feeling pressure about timing, or wondering whether it's too late to grow your family, this episode offers an evidence-based and compassionate perspective.In this episode, we discuss:✔️ Induction pressure and spontaneous labor after 40✔️ How to evaluate pregnancy risks realistically✔️ Miscarriage and chromosomal risk explained simply✔️ When shorter age gaps may make sense biologically✔️ The truth about twins and fertility after 40✔️ Longevity myths — why later fertility may signal better health✔️ Breastfeeding, family planning & timing decisions✔️ Breast cancer risk reduction linked to pregnancy and nursing✔️ Lifestyle factors that matter most in pregnancy after 40✔️ Preconception health, nutrition, and exercise recommendations00:00 Trailer + Podcast Intro01:45 Episode Begins — Pregnancy & Birth Over 40 Overview02:13 Why More Women Are Having Babies After 4003:55 Advanced Maternal Age: What Actually Matters06:02 Chromosomal Risks Explained (Down Syndrome & Testing)08:00 NIPT Testing — Pros, Cons & When It Makes Sense10:14 Twin Pregnancy Risk After 4013:27 Miscarriage Statistics by Age16:54 Pregnancy Complications Over 40 (Hypertension & Preeclampsia)19:35 Placenta Previa Risk Factors21:35 Gestational Diabetes & Lifestyle Factors23:30 Growth Restriction & Paternal Health Influence24:58 Preterm Labor Risk25:47 Stillbirth Risk — What the Numbers Really Mean28:02 Induction & Cesarean Rates After 4030:35 Medical System vs Physiological Birth DiscussionPregnancy outcomes are influenced by far more than age alone: metabolic health, lifestyle, and individualized care play a major role. Whether you're trying to conceive, are currently pregnant, or are simply exploring your options, this episode aims to replace fear with clarity.Watch Part 1 of this series HEREOther Resources Mentioned:Dr. Morgan's 6 Week Pregnancy CallEpisode #31 The Power of ProgesteroneEpisode #150 Everything You Were Never Taught About The PlacentaEpisode #113 Breastfeeding and TTCFind more from Dr. Leah:Dr. Leah Gordon | InstagramDr. Leah Gordon | WebsiteWomanhood Wellness | WebsiteFind more from Dr. Morgan:Dr. Morgan MacDermott | InstagramDr. Morgan MacDermott | WebsiteUse code HEALTHYMOTHER and save 10% at FondUse code HEALTHYMOTHER and save 15% at RedmondFor 20% off your first order at Needed, use code HEALTHYMOTHERSave $260 at Lumebox, use code HEALTHYASAMOTHER

Helping you diagnose a common cause of hypertension!Hypertension is a growing disease globally, affecting millions of individuals and increasing the risk of heart disease and stroke. Along with the expert help of Dr. Vaidya (Brigham and Women's Hospital), we help reimagine the approach of clinicians in terms of hypertension and help them navigate common diagnostic dilemmas! @AnandVaidya17 (Bluesky) @AnandVaidya17 (X)Claim CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CMEShow Segments Introduction and Personal Interests Advice and Wisdom in Medicine  Case 1 Defining Primary Aldosteronism Screening for Primary Aldosteronism How common is Primary Aldosteronism Challenges in Diagnosis and Testing Medication Management and Testing Protocols Managing indeterminate cases Aldosterone Suppression Testing and its role Discussing treatment options with patients Case 2 Considering genetic causes of Primary Aldosteronism The need for AVS for lateralization Upcoming imaging modalities for Primary Aldosteronism Case 3 Medical Management of Primary Aldosteronism Future Directions in Treatment Credits Producer, Writer, Show Notes:Mobeen Ahmad MBBS  Infographic:Kate Grant MBChB MRCGP Cover Art:Kate Grant MBChB MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:  Anand Vaidya MD, MMSc DisclosuresDr. Vaidya has disclosed the following: Financial Relationships: Astra Zeneca-Consulting Fee and Corcept-Consulting Fee, relationships have not ended. The Curbsiders report no relevant financial disclosures. Sponsor: The Sanford GuideCurbsiders listeners can get 20% off the already very moderately priced yearly subscriptions directly at sanfordguide.com. Go to sanfordguide.com and use the code, CURB at checkout.Sponsor: MedStudy PodcastCurbsiders listeners get 15% off with code CURB15 atmedstudy.comSponsor: Panacea Legal Visit Panacea.Legal and use code CURB20 for 20% off contract review services.Sponsor: DeleteMeGet 20% off your DeleteMe plan when you go to joindeleteme.com/CURB and use promo code CURB at checkout.

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Hypertension is one of the most common conditions nurses manage, yet small details can make a big difference in patient outcomes. In this episode, we break down essential hypertension pearls every nurse should know. Whether you're preparing for exams or caring for patients at the bedside, this episode delivers concise, high-yield strategies to help you manage hypertension with confidence and clarity. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Hypertension medications are a cornerstone of nursing practice, and understanding how they work can dramatically improve patient safety and outcomes. In this episode, we break down the major antihypertensive drug classes, including ACE inhibitors, ARBs, beta blockers, calcium channel blockers, and diuretics, in a practical and easy-to-understand way. You'll learn how each class lowers blood pressure, key monitoring parameters, common side effects, and important nursing considerations. We'll also cover when to hold medications, what lab values matter most, and how to educate patients to improve adherence. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

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/.

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from February 7-13, 2026.

Is there a built-in "fat switch" in our genes—something nature designed to help us store fat for survival? And if so, what does that mean for food addicts living in a world saturated with ultra-processed food? In this episode, Dr. Vera Tarman sits down with Dr. Richard Johnson, Professor Emeritus at the University of Colorado, former Chief of the Division of Renal Diseases and Hypertension, author of The Sugar Fix, The Fat Switch, and Nature Wants Us to Be Fat, and a researcher with 700+ scientific papers to his name. Dr. Johnson explains how fructose (from sugar and high-fructose corn syrup—but also produced inside the body under certain conditions) can activate a powerful metabolic pathway that increases hunger, lowers cellular energy, and shifts calories toward fat storage. He connects this to uric acid, salt, high-glycemic carbohydrates, and the modern "perfect storm" of ultra-processed foods engineered to intensify cravings. Together, they explore the evolutionary logic of fat storage, why visceral fat may have had survival value, why "calories in/calories out" fails to explain the whole picture, and what practical steps can help people restore metabolic flexibility—including carbohydrate reduction, movement that supports mitochondrial health, and the emerging role of GLP-1 medications as a tool (not a replacement) for nutrition change. What You'll Learn

  Genes. Glands. Vessels.

The ProLongevity Podcast with Graham Phillips | Episode 44Chapters00:00 The Journey to Wellness and Metabolism06:37 The Transformative Power of Sauna13:02 Detoxification and Cellular Health23:37 The Role of Light in Energy Production33:41 The Impact of Modern Lighting on Health34:42 Dementia and Neurodegenerative Diseases37:34 The Role of the Nervous System in Healing40:29 Light Therapy and Brain Health47:28 Heat vs. Light Therapy: Understanding the Differences55:46 Sauna Use and All-Cause Mortality01:03:09 Future Perspectives on Sauna and Light Therapy01:08:15 TheProLongevityPodcast-Outro.mp4This podcast video is brought to you by ProLongevity, the multi-award-winning lifestyle change program that helps reverse and prevent and reverse avoidable killer diseases like Type 2 Diabetes, Strokes, and Hypertension.Founder of ProLongevity, Graham Phillips discusses the latest controversial yet scientifically proven breakthroughs in understanding how to live healthy for longer. View a range of topics that will offer a new understanding that will help improve your health. From the damage caused to public health, by Big Food and Big Pharma that costs the UK and US Billions, why you can't just simply run off extra pounds by joining the gym, the connection between the brain and gut, why certain diets don't always work and can even damage your health.Brian Richards Socials:https://www.instagram.com/iamthelovelight/?hl=enSaunaSpace: @SaunaSpaceGraham Phillips Socials:website - https://www.prolongevity.co.uk/X/Twitter - https://twitter.com/grahamsphillipsFacebook -https://www.facebook.com/Prolongevity1Instagram - https://www.instagram.com/prolongevity_In each episode, you'll meet world-renowned experts who fully support ProLongevity. After watching, feel free to reach out to Graham Phillips with any questions or for any advice by contacting him here. https://www.prolongevity.co.uk/For more great videos like this, make sure you've subscribed.Or why not join our private members Facebook Group for future events and webinars, packed with news, debates, educational resources, free health risk assessments, and much more; https://www.facebook.com/groups/278916313071738/

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/. 

Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from January 31-February 6, 2026.

In this episode of Liver Lineup: Updates and Unfiltered Insights, hosts Kimberly Brown, MD, and Nancy Reau, MD, break down several of the most consequential hepatology developments of 2025, focusing on practical advances in the management of patients with advanced liver disease. From renal protection in metabolic dysfunction-associated steatotic liver disease (MASLD) cirrhosis to long-debated questions around albumin dosing and emerging tools for monitoring hepatic encephalopathy at home, the discussion centers on how new data may begin to shift everyday clinical decision-making.Key episode timestamps:0:00:00 – Dapagliflozin in MASLD cirrhosis with ascites0:04:41 – Clinical perspective on dapagliflozin & management strategy0:06:37 – Albumin for hyponatremia in cirrhosis0:12:28 – How clinicians currently use albumin in practice0:18:43 – Low‑dose vs conventional‑dose albumin in high‑risk SBP 0:25:03 – Beacon device: at‑home critical flicker frequency for HE0:27:47 – Future of at‑home HE monitoring & closing remarks

Send a textKey Takeaways:Cardiovascular disease is the leading cause of death in women.Know your blood pressure and cholesterol numbers.Hypertension has different types—monitor consistently.Smoking cessation dramatically reduces risk.7–9 hours of sleep protects vascular health.Many heart conditions are preventable.Learning CPR saves lives.Support the showThe hashtag for the podcast is #nourishyourflourish. You can also find our firm, The Eudaimonia Center on the following social media outlets:Facebook: The Eudaimonia CenterInstagram: theeudaimoniacenterThreads: The Eudaimonia CenterFor more integrative reproductive medicine and women's health information and other valuable resources, make sure to visit our website.Have a question, comment, guest suggestion, or want to share your story? Email us at info@laurenawhite.com

High blood pressure is the number one risk factor for deaths globally. But what if your blood pressure numbers were only part of that story? In this episode, we're joined by leading cardiologist Dr Sanjay Gupta, who explains why blood pressure is not a disease, but often a scream for help. Together with ZOE's Chief Scientist, Professor Sarah Berry, he explores when blood pressure is a harmless response to stress, food, or movement, and when it signals real, long-term damage. You'll learn why blood pressure targets aren't universal, why worrying can make things worse, and why quality of life matters as much as numbers. This episode also breaks down what you can do to lower your blood pressure. Not quick fixes. Not pills. But everyday lifestyle changes that address the root cause. If your blood pressure is your body sending a message, what might it be asking you to change? Unwrap the truth about your food

Robert Kocher is an adjunct professor at the Stanford University School of Medicine, a nonresident senior scholar at the University of Southern California Schaeffer Institute, and a partner at Venrock. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. S.P. Kishore and R. Kocher. The Hypertension Control Paradox — Why Is America Stuck? N Engl J Med 2026;394:417-420.

In this episode of Moving Medicine Forward, Dr. Monica Shah, Chief Medical Officer at CTI and President-Elect of the American Heart Association's Greater Washington Region Board of Directors, reflects on why Wear Red Day holds personal significance to her.  Dr. Shah shares her path through cardiology and clinical research, the American Heart Association's community impact across the region, and the organization's priorities for advancing equitable care. She also shares her perspective on the future of cell and gene therapies and emphasizes the need for diverse representation in clinical trials. 01:08 Dr. Shah's path through cardiology, research training at Duke, and career across academia, NIH, and industry.03:38 Early involvement with the American Heart Association and the fellowship grant that launched her research career.05:35 Responsibilities and priorities as President‑Elect of the AHA Greater Washington Region Board.07:00 Leadership development and building a diverse pipeline of future AHA leaders.08:10 Regional community impact: CPR education, school programs, nutrition initiatives, and policy advocacy.10:07 Translating the AHA's national mission into local, lifesaving change - including DC's CPR Act.11:32 Hypertension control and partnerships addressing nutrition security.12:26 Barriers to cardiovascular health and how AHA programs support access and education.13:22 COVID‑19's long-term cardiovascular impact and AHA's research and telehealth initiatives.14:52 Advocating for equitable representation in clinical trials.15:59 Emerging opportunities in cell and gene therapy and the importance of genetic testing.17:34 How public–private partnerships accelerate cardiovascular innovation.18:55 Advice for early-career clinicians and researchers, especially women and underrepresented groups.20:00 Identifying and nurturing community and clinical champions.21:52 Dr. Shah's top priorities as incoming AHA president.23:05 How listeners can get involved and closing reflections on advancing heart health.

 We all know that sleep is important, but how much can eight hours really do for us? Turns out, a good night's rest does more than restore our energy; restful sleep helps regulate weight, blood sugar, and even blood pressure. Ding Zou, MD, PhD, and Mio Kobayashi Frisk, MD, of the University of Gothenburg, studied how conditions like sleep apnea and insomnia affect hypertension, with those getting less sleep having higher instances of elevated blood pressure levels. Host Patti Tripathi discusses their study, what solutions exist for better sleep, and what future studies may look like. Read the paper: https://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.202501-080OC 

The panel breaks down salt and fat intake, stroke risks, genetic individuality, and the science behind optimizing nutrient absorption. #SaltDebate #FatIntake #FunctionalMedicine #HealthTalks

In this episode, Tracey Davidoff, MD and Joe Toscano, MD discuss the December 2025 Evidence-Based Urgent Care article, An Evidence-Based Approach to Asymptomatic Hypertension in Urgent CareEpisode Overview: Asymptomatic HypertensionNew Guidelines and RecommendationsUnderstanding Blood Pressure NumbersEnd Organ Damage: The BARKH AcronymSafe Management of High Blood PressureLifestyle Modifications for HypertensionMedication Management in Urgent CareMeasuring Blood Pressure CorrectlySpecial Considerations: Pregnancy and HypertensionConclusion and Takeaways???? Subscribers, take the CME test here.✅️ Not a subscriber? Join here!

In this interview, Dr.SHIVA Ayyadurai, MIT PhD, Inventor of Email, Scientist, Engineer and Candidate for President, Talks about Oats on Hypertension: A Whole Systems Approach

This week, Brent sits down with Dr. Luke Laffin, a preventive cardiologist and hypertension specialist, to break down what blood pressure really tells us about long-term health. Dr. Laffin explains why high blood pressure is one of the strongest predictors of heart attack, stroke, kidney disease, and dementia, even when it shows up early or seems "borderline." They discuss how blood pressure should be measured correctly, the difference between office readings and home monitoring, and why lifestyle changes alone aren't always enough. The conversation also covers when medication makes sense, common myths about side effects, and how treating blood pressure early can dramatically reduce lifetime risk. He's a wonderful guest, hope you enjoy.

Nearly half of U.S. adults have undiagnosed hypertension, which increases risks for stroke, heart attack, and early brain impairment due to reduced oxygen and nutrient delivery to neural tissue Early hypertension triggers rapid cellular damage, including endothelial aging, neuronal energy loss, myelin disruption, and blood-brain barrier leakage, all of which accelerate inflammation and cognitive decline even before symptoms appear Long-term high blood pressure leads to changes such as white matter hyperintensities, microbleeds, and brain volume loss. These findings are strongly linked to slower processing, stroke risk, and dementia Dementia risk rises with midlife hypertension, and older adults with high blood pressure show accelerated brain aging; regular monitoring beginning around age 40 helps reduce long-term cognitive decline Treatment can reverse some early damage, while lifestyle strategies such as diet changes, exercise, and better sleep significantly lower blood pressure and help protect long-term brain health

Think you know the Health app? Think again. This episode unpacks Apple's quiet rollout of powerful and important features, from crash detection to real-time medication reminders, that are quietly transforming the way you can track your wellbeing. • Dive into emergency SOS, medical ID, and safety alerts • Apple Watch-exclusive notifications: heart rate, crash, fall, and walking steadiness • Hypertension and blood pressure notifications arrive for Apple Watch users • Cardio fitness, ECG, and irregular rhythm alerts explained • Court drama and a workaround for Apple's blood oxygen feature • Monitoring vitals, hearing safety, and sleep apnea detection • AFib history versus irregular rhythm notifications • Health data trends and fresh health records notifications • Sleep tracking, wind down routines, and schedule-based alerts • Medication reminders with smart time zone adjustments • Mental wellbeing tracking with state-of-mind check-ins and depression/anxiety quizzes • Walking steadiness notifications and quick access to the checklist Host: Mikah Sargent Download or subscribe to Hands-On Apple at https://twit.tv/shows/hands-on-apple Want access to the ad-free audio and video and exclusive features? Become a member of Club TWiT today! https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord.

Think you know the Health app? Think again. This episode unpacks Apple's quiet rollout of powerful and important features, from crash detection to real-time medication reminders, that are quietly transforming the way you can track your wellbeing. Dive into emergency SOS, medical ID, and safety alerts Apple Watch-exclusive notifications: heart rate, crash, fall, and walking steadiness Hypertension and blood pressure notifications arrive for Apple Watch users Cardio fitness, ECG, and irregular rhythm alerts explained Court drama and a workaround for Apple's blood oxygen feature Monitoring vitals, hearing safety, and sleep apnea detection AFib history versus irregular rhythm notifications Health data trends and fresh health records notifications Sleep tracking, wind down routines, and schedule-based alerts Medication reminders with smart time zone adjustments Mental wellbeing tracking with state-of-mind check-ins and depression/anxiety quizzes Walking steadiness notifications and quick access to the checklist Host: Mikah Sargent Download or subscribe to Hands-On Apple at https://twit.tv/shows/hands-on-apple Want access to the ad-free audio and video and exclusive features? Become a member of Club TWiT today! https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord.

Think you know the Health app? Think again. This episode unpacks Apple's quiet rollout of powerful and important features, from crash detection to real-time medication reminders, that are quietly transforming the way you can track your wellbeing. Dive into emergency SOS, medical ID, and safety alerts Apple Watch-exclusive notifications: heart rate, crash, fall, and walking steadiness Hypertension and blood pressure notifications arrive for Apple Watch users Cardio fitness, ECG, and irregular rhythm alerts explained Court drama and a workaround for Apple's blood oxygen feature Monitoring vitals, hearing safety, and sleep apnea detection AFib history versus irregular rhythm notifications Health data trends and fresh health records notifications Sleep tracking, wind down routines, and schedule-based alerts Medication reminders with smart time zone adjustments Mental wellbeing tracking with state-of-mind check-ins and depression/anxiety quizzes Walking steadiness notifications and quick access to the checklist Host: Mikah Sargent Download or subscribe to Hands-On Apple at https://twit.tv/shows/hands-on-apple Want access to the ad-free audio and video and exclusive features? Become a member of Club TWiT today! https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord.

Think you know the Health app? Think again. This episode unpacks Apple's quiet rollout of powerful and important features, from crash detection to real-time medication reminders, that are quietly transforming the way you can track your wellbeing. Dive into emergency SOS, medical ID, and safety alerts Apple Watch-exclusive notifications: heart rate, crash, fall, and walking steadiness Hypertension and blood pressure notifications arrive for Apple Watch users Cardio fitness, ECG, and irregular rhythm alerts explained Court drama and a workaround for Apple's blood oxygen feature Monitoring vitals, hearing safety, and sleep apnea detection AFib history versus irregular rhythm notifications Health data trends and fresh health records notifications Sleep tracking, wind down routines, and schedule-based alerts Medication reminders with smart time zone adjustments Mental wellbeing tracking with state-of-mind check-ins and depression/anxiety quizzes Walking steadiness notifications and quick access to the checklist Host: Mikah Sargent Download or subscribe to Hands-On Apple at https://twit.tv/shows/hands-on-apple Want access to the ad-free audio and video and exclusive features? Become a member of Club TWiT today! https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord.

Think you know the Health app? Think again. This episode unpacks Apple's quiet rollout of powerful and important features, from crash detection to real-time medication reminders, that are quietly transforming the way you can track your wellbeing. Dive into emergency SOS, medical ID, and safety alerts Apple Watch-exclusive notifications: heart rate, crash, fall, and walking steadiness Hypertension and blood pressure notifications arrive for Apple Watch users Cardio fitness, ECG, and irregular rhythm alerts explained Court drama and a workaround for Apple's blood oxygen feature Monitoring vitals, hearing safety, and sleep apnea detection AFib history versus irregular rhythm notifications Health data trends and fresh health records notifications Sleep tracking, wind down routines, and schedule-based alerts Medication reminders with smart time zone adjustments Mental wellbeing tracking with state-of-mind check-ins and depression/anxiety quizzes Walking steadiness notifications and quick access to the checklist Host: Mikah Sargent Download or subscribe to Hands-On Apple at https://twit.tv/shows/hands-on-apple Want access to the ad-free audio and video and exclusive features? Become a member of Club TWiT today! https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord.

Hypertension is one of the most heavily tested topics on NP board exams, but recent guideline updates can make it hard to know what you actually need to focus on.    In this episode, I walk you through how to think about hypertension guidelines when you're preparing for boards, including what's still being tested and what's changing in real-world practice.  Learn how to study with clarity and avoid confusion around guideline updates.   Get full show notes, transcript, and more information here: https://blog.npreviews.com/hypertension-guidelines-np-boards-matters-exam-vs-practice     Follow us on Instagram: instagram.com/smnpreviewsofficial

Hermann Haller, MD, PhD President, Professor, MDI Biological Laboratory; Professor, Department of Nephrology and Hypertension, Hannover Medical School Haller received his medical degree from the Free University of Berlin and completed his postdoctoral work at Yale University. He has published more than 700 peer-reviewed articles, holds six world-wide patents and has founded four biotech companies. He has received many honors and awards and serves on numerous advisory boards, including those of Bayer, Boehringer Ingelheim, Genzyme and Novo Nordisk. In addition to his position at the MDI Biological Laboratory, he is also a full professor of medicine and former chairman of the Division of Nephrology at the Hannover Medical School in Germany. INNOVATORS is a podcast production of Harris Search Associates.      *The views and opinions shared by the guests on INNOVATORS do not necessarily reflect the views of the interviewee's institution or organization.*

On this ENCORE of our most popular episode of 2025, hosts Dr. Mojola Omole and Dr. Blair Bigham speak with two authors of the latest “Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care”The discussion reflects a shared urgency: despite past successes, Canada's hypertension control rates are declining. The new guidelines aim to reverse this trend by simplifying diagnosis and treatment for frontline clinicians.Dr. Rémi Goupil, a nephrologist and clinician researcher at Sacré-Cœur Hospital in Montreal, and Dr. Greg Hundemer, a nephrologist and clinician scientist at The Ottawa Hospital, explain that the updated guideline is deliberately designed for primary care providers. They highlight key shifts: lowering the diagnostic threshold for hypertension to  ≥ 130/80 mm Hg, simplifying blood pressure targets, and emphasizing accurate, standardized measurement techniques both in clinic and at home. The guidelines were created with input from a majority-primary care committee—including family physicians, nurses, pharmacists, and patient partners—to ensure clinical applicability.Together, the panel outlines a streamlined nine-step treatment algorithm, emphasizing combination therapy as first-line pharmacologic management. They explain the evidence supporting ARB–thiazide combinations, discuss cost considerations for drug selection, and address adherence challenges. They also explore red flags for secondary hypertension and how the algorithm supports—but does not replace—clinical judgment.For physicians, this guideline offers a clear and practical roadmap: measure blood pressure correctly, aim for systolic pressure below 130 mm Hg, and use the simplified treatment sequence to improve adherence and outcomes. Designed to be easy to implement, the new approach aims to empower primary care providers to act with confidenceComments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Aujourd'hui, je reçois le Dr Yoan Kiavué, cardiologue à Saint-Raphaël, pour une conversation qui peut littéralement changer ta trajectoire de santé.Parce que la cardiologie, comme il le dit très bien, est aussi une médecine de probabilité : on peut mesurer des facteurs de risque, les comprendre, et surtout les modifier… bien avant que la maladie ne se déclare. Et c'est là que tout se joue.Cet épisode est, à mes yeux, l'un des plus importants de « Et surtout la santé » : concret, accessible, et potentiellement immense en termes de prévention cardiovasculaire. Si tu veux reprendre le pouvoir sur ta santé (ou aider un proche à le faire), tu es au bon endroit.Hébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.

Eve gives an overview of current and future consumer trends where dairy can play a role. Functional foods, health and wellness, high protein foods, fermented and cultured foods, women's health, brain health, and aging are all part of the mix. (7:26)The panelists discuss the healthfulness of saturated fats, the resurgence of butter, milk's bioactive compounds, and how best to reach the public about the health benefits of dairy. (10:41)Eve talks about marketing to Gen Z consumers, who are motivated by novelty. How do we reimagine a food that's been here for thousands of years? What new ways can we talk about it? What ways can we optimize dairy science and research to show up in generative systems like ChatGPT? (20:34)The group then tackles the topic of lactose. Lactose and honey are the only two sugars not made by plants. Why is it lactose that is in the milk of mammals? Dr. Jiminez-Flores thinks lactose is a dark horse in dairy and we have much yet to discover about it. He notes that some milk oligosaccharides are not digested by babies, but are used by bacteria in the development of a healthy microbiome. Dr. Lucy notes that dairy also contains peptides that have been found to reduce hypertension. The group also delves into how dairy products can be part of preventative health care. (23:53)Do consumers perceive dairy products to be minimally processed? Eve explains that dairy is perceived as a clean, fresh food. Given the current trend to reduce additives and food dyes, she sees potential for dairy food science innovation in this area. Dr. Aldrich talks about the glycemic index of lactose-free milk. (38:13)The panelists agree that dairy has a great upcycling story to tell. Converting fiber into milk and meat and feeding non-human grade byproducts are just two examples. Eve notes that younger consumers care about sustainability, but there's a huge “say-do” gap: 76% of North American consumers identify as caring about conscious and sustainable practices, but less than 40% actually act on those values when making purchases. The panel also notes that whey is another great upcycling story. Dr. Jiminez-Flores emphasizes how important consumer trust in science and research is, and how we are currently experiencing a loss of that trust. (45:48)Panelists share their take-home thoughts. (1:01:01)Please subscribe and share with your industry friends to invite more people to join us at the Real Science Exchange virtual pub table.  If you want one of our Real Science Exchange t-shirts, screenshot your rating, review, or subscription, and email a picture to anh.marketing@balchem.com. Include your size and mailing address, and we'll mail you a shirt.

Obesity, Hypertension, and Risk Factors in Terms of Prevention and Decreasing the Risk of HfpEF   Guest: Affan Irfan, M.D., Ph.D. Host: Stephen L. Kopecky, M.D.   HFpEF is a type of heart failure where the heart pumps normally but becomes stiff. This leads to fatigue, shortness of breath, and fluid retention. It is closely linked to obesity, hypertension, and metabolic disorders, with cases rising as these conditions become more common.   Topics Discussed: What is HFpEF and its risk factors? How common are obesity and hypertension, and how often do they lead to HFpEF? How do you diagnose HFpEF? How effective are weight loss, diet, and exercise in preventing HFpEF? What medical and public health strategies help reduce these risk factors and HFpEF cases?    Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode.   Podcast episode transcript found here.

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter In this "Ask Me Anything" (AMA) episode, Peter tackles a wide-ranging set of listener questions spanning lifespan interventions, exercise, cardiovascular risk reduction, time-restricted eating, blood pressure management, hormone therapy, diagnostics, and more. Peter reveals the single most important lever for extending healthspan and lifespan, and explains how he motivates midlife patients using the Centenarian Decathlon framework. He discusses the importance of addressing high apoB and cholesterol even in metabolically healthy individuals with calcium scores of zero, how to manage high blood pressure, and how to accurately evaluate metabolic health beyond HbA1c. Additional topics include time-restricted eating, practical considerations around ultra-processed foods, nuanced approaches to HRT for women and TRT for men, and why early and expanded screening for chronic disease—colonoscopy, PSA, coronary imaging, low-dose CT—can be lifesaving. He also offers insights into treating prediabetes, crafting exercise programs for those short on time, and safely incorporating high-intensity training in older adults. If you're not a subscriber and are listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #78 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Introducing a wide-ranging AMA: practical perspectives on lifespan interventions, metabolic health, diet, hormones, diagnostics, and more [2:45]; Why exercise is the most powerful single intervention for lifespan and healthspan [4:15]; How Peter motivates midlife patients to prioritize exercise [6:00]; Why lifespan and healthspan should not be treated as competing priorities and how choosing sustainable interventions benefits both [9:30]; Why high apoB deserves treatment even in a metabolically healthy patient with a CAC score of zero [14:00]; Managing hypertension: ideal targets for blood pressure, lifestyle levers, and why early pharmacology matters [18:15]; Assessing metabolic health beyond HbA1c: fasting insulin, triglycerides, lactate, zone 2, and more [23:30]; How to avoid common self-sabotaging patterns by choosing sustainable habits over extreme health interventions [26:00]; Time-restricted eating: minimal effect beyond calorie control, implications for protein intake, and practical considerations for implementing it [28:00]; Ultra-processed foods: definitions, real-world risks, and practical guidelines for smarter consumption [30:30]; How women should prepare for menopause and think about hormone replacement therapy: early planning, symptom awareness, and guidance on HRT [36:45]; Testosterone replacement for aging men: indications, benefits, and safe clinical management [39:45]; Why Peter recommends earlier and more aggressive screening tests than guidelines suggest: colonoscopies, coronary imaging, PSA, Lp(a), and low-dose CT scans, and more [43:30]; Full-body MRI screening: benefits, limitations, potential false positives, and the importance of physician oversight [47:15]; Prediabetes: individualized treatment strategies using tailored combinations of nutrition, sleep, and training interventions [51:00]; Time-efficient training plans for people with only 30 minutes per day to exercise [53:00]; How to safely introduce high-intensity exercise for older adults [55:00]; Timed dead hangs and ripping phone books: a playful look at Peter's early attempts to impress his wife [57:15]; Peter's carve out: The Four Kings documentary about a golden era of boxing [1:01:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

Joanne Mitchell-McLaren is a Lifelong Patient Advocate and Educator, Clinical Expert and Rare Disease Specialist. Her overall goal is to prepare and provide patients and caregivers with the awareness, support and education they need as it relates to their health. She has provided tools, education and encouragement that patients need to feel confident to have courageous conversations with their health care providers; in hopes to empower them to make the best decision and to use their voice to advocate for themselves.Patient advocacy is her birth right. She believe the greatest gift one can provide is the gift of a servant, especially to those with vulnerabilities in our community regardless of their diagnosis, neighborhood one resides in or any other health disparity reason.

L'hypertension artérielle pulmonaire (HTAP) touche les petites artères des poumons, augmentant progressivement la pression artérielle et pouvant provoquer une insuffisance cardiaque sévère. Se manifestant par un essoufflement et des malaises, cette maladie rare ne se guérit pas, mais de récentes avancées dans la recherche ont permis de mettre au point un traitement prometteur : le sotatercept. En quoi consiste ce traitement ? Comment les patients sont-ils actuellement pris en charge ?  L'hypertension artérielle pulmonaire est une maladie rare, qui touche deux femmes pour un homme et, en France, concernerait entre 2 500 et 3 500 personnes. L'obstruction des vaisseaux des poumons perturbe la circulation sanguine et, à terme, épuise le cœur. Les premiers symptômes sont l'essoufflement, des douleurs thoraciques, des palpitations, des œdèmes des pieds. L'hypertension artérielle pulmonaire doit être, bien sûr, distinguée de l'hypertension artérielle, une maladie chronique fréquente et, dans certains cas évitables, qui concernerait un adulte sur trois, en France, d'après l'Inserm.  Une maladie rare et grave  Sans traitement, une fois le diagnostic posé, l'espérance de vie d'un patient atteint d'hypertension artérielle pulmonaire se limitait à trois ans. Grâce à un diagnostic précoce et une prise en charge adaptée, ce pronostic a été sensiblement amélioré pour les patients qui bénéficient d'un système de santé offrant les options thérapeutiques innovantes.   Avancées de la recherche   Les travaux d'un médecin chercheur français viennent d'être couronnés du Grand prix Inserm 2025 et du Grand prix de la Fondation de l'Assistance Publique AP-HP : le Pr Marc Humbert, médecin pneumologue et doyen de la Faculté de médecine de Paris-Saclay s'est engagé, depuis 30 ans, dans des recherches pour mieux comprendre et prendre en charge l'hypertension artérielle pulmonaire. Après en avoir cerné les caractéristiques inflammatoires, il a développé une biothérapie ciblant une protéine qui active cette inflammation de la paroi des vaisseaux. Ce traitement a été autorisé en 2024 par l'Agence Européenne du Médicament. L'amélioration de la prise en charge des patients atteints d'HTAP a permis de doubler leur espérance de vie en l'espace de 20 ans.  Avec : Pr Marc Humbert, chef du service de Pneumologie et soins intensifs respiratoires de l'Hôpital Bicêtre AP-HP (Centre de référence de l'hypertension pulmonaire) – Doyen et professeur de Pneumologie à la Faculté de Médecine Paris-Saclay. Directeur de l'Unité Mixte de Recherche Hypertension Pulmonaire Inserm/Paris-Saclay et Lauréat du Grand Prix Inserm 2025 Pr Eric Walter Pefura Yone, professeur de Médecine à la Faculté de Médecine et Sciences biomédicales de l'Université de Yaoundé 1. Médecin interniste, pneumologue et allergologue à l'Hôpital Jamot de Yaoundé au Cameroun  Maggy Surace, présidente de l'Association des malades, aidants et transplantés hypertension pulmonaire.   Programmation musicale : ► Abou Tall – Merci ► Rusowsky – malibU.

This week, we kick off a 4-part series on the #1 killer in America by talking about the problem of Cardiovascular Disease.   In this episode, you'll discover:—How Cardiovascular Disease was identified as the #1 killer back in the 1950's and is STILL the #1 killer today, which Dr. Prather says "raises some questions".—The two top competing theories about the underlying cause of Heart Disease among researchers back in the 1970's.  And why Dr. Prather believes the winning theory of Cholesterol as the main cause is wrong.—The dangerous side effects of anti-cholesterol Statin drugs and why patients come to Dr. Prather seeking alternatives. —How Cholesterol is in our bodies for healing and is "there to save your life".  And the connection between those who live over the age of 100 and an overall Cholesterol level of 300.—The Cardiac C-Reactive Protein Test that is "probably the best indicator of whether you're going to have a heart attack or not". —The four main things Dr. Prather says are the real cause of Cardiovascular Disease:  Inflammation, Oxygenation and Nutrient Deprivation,  Electrical Conduction Disruption from Nerve and Mineral Issues, and Food Allergies.—How Inflammation is the cause of Vascular Disease.  And how that Inflammation increases when you try to "artificially" lower Cholesterol levels. —Why the Coxsackie B Virus is so prevalent in Indianapolis and can lead to Cardiovascular Disease. —How the Atlas Orthogonal Chiropractic Adjustment can have a bigger effect on Hypertension than Prescription High Blood Pressure Medication. —Why Dr. Prather says "the heart can actually regenerate in an amazing type of way" and that he did not even expect to see the things he has seen in his office with all the positive changes in patients. http://www.TheVoiceOfHealthRadio.comReceive exclusive bonus content as a member of our Voice Of Health Patreon Community:https://www.patreon.com/cw/VoiceofHealthPodcast

Dr. John Osborne of Clear Cardio, a Preventative Cardiologist, sits down with intuitive healer, psychic medium, and wellness expert Laura Michelle Powers for a fascinating conversation about the connection between intuition, health, and the heart.Laura shares her powerful journey—from earning a master's degree in political science and working in government to facing a major health crisis that led her to rediscover her intuitive gifts and realign her life purpose. Laura and Dr. Osborne explores how emotional stress and energetic imbalance can affect physical health, why meditation and stillness are essential to healing, and how listening to your intuition can help you prevent illness and find greater peace.Dr. John Osborne is not your typical cardiologist.He's one of fewer than 50 Cardiologist out of 33,000 in the U.S. triple board-certified in Cardiology, Lipidology, and Hypertension — and one of only a handful globally trained to interpret the most advanced heart imaging on the planet.But what truly sets him apart is how he practices.With a PhD in Cardiovascular Physiology and more than 25,000 advanced heart scans performed, Dr. Osborne has spent the last 25 years developing a completely different approach to heart health — one that's holistic, non-invasive, and deeply human.He's the co-founder of ClearCardio™, a revolutionary prevention-first annual heart disease, detection and treatment practice that detects disease before symptoms show up — and reverses it without surgery or scare tactics.His method blends AI-powered diagnostics with lifestyle medicine, medication precision, and deep listening. He looks at the full person — genetics, stress, sleep, hormones, nutrition, environment — not just lab numbers.He believes heart attacks are largely preventable.And that your body, when given the right tools, already knows how to heal.Learn more at https://clearcardio.com/Laura is a Celebrity Psychic who has been featured by Buzzfeed, The Weakest Link, Beast Games, NBC, ABC, CBS, FOX, the CW, Motherboard by Vice Magazine and the #1” Ron Burgundy Podcast” with Will Ferrell. Laura Powers is a clairvoyant, psychic medium, writer, actress, producer, writer, and speaker who helps other receive guidance and communicate with loved ones. Laura travels nationally and internationally for clients, events, television appearances, and speaking engagements. She is also the author of 7 books on the psychic realm and 1 book on podcasting. Laura also works as a psychic, entertainer, and creative entrepreneur.For more information about Laura and her work, you can go to her website www.healingpowers.net or find her on X @thatlaurapowers, on Facebook at @realhealingpowers and @mllelaura, and on Instagram, TikTok and Insight Timer @laurapowers44.

My granddaughter suffers from menstrual cramps.  Do you have any suggestions?Do you recommend nicotinamide daily to prevent recurrence of basal cell cancers?What works best to lower fibrinogen?I've been on Ozempic for a year and have diarrhea every morning!Is bypass surgery still being done?Would you recommend Bergamot for fatty liver?

Thanksgiving and overindulgenceA food poisoning incidentObservations on health at ThanksgivingWhat do you think of online sites offering prescriptions for hair loss via a questionnaire?

A recent meta-analysis finds that childhood hypertension rates (commonly known as high blood pressure) are increasing significantly around the world. Professor of cardiovascular medicine and population health at the University of Oxford, Kazem Rahimi, explains what is driving this trend. Recent changes in hormone therapy labels in the US come after years of lobbying by physicians and activists. Presenter's friend, Dr Ann Robinson, explains how our understanding of hormone therapy – its risks and its benefits – has changed over time.Can stress during pregnancy impact a baby's development even after birth? Claudia speaks to associate professor Ying Meng at the University of Rochester School of Nursing in the US to find out more about the surprising impact of cortisol on baby teeth emergence.Can weight loss drugs reduce symptoms of Alzheimer's disease? A new study sheds light on the answer. And, Health Check hears about an artificial tongue with a taste for spice.Presenter: Claudia Hammond Producers: Helena Selby & Georgia Christie

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-460 Overview: Join us as we discuss how frequently patients with stable hypertension should monitor their blood pressure at home. Hear insights from two trials to help you provide evidence-based, cost-conscious guidance—reducing unnecessary alarms while supporting better long-term management. Episode resource links: Rose, Francesa; Stevens, Richard S.a; Morton, Kate S.b; Yardley, Lucyc; McManus, Richard J.a,d. How often should self-monitoring of blood pressure be repeated? A secondary analysis of data from two randomized controlled trials. Journal of Hypertension ():10.1097/HJH.0000000000004123, August 20, 2025. | DOI: 10.1097/HJH.0000000000004123 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Some fluctuations in blood pressure during preganncy are expected, but hypertensive disorders are one of the leading causes of maternal and perinatal mortality worldwide. This includes chronic or gestational hypertension, preeclampsia, HELLP, and eclampsia. High blood pressure during pregnancy can place significant stress on your heart and kidneys leading to heart and kidney disease and stroke. It also increases the risk of preterm birth, placental abruption, and cesarean. Plus, it can reduce blood flow to the placenta and limit the oxygen and nutrients available to your baby. Most pregnancy-related conditions resolve after birth, but the risk from hypertensive disorders does not end there. Mothers can develop dangerous symptoms in the days and weeks after birth, even if their blood pressure was normal throughout pregnancy. Recognizing warning signs and seeking medical attention right away can be life-saving. Full article and resources for this episode: https://pregnancypodcast.com/hypertension/ Thank you to the brands that power this podcast: Zahler goes above and beyond in formulating their Prenatal +DHA. It's made with high-quality nutrients like the active form of folate and bioavailable iron. Plus, it includes essential nutrients like omega-3s that you will not find in most other prenatal vitamins. In November 2025, save 35% with the code PREPOD35 on Amazon: http://amzn.to/2tFOBgb You can always see the current promo code at: https://pregnancypodcast.com/vitamin/ The VTech V-Hush Stroller Rocker is a portable device that gently rocks your baby's stroller or crib to help them sleep peacefully anywhere. With three adjustable motion levels, you can choose the perfect calming rhythm for your baby. It also includes a built-in amber night light, a rechargeable battery, soothing sounds, white noise, and lullabies. Soothe your baby to sleep anywhere with the V-Hush Stroller Rocker. Save 20% with code VTPODCAST20 and check it out at https://pregnancypodcast.com/strollerrocker 8 Sheep Organics makes amazing, 100% Clean, natural pregnancy products. From skin care to treating stretch marks, 8 Sheep Organics has you covered. Every product from 8 Sheep Organics comes with a 100-Day Happiness Guarantee. If you're not 100% happy with your purchase, simply send them an email and they will get you a refund, no questions asked. Check out 8 Sheep Organics and save 10% when you go to https://pregnancypodcast.com/8sheep Get More from the Pregnancy Podcast Join thousands of expecting parents who get the Pregnancy Podcast newsletter: https://pregnancypodcast.com/newsletter Upgrade to Pregnancy Podcast Premium for ad-free episodes, full archive access, and the Your Birth Plan book: https://pregnancypodcast.com/premium Save with discounts and deals available for Pregnancy Podcast listeners: https://pregnancypodcast.com/resources Follow your pregnancy week-by-week with the 40 Weeks podcast: https://pregnancypodcast.com/week Find more evidence-based information on the Pregnancy Podcast website: https://pregnancypodcast.com