Podcasts about Hypertension

What if high blood pressure is not the root problem but a signal pointing to something deeper? This week on Health Coach Talk, Dr. Sandi welcomes Dr. Mark Young, CEO of Zona and a PhD in functional medicine, to explore a fresh perspective on hypertension and what it really takes to support cardiovascular health. Together, they unpack the science behind blood pressure, challenge conventional approaches, and introduce an innovative tool designed to work with the body, not against it.Full show notes: https://functionalmedicinecoaching.org/podcast/mark-young-172/

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let's dive into the latest updates impacting clinicians and healthcare providers like you!Interested in a more traditional, text rundown? Check out the HCPFive!RAINIER: Povetacicept Reduces Proteinuria By 52.0%A pre-specified week 36 interim analysis of the phase 3 RAINIER trial found that povetacicept, a dual BAFF/APRIL inhibitor, reduced proteinuria by 52% from baseline and achieved a statistically significant 49.8% reduction in UPCR versus placebo in patients with IgA nephropathy.Lorundrostat Secures FDA NDA Acceptance for Hypertension, Falls Short in Phase 2 OSA TrialThe FDA accepted Mineralys Therapeutics' NDA for lorundrostat as an add-on treatment for hypertension, supported by phase 3 and phase 2 trial data, with a PDUFA action date set for December 22, 2026.Discontinuing GLP-1 Treatment Associated With Up to 60% Weight Regain, With Brajan BudiniNew findings indicate that stopping GLP-1 receptor agonist therapy leads to a predictable pattern of weight regain—reaching approximately 60% at one year before plateauing—suggesting meaningful but substantially diminished long-term benefit after cessation.FDA Approves Leucovorin Calcium (Wellcovorin) Tablets as First Cerebral Folate Deficiency TreatmentThe FDA approved GSK's leucovorin calcium tablets as the first treatment for cerebral folate deficiency in patients with a confirmed FOLR1 gene variant, based on a systematic review of published literature and mechanistic data.New Long-Term Data Announced on Roflumilast Cream for Atopic Dermatitis in ChildrenLong-term data from the INTEGUMENT-OLE extension study show that once-daily roflumilast cream 0.05% is safe and well-tolerated in children aged 2 to 5 with mild-to-moderate atopic dermatitis, with efficacy not only sustained but continuing to improve through 56 weeks of treatment.

In this episode, Dr. Kara Odom Walker, Chief Medical Officer for Aetna Medicaid, discusses a new collaboration with National Association of Community Health Centers to improve hypertension control in underserved communities. She shares how data, community partnerships, and addressing social drivers of health can help reduce disparities, prevent chronic disease complications, and improve outcomes for Medicaid members.

In this special edition on Obesity as a Chronic Disease our host, Dr. Neil Skolnik will discuss epidemiology, pathophysiology and screening for CKD in People with Diabetes. This special episode is supported by an independent educational grant from Bayer. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Holly Kramer, M.D., Professor of Public Health Sciences and Medicine in the Division of Nephrology and Hypertension at Loyola University Chicago, past-president of the National Kidney Foundation, Editor-in-Chief of the National Kidney Foundation's journal,  Advances in Kidney Disease and Health (AKDH).   Selected references: Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 . The American Diabetes Association's Standards of Care 2026, Diabetes Care 2026;49 (Supplement_1) :S246–S260  

Diagnosing hypertension, known as a "silent killer," is incredibly important. Interventional cardiologists Ricardo Yaryura, MD, Jeffrey Rossi, MD and Daniel Molloy, MD, explain the diagnosis, traditional treatments and a newer option for uncontrolled blood pressure. You can also watch the video recording on our Vimeo channel here. For more health tips & news you can use from experts you trust, sign up for Sarasota Memorial's monthly digital newsletter, Healthe-Matters.

Sotyktu's approval expanded to encompass active psoriatic arthritis; the FDA approves leucovorin for rare disorder, not autism; safety concerns prompt Tazverik withdrawal; FDA to review potential new hypertension treatment.

Biomechanist Katy Bowman and biologist Dr. Jeannette Loram explain how just nine minutes of vigorous activity can make a measurable difference for your cardiovascular health. They break down what counts as vigorous exercise, how to gauge it “old skool” without complicated gadgets, and how much is needed based on the movement patterns of the heart-healthy Hadza. Plus, they share nine practical ways to fit short bursts of higher-intensity movement into your day, from running stairs and kitchen dance parties to treading water in a pool.The episode also explores a personal experience related to the menopause transition, including the onset of salt sensitivity, water retention, and hypertension. Katy and Jeannette discuss the link between estrogen and salt management, explaining why the loss of estrogen can make women more susceptible to salt-induced high blood pressure—and what lifestyle shifts can help protect heart health.Enhanced Show Notes and Full Transcript00:00 — Introduction & Sponsors01:50 — Heart Health and Midlife Movement03:45 — What Counts as Vigorous Exercise?07:00 — How Much Vigorous Do We Actually Need? Insights from the Hadza 12:30 — Nine Minutes of Vigorous Movement: Practical Ideas to fit into your life25:00 — Listener Question: Vigorous Movement in the Pool36:20 — Warming Up for Vigorous Movement Snacks 41:30 — Salt Sensitivity, Menopause & Blood PressureLinks & Research Mentioned:Physical Activity Patterns and Biomarkers of Cardiovascular Disease Risk in Hunter Gatherers  by Raichlen et al (2017) Lifestyle and Patterns of Physical Activity in Hadza Foragers by Sayre et al (2023)Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality by Stamatakis et al (2022) Postmenopausal Salt Sensitivity and Hypertension by Kim et al (2014)Estrogen negatively regulates the renal epithelial sodium channel (ENaC) by promoting Derlin-1 expression and AMPK activation by Zhang et al (2019) Salt Sensitivity of Blood Pressure in Women by Barris et al (2023)Connect, Move & Learn:Join Our Newsletter: Movement Colored GlassesFollow Katy on SubstackTry Katy's Virtual Studio Free for 7 days!Made Possible By Our Wonderful Sponsors:Movemate: Active standing boards with smoothly articulating wooden slats. Designed to keep you moving without interrupting your focus.Peluva: Five-toe minimalist shoes that move like you do—take 10% off with code NUTRITIOUSMOVEMENTMy Happy Feet: Toe-spacing socks that gently realign toes for comfortable recovery—take 20% off with code MYDNA.Venn Design: Beautifully upholstered ball-shaped Air Chairs that encourage dynamic sitting.Ikaria Design: The Soul Seat® offers height-adjustable, multi-position sitting—get 10% off new chairs and desks with code DNA10.Smart Playrooms: Beautiful playroom design and movement-rich equipment—save 10% on monkey bars and rock-wall items with code DNA10.Thoughts/questions email us at podcast@nutritiousmovement.comYour Voice on the Podcast: Read The Credits 

Explore 30–200 root causes of Alzheimer's including sleep, inflammation, ApoE4, and lifestyle habits that either prevent or accelerate cognitive decline. #AlzheimersCauses #Inflammation #GeneticsAndLifestyle #CognitiveCare

Dismal prediction that, by 2050, 60% of women will suffer from cardiovascular disease; Yes, it's true that childhood and adolescent obesity, once rare, is now soaring; Treatments for osteopenia; Dentists continue to write prescriptions for potentially deadly antibiotic; A man, in love with his Chatbot, commits suicide to join her in the virtual world; Olive oil is calorie dense—but its consumption results in weight loss; Can “bio-regulator peptides” stave off kidney failure?

Southern Remedy Healthy and Fit is hosted by Josie Bidwell, Professor of Preventive Medicine and Nurse Practitioner at UMMC. If you have a question for Josie, you can email fit@mpbonline.org. It this episode, Josie talks about hypertension and how it is treated and controlled. If you enjoy listening to this podcast, please consider contributing to MPB. https://donate.mpbfoundation.org/mspb/podcast. Hosted on Acast. See acast.com/privacy for more information.

🧭 REBEL Rundown 🔑Key Points Try the coffee nap! Where you combine caffeine and a 30-minute nap to then have that boost energy and alertness by the time it kicks in.💤 Sleep isn’t optional—it’s crucial for memory, mood regulation, and physical recovery. It is fundamentally different from rest❌ Replacing sleep with caffeine isn’t effective and can have negative health impacts. Make getting enough sleep a priority🌞 Sunlight exposure is important for maintaining circadian rhythms and sleep quality. This applies even if you work as a nocturnist💡 Creating a personalized sleep system enhances quality and consistency. It gives you back control of a schedule that you may feel like is out of your hands.🧩 If you’ve tried these strategies and you’re still struggling, consider true sleep pathology (insomnia, shift work disorder, sleep apnea) and get help—this is not a “be tougher” problem.🩺 Better sleep isn’t just about feeling good; it’s directly tied to error reduction, patient safety, and longevity in EM/ICU careers. Click here for Direct Download of the Podcast. 👀Previously Covered and Related Content: REBEL Core Cast: Sleep HygieneREBEL MIND: Rest Is Not Sleep: The Seven Dimensions of True RecoveryRebellion in EM: Care For Yourself – Sleep HygieneFirst10EM: Some Evidence For Working Night ShiftsREBEL MIND: Dunning Kruger Effect 📝 Introduction Welcome to this episode of REBEL MIND, where MIND stands for Mastering Internal Negativity during Difficulty. Here we sharpen the person behind the practitioner by focusing on things that improve our performance, optimizing team dynamics and the human behavior that embodies the hidden curriculum of medicine. Today we are exploring the imperative topic of rest and why it’s not just about sleeping. The second of a two part series, hosted by Dr. Mark Ramzy with guests Dr. Maureen Aiad and Dr. Amil Badoolah, continue our discussion but this time on the multifaceted nature of sleep, how it serves as medicine and how we can use our tools deliberately to get more of it! Cognitive Question How would your clinical performance, patience with families, and long-term career sustainability change if you treated sleep as a non-negotiable clinical intervention rather than a flexible “nice-to-have”? 💤How is Sleep Different From Rest? 1. Rest reduces load; sleep repairs systemsWe previously talked about the 7 types of rest and you can check that out hereExamples of physical rest include: pausing tasks, stepping away from the monitor, taking a walk, stretching, breathing, journaling, connecting with a colleague. This lightens your cognitive/emotional burden.Sleep is fundamentally different in that it’s an active biologic process that helps:Consolidates memory and learning (yes, including the tough cases from last night).Regulates mood, impulse control, and emotional reactivity.Supports immunity, metabolic health, and cardiovascular function.Repairs tissue, replenishes neurotransmitters, and fine-tunes neural networks.You can have “rested but underslept” days (you took breaks but got 4 hours in bed), and “slept but unrested” days (you got hours, but all junk sleep). Both matter, but they are not interchangeable.2. Sleep architecture vs. “knocking out”True restorative sleep cycles through NREM and REM in predictable patterns.Alcohol, late caffeine, and fragmented nights may help you fall asleep faster but:Suppress REM.Shorten deep sleep.Increase awakenings and light sleep.The result: you technically slept, but your brain didn’t get the “software updates” it needed.Biology isn’t built for your scheduleCircadian rhythms were designed for light-day / dark-night cycles, not:10 pm–7 am ED shifts.24-hour calls.6 nights in a row followed by days.Your body can adapt partially, but not instantly and not perfectly. That’s why:You can feel “jet-lagged” even when you haven’t traveled.Sleep before and after nights feels odd and fragile.Recognizing that “this is biologically unnatural” is key: you’re not weak; you’re fighting physiology. 🏥How This Applies to the Emergency Department or ICU? Performance & safetySleep deprivation:Slows reaction time and increases error rate.Impairs risk assessment and complex decision-making.Drops your frustration tolerance with consultants, families, and staff.In both emergency medicine and critical care, that translates into:Anchoring on the wrong diagnosis.Missing subtle clinical changes.Snapping at a tech, nurse or resident and damaging team culture. Chronic health for chronic shift workLong-term sleep disruption is associated with:Hypertension, diabetes, obesity.Depression, anxiety, burnout.Arrhythmias (e.g., AFib) and increased stroke risk.Possibly increased all-cause mortality.You’re already in a high-stress, high-exposure specialty. Chronically poor sleep amplifies that risk profile and can end a career early—or make you miserable while you’re still in it.Culture of “heroics” vs. healthSkipping sleep to pick up extra shifts, late meetings, or “just one more note” is often praised.We rarely celebrate:The attending who says “no” to a 2 pm meeting post-nights.The resident who defends their blackout-curtains-and-earplugs routine. 🛏️Different Ways to Improve Your Sleep Clarify your “sleep non-negotiables”Decide how many hours you realistically need to function (e.g., 7–9 on off days, realistic blocks on nights).Treat those hours as you would a procedure time—blocked, protected, and respected.Use caffeine like a drug, not a reflexAim for ≤ 2 cups equivalent on most days.Avoid caffeine within 4–6 hours of your planned sleep time (remember: it can hang around up to 12 hours).Consider scheduling caffeine for:Early in the shift for alertness.Strategic “coffee naps” (see below), not late-night chugging.Respect alcohol’s impact on sleepRecognize that even small to moderate doses degrade sleep architecture.Avoid using alcohol as a “sleep aid”—you’ll fall asleep faster but sleep worse.If you do drink, separate it from bedtime and keep it modest.Optimize food and fluid timingHydrate consistently on shift, but taper fluids ~4 hours before bed to reduce nocturnal bathroom trips.Avoid heavy, spicy, or large meals within 2–3 hours of sleep to decrease reflux and discomfort.Plan a light, balanced “pre-sleep” snack if going to bed hungry keeps you awake.Move your body (but not right before bed)Regular exercise improves sleep depth and latency.Try to avoid intense workouts within 2 hours of bedtime.On shift: micro-movement (stairs, brisk walks between pods, quick stretch sessions) can help alertness without wrecking sleep later.Control light exposureMaximize sunlight or bright light after waking (even if that’s 3–4 pm after a night).Minimize bright light and screens before sleep:Dim lights.Use night mode/blue-light filters if you must scroll.For daytime sleep:Use blackout curtains, tinfoil, cardboard, or sleep masks.Yes seriously use tinfoil if you have to, we talk about it on the podcast episode!Aim for “I might be blind” darkness—so dark you can’t see your hand in front of your face.Dial in your sleep environmentCool room temperature (fan or AC if possible).White noise or sound machine to mask household/traffic noise.Earplugs and eye masks as needed.Bed used primarily for sleep (and sex)—not for charting, doom scrolling, or email.Strategic power napsKeep naps ≤ 20–30 minutes to avoid sleep inertia.Prefer early-afternoon or pre-night-shift naps.Coffee nap strategy:Drink a small coffee.Immediately lie down for a 20–30 min nap.Wake up as the caffeine kicks in, combining nap benefit + stimulant.Thoughtful melatonin useRemember melatonin is a hormone, not a vitamin gummy.Lower doses often work as well as (or better than) large OTC doses.Use it intentionally and intermittently, not as a crutch every night.Over-reliance may reduce your own natural production and its effectiveness over time.Build pre-sleep ritualsRepeated, calming habits signal your body it’s time to downshift:Warm shower, gentle stretching, or yoga.Guided breathing or body scan.Brief journaling or “brain dump” of tasks to get them out of your head and onto paper.Protect from pathologic patternsIf despite consistent effort you:Snore heavily, stop breathing, or gasp in sleep.Feel excessively sleepy driving home or at work.Cannot fall asleep or stay asleep for weeks to months.Consider evaluation for sleep apnea, insomnia, or shift-work sleep disorder with your physician or sleep specialist. ⏩Immediate Action Steps for Before/During/After Your Next Shift 1. **Before the Shift**: Plan a 20–90 minute nap before your first night shift (many clinicians find 3–5 hours earlier in the day is ideal).I treat ED and ICU shifts very differently. I always sleep 3-5 hours before my night shifts aiming for the full 5 (sometimes 6 or more) hours for my ED shifts because you always have to be “on”. Depending on the ICU I’m working in, I may have a bit more downtime so 3 to 5 hours is plenty.Set a caffeine plan: decide in advance when your last dose will be (e.g., none after 2–3 am if sleeping at 8–9 am).Tell your household, “This is my sleep block” and agree on a plan for kids, pets, deliveries, etc.On my calendar, I completely block off time called “Pre-call sleep” so no meetings can be scheduled and then put my phone in airplane mode2. **During the Shift** Hydrate early; taper fluids in the last 3–4 hours of your shift Eat something light but adequate; avoid “last-minute” heavy meals right before sign-out.Build in micro-breaks and movement: one or two short walks, a few stretches, even a quick stair run if safe.Get outside or near a window for a few minutes of light exposure if possible.3. **After the Shift**On the way home:Use sunglasses to reduce bright morning light if you’re aiming for sleep soon.Avoid “just checking” email or messages; shift into wind-down mode.At home:Do a brief, calming decompression (shower, light snack, 10–15 minutes of low-stimulation TV or reading).Make your room cold, quiet, and dark (blackout curtains, tinfoil/cardboard, white noise, fan).Put your phone on Do Not Disturb and physically place it away from the bed.On my calendar, I completely block off time called “Post-call sleep” so again no meetings can be scheduled and then I personally don’t just put my phone on Do Not Disturb but rather in airplane mode and WIFI OFF If you can’t sleep after ~20–30 minutes:Get out of bed, do something calming in dim light (breathing, gentle stretching, journaling).Return to bed when sleepy—this trains your brain to associate bed with sleep, not frustration. Conclusion Rest and sleep are both critical—but they’re not interchangeable. Rest helps you step out of the constant “on” of our jobs, while sleep is the biological intervention that restores your ability to show up safely and sustainably. Rest ≠ sleep. Rest reduces load; sleep repairs your brain and body. You need both, on purpose.As EM and ICU clinicians, we’re trying to perform formula-one-level medicine with engines that often only see half their maintenance. You won’t fix shift work. You can build a sleep system that respects your biology, your schedule, and your life at home.That system starts with valuing sleep, then prioritizing it, personalizing it, trusting the process when it’s imperfect, and actively protecting both your routine and your mindset. 🚨 Clinical Bottom Line Sleep is medicine. Shift work is biologically unnatural. Struggling does not mean you’re weak; it means you’re human fighting physiology. Use your tools deliberately. Caffeine, naps, light, food, movement, melatonin, and environment can be leveraged—or can quietly sabotage you. Build and defend a personalized sleep routine. Communicate it, normalize it, and protect it from casual encroachment. You can’t control every trauma, code, or admission—but you can control how seriously you take your own recovery. Your patients, your team, and your future self all benefit when you do. Further Reading Espie CA. The ‘5 principles’ of good sleep health. J Sleep Res. 2022 Jun; PMID: 34676592Solodar, J“Sleep hygiene: Simple practices for better rest.” Harvard Health, 31 January 2025 Link is HereSuni, E.“Mastering Sleep Hygiene: Your Path to Quality Sleep.” Sleep Foundation, 7 July 2025, Link is Here Meet the Authors Mark Ramzy, DO Co-Editor-in-Chief Cardiothoracic Intensivist and EM Attending RWJBH / Rutgers Health, Newark, NJ Maureen Aiad, DO Assistant Professor of Emergency Medicine NYU Grossman Long Island School of Medicine, New York Amil Badoolah, DO Assistant Professor of Emergency Medicine NYU Grossman Long Island School of Medicine, New York REBEL Core Cast 119.0 – Sleep Hygiene REBEL Core Cast 119.0 – Sleep Hygiene Click here for Direct Download of ... Read More The post REBEL MIND – How to Sleep When the World Says You Can't appeared first on REBEL EM - Emergency Medicine Blog.

Heart disease should be treated just like cancer, says guest Mike McConnell, an author and expert in preventive cardiology at Stanford: Detect and stage early, then treat aggressively. In his practice, McConnell focuses on using low-dose CT imaging for detecting early coronary artery disease. He also helped pioneer the use of AI to infer cardiovascular risk from retinal scans. Such non-invasive, consumer-friendly tools could expand prevention, personalize therapy, and cut heart attacks and strokes across the board, he says. “Everybody also deserves a proactive preventive cardiologist in their phone,” McConnell tells host Russ Altman of the latest approaches to heart disease on this episode of Stanford Engineering's The Future of Everything podcast. Have a question for Russ? Send it our way in writing or via voice memo, and it might be featured on an upcoming episode. Please introduce yourself, let us know where you're listening from, and share your question. You can send questions to thefutureofeverything@stanford.edu. Episode Reference Links: Stanford Profile: Michael V. McConnell, MD, MSEE Connect With Us: Episode Transcripts >>> The Future of Everything Website Connect with Russ >>> Threads / Bluesky / Mastodon Connect with School of Engineering >>> Twitter/X / Instagram / LinkedIn / Facebook Chapters: (00:00:00) Introduction Russ Altman introduces guest Michael McConnell, a professor of cardiology at Stanford University. (00:03:02) Reframing Heart Disease Why coronary disease should be approached the same as cancer. (00:05:46) Core Risk Factors The key drivers of cardiovascular disease, and life's essential eight. (00:07:18) Coronary Artery Calcium Scoring How low-dose CT scanning detects disease before symptoms develop. (00:08:57) The Limits of Stress Testing Why traditional stress tests often miss early coronary disease. (00:10:18) AI in Cardiac Imaging Using AI to identify hidden risks in routine chest scans. (00:11:30) Retinal Imaging How AI analysis of retinal blood vessels can predict heart disease risk. (00:14:55) Detecting Risk Before Symptoms Why retinal and vascular changes occur long before clinical signs appear. (00:15:58) Staging Coronary Disease Using calcium scores to stage coronary disease and personalize treatment. (00:19:36) Direct-to-Consumer Prevention The rise of mobile health records, wearable devices, and AI tools. (00:22:23) Opportunities & System Challenges Balancing accessibility, guideline-based care, and healthcare system capacity. (00:25:26) AI-Powered Health Record Analysis The potential of automated reviews to identify silent risk factors. (00:27:41) Physician Adoption & System Friction Barriers to integrating early detection tools into clinical practice. (00:30:12) Advances in Treatment Overview of current cholesterol therapies and plaque stabilization. (00:33:31) Future In a Minute Rapid-fire Q&A: prevention, implementation science, and future hopes. (00:35:38) Conclusion Connect With Us:Episode Transcripts >>> The Future of Everything WebsiteConnect with Russ >>> Threads / Bluesky / MastodonConnect with School of Engineering >>>Twitter/X / Instagram / LinkedIn / Facebook Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

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

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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.

Vitamin D testing is vital for tailoring doses to optimize health—but regulators are conducting a campaign to deny coverage; Can magnesium be taken simultaneously with blood pressure meds? Lifelong learning delays Alzheimer's onset by 5 years; Your MRI says you have a bum shoulder—but 99% of people show abnormalities even when they have no discomfort; Saunas can help stave off dementia. 

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

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

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.

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.

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

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.

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

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.

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