The 2024 European Society of Cardiology guidelines introduce a new blood pressure (BP) classification: (1) nonelevated (<120/70 mmHg, no treatment), (2) elevated (120–139/70–89 mmHg, treatment based on risk), and (3) hypertension (≥140/90 mmHg, treatment for all). The default systolic BP target is 120–129 mmHg, with relaxed targets for specific populations. This summary highlights key updates and differences from other international guidelines to help clinicians navigate their implementation.
A new study presents an innovative, non-invasive method for detecting high blood pressure using natural speech sounds and demographic data. Researchers developed a Graph Diffusion Network (GDN) model that accurately predicts systolic and diastolic blood pressure, achieving a high correlation. The model effectively identifies early-stage hypertension and offers a promising digital health solution for remote monitoring. This research highlights the potential of speech-based health assessments, overcoming limitations of traditional cuff-based and sensor-dependent methods.
A new study confirms that intensive blood pressure control in adults with hypertension and high cardiovascular risk can lower the risk of mild cognitive impairment or dementia over time. Researchers analyzed data from the SPRINT trial, involving over 9,000 participants, and found that maintaining systolic blood pressure below 120 mm Hg significantly reduced cognitive decline compared to standard treatment. While lifestyle changes are recommended, medication is often necessary for effective blood pressure management. Experts emphasize that uncontrolled hypertension causes gradual brain damage, increasing dementia risk, particularly in middle age.
Effectiveness of preoperative micronized purified flavonoid fraction treatment and sucralfate based rectal ointment on hemorrhoidal disease A case matched analysis
Springer Nature | Sep 17, 2024
Hemorrhoidal disease (HD) significantly impacts patients’ quality of life. This study aimed to evaluate the effectiveness of preoperative treatment with the micronized purified flavonoid fraction (MPFF) and a sucralfate-based rectal ointment in managing HD symptoms and reducing interventions.
Chronic venous insufficiency, cardiovascular disease, and mortality: a population study
European Heart Journal | October 21, 2021
Chronic venous insufficiency is highly prevalent in the population and is associated with the presence of cardiovascular risk factors and disease. Individuals with CVI experience an elevated risk of death, which is independent of age and sex, and present cardiovascular risk factors and comorbidities.
Chronic venous insufficiency is highly prevalent in the general population and associated with arterial cardiovascular disease and an increased risk of all-cause mortality.
Cardiovascular Insights for the Appropriate Management of Chronic Venous Disease: A Narrative Review of Implications for the Use of Venoactive Drugs
Springer Link | September 28, 2023
Evidence suggests that chronic venous disease (CVD) may be a cardiovascular disorder, as patients with CVD are prone to developing arterial (atherosclerosis) and venous (thromboembolism) diseases. This may be partly explained by shared risk factors. Thus, patients with CVD or cardiovascular disease require careful history-taking and physical assessment to identify coexisting pathologies and risk factors. This article summarises a symposium at the XIX World Congress of the International Union of Phlebology held in Istanbul, Turkey, in September 2022. Common pathophysiological features of CVD and cardiovascular disease are endothelial injury, hypercoagulability and systemic inflammation. In CVD, inflammation primarily affects the microcirculation, with changes in capillary permeability, vein wall and valve remodelling and increase in oxidative stress. Once patients develop symptoms/signs of CVD, they tend to reduce their physical activity, which may contribute to increased risk of cardiovascular disease. Data show that the presence of CVD is associated with an increased risk of cardiovascular disease, including peripheral arterial disease and heart failure (HF), and the risk of adverse cardiovascular events increases with CVD severity. In addition, patients with cardiovascular disease, particularly those with HF, are at increased risk of venous thromboembolism (VTE) and should be assessed for VTE risk if they are hospitalised with cardiovascular disease. Therefore, CVD management must include a multi-specialty approach to assess risk factors associated with both the venous and arterial systems. Ideally, treatment should focus on the resolution of endothelial inflammation to control both CVD and cardiovascular disease. International guidelines recommend various conservative treatments, including venoactive drugs (VADs), to improve the symptoms/signs of CVD. Micronized purified flavonoid fraction (MPFF) is a VAD, with high-quality evidence supporting its use in relieving symptoms/signs of CVD and improving quality of life. Moreover, in large-scale observational studies, MPFF has shown superior effectiveness in real-world populations compared with other VADs.
This study evaluated the management of dyslipidemia in Turkey with the goal of understanding current diagnosis and treatment patterns, as well as identifying unmet needs in achieving effective low-density lipoprotein cholesterol (LDL-C) targets. Using a Delphi panel consisting of nine expert cardiologists, the study reveals key gaps in dyslipidemia management, particularly in the underutilization of combination therapies, such as statins and PCSK9 inhibitors, which are crucial for achieving LDL-C targets in high-risk patients. The findings indicate that while many patients with very high cardiovascular risk are diagnosed, a significant proportion do not receive optimal treatment to reach LDL-C levels recommended by European guidelines. Addressing these gaps could lead to more effective management of dyslipidemia and reduce the burden of cardiovascular disease in Turkey. The study’s insights provide critical recommendations for clinicians and policymakers to improve clinical practice and health outcomes through more aggressive lipid-lowering strategies.
This study analyzed NHANES 2011–2018 data to assess the link between visceral obesity (VATob) and prescription use. Among 10,952 participants, VATob was associated with higher prescription use (52.0% vs. 36.7%, p<0.001), particularly for metabolic and cardiovascular medications. Logistic regression confirmed an increased risk (ORoverall = 1.9, 95%CI: 1.7–2.1, p<0.001), with normal-weight individuals showing the highest association. These findings highlight the significant impact of VATob on medication use.
The article provides a comprehensive review of antiobesity medications (AOMs), which, when combined with lifestyle interventions, are effective in managing obesity—a condition affecting a significant portion of the global population. These medications work through various mechanisms, including altering digestive processes (e.g., orlistat), regulating appetite in the brain (e.g., phentermine-topiramate, naltrexone-bupropion), and mimicking enteropancreatic hormones (e.g., liraglutide, semaglutide, tirzepatide). Each medication has varying efficacy and side effects, with the most potent, tirzepatide, showing up to 12.4% greater weight loss compared to placebo. The review underscores the importance of AOMs as a valuable adjunct to lifestyle changes for improving obesity-related health outcomes.
The TeleTAVI study, presented at ESC Congress 2024, demonstrated that an AI-based virtual voice assistant, named LOLA, effectively identified complications after transcatheter aortic valve implantation (TAVI) while achieving high patient satisfaction. The virtual assistant made over 1,000 follow-up calls to patients, facilitating early discharge and enabling close monitoring without significantly increasing healthcare resources. Among the 274 patients involved, 89% reported good or very good satisfaction with the service, and 86% would recommend its use. The study highlights the potential of telemedicine to enhance post-procedure care for heart patients.
American College of Cardiology | September 2, 2024
Two late-breaking studies presented at the ESC Congress 2024 explored the role of AI in enhancing clinical decision-making in the emergency department (ED). The PROTEUS trial from the UK found that AI-augmented decision-making improved accuracy among less-experienced clinicians in selecting patients for invasive coronary angiograms, though overall outcomes were similar to standard practices. The RAPIDxAI trial revealed that while AI did not improve cardiovascular outcomes in managing suspected myocardial infarction (MI) patients, it did promote evidence-based care practices. Both studies suggest AI's potential to standardize care and influence clinical decisions, especially among less experienced practitioners.
Cardiovascular diseases (CVDs) pose a severe threat in the WHO European Region, claiming 10,000 lives daily, with men at higher risk. A new WHO/Europe report emphasizes the alarming prevalence of high salt consumption and uncontrolled high blood pressure, major drivers of CVDs. Almost all countries exceed WHO-recommended salt intake levels, and hypertension affects over one-third of adults aged 30-79. The report advocates for integrated strategies to reduce salt intake, control hypertension, and save lives, stressing the need for policy interventions, industry cooperation, improved treatment protocols, patient education, and gender-responsive approaches.
The BMJ - British Medical Journal | March 06, 2025
A retrospective cohort study in Hong Kong analyzed data from 343,966 newly diagnosed type 2 diabetes mellitus (T2DM) patients over a median follow-up of 10.5 years and found that aspirin use (≥180 days/year) was associated with a significantly lower risk of pancreatic cancer (PC) (adjusted hazard ratio [aHR]: 0.58) and reduced PC-related mortality (aHR: 0.43) as well as all-cause mortality (aHR: 0.78). A dose-response relationship was observed, with increasing aspirin use linked to a further decline in risk. These findings suggest that aspirin may serve as a preventive strategy for PC in T2DM patients, though further studies are needed to confirm these results.
A recent study by the University of Dundee has shown that AI can analyze eye images taken during routine diabetes screenings to predict kidney health in people with type 2 diabetes. By examining nearly 1 million retinal images from individuals with diabetes, the AI tool was able to detect existing kidney disease with 86% accuracy and predict future kidney issues with 78% accuracy—surpassing traditional kidney function tests. This approach could enable earlier intervention, potentially preventing severe kidney damage and its complications. The research opens up new possibilities for using eye screenings as a tool to predict other diabetes-related conditions, offering healthcare professionals valuable early insights.
A systematic review and meta-regression analysis of 22 studies found a strong dose-response relationship between bodyweight loss and type 2 diabetes remission, independent of factors like age, diabetes duration, BMI, and intervention type. The analysis showed that the likelihood of complete remission increased significantly with greater weight loss: 0.7% for losses under 10%, 49.6% for 20-29%, and 79.1% for 30% or more. Partial remission followed a similar pattern, with up to 89.5% remission at the highest weight loss levels. For each 1% bodyweight reduction, the probability of complete and partial remission increased by 2.17 and 2.74 percentage points, respectively, emphasizing the critical role of weight management in diabetes care.
The role of precision medicine in advanced colorectal cancer (CRC) has made significant inroads. Although standard regimens that involve a combination of surgery, chemotherapy, and targeted and immunotherapies have demonstrated beneficial outcomes, once patients become refractory to them, the treatment options are limited. Historically, before the emergence of data from the SUNLIGHT trial (NCT04737187),1 there were only 2 options of therapy: trifluridine/tipiracil (Lonsurf) and regorafenib (Stivarga).
But in the past few years, in the refractory metastatic CRC setting, the approvals of the combination of trifluridine/tipiracil plus bevacizumab (Avastin) and fruquintinib (Fruzaqla) have been encouraging.2-4
Targeted Therapies in Oncology interviewed Marwan G. Fakih, MD, a professor in the Department of Medical Oncology and Therapeutics Research and an associate director for clinical sciences at City of Hope in Duarte, California, about the current treatment landscape in refractory metastatic CRC.
Ivosidenib (IVO) has demonstrated efficacy as an oral inhibitor of the protein encoded by the mutant isocitrate dehydrogenase 1 (mIDH1) gene in patients (pts) with cholangiocarcinoma (CCA) in the phase 3 ClarIDHy study. To further consolidate safety and efficacy data of IVO in the real world, the ProvIDHe study was initiated. The study is in a setting similar to daily practice, enabling access to treatment with IVO for pts with CCA.
The fluorinated thymidine analog trifluridine (FTD) is a chemotherapeutic drug commonly used to treat cancer; however, the mechanism by which FTD induces cytotoxicity is not fully understood. In addition, the effect of gain-of-function (GOF) missense mutations of the TP53 gene (encoding p53), which promote cancer progression and chemotherapeutic drug resistance, on the chemotherapeutic efficacy of FTD is unclear. Here, we revealed the mechanisms by which FTD-induced aberrant mitosis and contributed to cytotoxicity in both p53-null and p53-GOF missense mutant cells. In p53-null mutant cells, FTD-induced DNA double-stranded breaks, single-stranded DNA accumulation, and the associated DNA damage responses during the G2 phase. Nevertheless, FTD-induced DNA damage and the related responses were not sufficient to trigger strict G2/M checkpoint arrest. Thus, these features were carried over into mitosis, resulting in chromosome breaks and bridges, and subsequent cytokinesis failure. Improper mitotic exit eventually led to cell apoptosis, caused by the accumulation of extensive DNA damage and the presence of micronuclei encapsulated in the disrupted nuclear envelope. Upon FTD treatment, the behavior of the p53-GOF-missense mutant, isogenic cell lines, generated by CRISPR/Cas9 genome editing, was similar to that of p53-null mutant cells. Thus, our data suggest that FTD treatment overrode the effect on gene expression induced by p53-GOF mutants and exerted its anti-tumor activity in a manner that was independent of the p53 function.
