Recent evidence suggests that lowering systolic blood pressure (SBP) to below 120 mm Hg, rather than the standard 130 mm Hg, significantly reduces cardiovascular risk in high-risk patients, with only a modest increase in adverse effects. Trials show that achieving this lower target typically requires one additional antihypertensive medication, often through combination therapy. Experts argue that this more intensive goal offers benefits comparable to other major cardiovascular treatments and should be considered in future guidelines.
The study investigated how genetic predisposition and lifestyle together affect the risk of metabolic syndrome (MetS) in nearly 5,000 Korean adults aged 40 and older with at least one cardiovascular risk factor. Researchers calculated a polygenic risk score (PRSMetS) based on multiple metabolic traits and categorized participants into high (top 7%) and low (bottom 93%) genetic risk. They also created a “healthy lifestyle” score based on obesity, physical activity, smoking, diet, and alcohol intake. A high genetic risk was associated with a 1.31 times increased odds of MetS, and risk rose progressively with worsening lifestyle quality. The highest risk—an approximately 9.35 fold increase—was seen in those with both high genetic risk and poor lifestyle. Importantly, even individuals with high genetic risk had substantially lower MetS risk if they maintained healthy lifestyle habits.
The TEAMLET (Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence) cluster-randomized trial tested whether automated detection of medication nonadherence (using linked EHR–pharmacy data) combined with team-based care workflows (including prompts for medical assistants to screen adherence barriers and alert clinicians) could improve adherence (measured as proportion of days covered, PDC) and blood pressure control among adults with uncontrolled hypertension. Conducted in 10 primary care sites in New York from October 2022 to November 2024, the intervention did not significantly improve 12 month adherence (both intervention and control groups increased PDC by about 18 percentage points, with no meaningful difference) or systolic blood pressure. The findings suggest that this scalable EHR based, teamlet intervention alone may not be sufficient to enhance adherence or blood pressure control.
What Are the Side Effects of Prostate Cancer Radiotherapy on the Bowels?
Healthline | October 18, 2023
Radiation therapy involves aiming radiation at cancer cells to damage their DNA. It can be a highly effective prostate cancer treatment but can also cause side effects involving your bowel.
About 1 in 4 peopleTrusted Source undergoing prostate cancer treatment receive radiation therapy. Two types of radiation therapy are used to treat prostate cancer:
External beam radiation therapy involves aiming radiation from an external machine at your prostate.
Internal radiation involves placing radioactive pellets near your cancer.
Research suggestsTrusted Source that every type of treatment for prostate cancer, including radiation therapy, causes numerous side effects. You can discuss these with your doctor when making treatment decisions. The side effects tend to improve over time across all treatment types.
In this article, we examine the possible short- and long-term bowel side effects of radiation therapy for prostate cancer.
VEIN STEP: A Prospective, Observational, International Study to Assess Effectiveness of Conservative Treatments in Chronic Venous Disease
Springer | September 20, 2023
Introduction
VEIN STEP was conducted to collect international data on the management of chronic venous disease (CVD) and to assess the effectiveness of conservative treatments for the relief of CVD signs and symptoms.
Methods
This international, observational, prospective, longitudinal, cohort study recruited adult outpatients consulting for symptomatic CVD. The primary objective was the effectiveness of conservative treatments on symptoms, signs and quality of life in a real-life setting assessed using a range of patient-reported outcome measures: 10-cm Visual Analog and Patient Global Impression of Change scales for symptoms; Venous Clinical Severity Score for physician assessment of signs; and 14-item ChronIc Venous Insufficiency Questionnaire (CIVIQ-14) for quality of life. At inclusion, patients were prescribed conservative treatment according to the physicians’ usual practice. Follow-up visits took place at weeks 2 and 4, with an optional week 8 visit.
Results
The analysis set comprised 6084 subjects (78% female) from nine countries with a mean age of 50.6 ± 13.8 years and BMI of 28.0 ± 4.9 kg/m2. The most common CEAP classifications were C1 (23.0%), C2 (31.6%), and C3 (30.7%). Conservative therapy consisted of oral venoactive drugs (VADs; 95.8% of subjects) including micronized purified flavonoid fraction (MPFF 75.5%) and diosmin (18.8%), compression (52.0%), and topicals (31.5%). Conservative therapy led to global symptom improvement in 89% of patients after 2 weeks and 96% at 4 weeks. Pain, leg heaviness, cramps, and sensation of swelling were improved in 82%, 71%, 45.5%, and 46% of patients, respectively. Conservative therapy was associated with a decrease over time in patient-assessed global symptom intensity: – 2.37 ± 1.73 (P < 0.001) and physician-assessed disease severity – 1.83 ± 2.82 (P < 0.001). Among the VADs, MPFF-based conservative therapy was associated with the greatest reduction in symptom and sign intensity. Improvements in CIVIQ-14 were observed with all treatments but were greatest for MPFF.
Conclusion
In this prospective study conducted in the real-world setting, treatment with conservative therapy, in particular MPFF, was associated with meaningful improvements in the clinical signs and symptoms of disease as well as in quality of life in patients with CVD.
Special Guest Laura Swoboda, DNP, talks MPFF for venous insufficiency
YouTube Frank & Lizzie channel | October 17, 2023
Dr Laura Swoboda, DNP, APNP, FNP-BC, CWOCN-AP, discusses pertinent research around the use of Micronized Purified Flavonoid Fraction (MPFF) and the data from all of the world to support its use. Frank & Lizzie are both strong supporters of this therapy, and both take it on a daily basis.
A new University of Oxford study shows that statins are both effective and cost-efficient for adults over 70, improving quality of life and reducing cardiovascular risks—even in those without prior heart disease. Despite their proven benefits, older adults remain under-prescribed statins. The research supports lifetime use, showing significant health gains and good value for money, prompting experts to recommend continued statin use in older age.
The article reviews how pediatric obesity triggers a cascade of metabolic disturbances—expanded fat mass elevates blood volume and heart workload, raising blood pressure—while also promoting insulin resistance via elevated free fatty acids from adipose tissue. This, in turn, contributes to dyslipidemia through increased triglycerides and VLDL in the liver, with a shift toward small, dense LDL and HDL particles that enhance atherogenic risk. Altogether, these processes help explain the rising morbidity and mortality linked to youth obesity and its disproportionate impact on certain ethnic groups
The article presents the PREVENT equations to estimate long-term cardiovascular disease (CVD) risk in U.S. adults aged 30–79. Using data from over 14,000 participants, about 20% showed elevated 10-year CVD risk, especially older adults. Including lipoprotein(a) improved risk prediction. The study supports using PREVENT equations for better identifying high-risk individuals and guiding prevention.
Contrary to the belief that heart disease primarily affects older adults, 4–10% of heart attacks occur in individuals under 45, especially men. Lifestyle choices made from a young age, such as diet, physical activity, and smoking habits, significantly influence long-term heart health. Adopting heart-healthy behaviors early can substantially reduce the risk of cardiovascular disease later in life.
This qualitative study explored the experiences of people with heart failure using the Activity Coach app to support physical activity. Over 12 weeks, interviews with ten users revealed that the app helped increase awareness and motivation through its ease of use, enjoyable monitoring features, and the physical and emotional benefits users experienced. Despite some difficulties in defining and tracking activity, the app supported habit formation and improved well-being. The findings suggest that mHealth tools like this app can effectively promote physical activity in heart failure patients.
A French study of over 650,000 heart failure patients found that 40% did not see a cardiologist annually. Regular cardiology visits were linked to a 24% lower risk of death within a year. The study recommends tailored follow-up based on patient risk, showing that even one annual visit can significantly improve outcomes.
A study published in the Journal of the American Heart Association found a significant association between higher marine microplastic concentrations and increased prevalence of type 2 diabetes, coronary artery disease, and stroke in coastal U.S. counties. This suggests that microplastic pollution may be a novel environmental risk factor for cardiometabolic diseases, highlighting the need for further research into its health impacts.
This observational cohort study of 1,503 patients with diabetes and chronic kidney disease (CKD) found that the severity of diabetic retinopathy (DR) is significantly associated with both existing heart failure (HF) and the risk of future HF hospitalization. Patients with more severe DR had higher odds of concurrent HF and a greater risk of acute HF hospitalization within five years compared to those with milder DR. These findings suggest that DR severity could serve as an important marker for cardiovascular risk stratification in patients with diabetes and CKD, helping to identify those at increased risk of heart failure.
A recent study focusing on older African American adults found that an eight-month Mediterranean diet intervention, with or without weight loss, did not improve cognitive function, challenging previous research suggesting cognitive benefits of the diet in other populations. Although participants showed meaningful weight loss and better adherence to the diet, the study’s relatively short duration and modest metabolic changes may explain the lack of cognitive improvement. Experts emphasize that longer-term studies are needed, especially in African American communities who face higher dementia risks, to fully understand the diet’s impact on brain health. Despite these findings, the Mediterranean diet’s benefits for weight management and overall metabolic health remain valuable, supporting its continued recommendation for reducing chronic disease risk.
This Express Update provides new recommendations for the following ESMO Clinical Practice Guideline (CPG): Pancreatic cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.1
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.
