Evidence-first health & aging science Newsletter
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Heart & Metabolic

Cardiometabolic health: weight, weight-loss drugs, blood sugar and diabetes, cholesterol, blood pressure and heart health.

Three hand-rolled joints on a scratched wooden table beside an ashtray
News

Regular cannabis users had 9% fewer extra heartbeats on days they were randomly assigned to inhale

UC San Francisco cardiologists set out to test whether cannabis adds extra heartbeats. In 108 regular users the count fell instead, and the team warns that is no evidence cannabis is good for the heart.

Sep 14, 2026

A woman in her fifties holding a glass of water beside a window, a large green leaf in the foreground
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Hormone therapy for hot flashes tied to lower heart risk when started within 10 years of menopause

University of Pittsburgh and Virginia Commonwealth University researchers tracked 2,737 women with hot flashes for 20 years. Starting hormones went with a fifth fewer heart events, but the authors warn against taking them for the heart.

Sep 14, 2026

Plain white tablets scattered across a yellow surface
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Benefits of a type 1 diabetes pill faded within a year of patients stopping it

Baricitinib preserved insulin production in newly diagnosed type 1 diabetes, raising hopes of a course of treatment rather than a lifetime of it. Following 88 patients after the drug stopped answered that.

Sep 8, 2026

A bedside monitor showing vital signs next to a patient lying out of focus in a hospital bed
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Turning on glucose monitor alarms helped hospital patients; making them predictive added nothing

Continuous glucose monitors are moving into hospital wards, with no agreement on whether their alarms should be switched on. Randomizing 533 inpatients tested the alarms rather than the sensor.

Sep 8, 2026

A person pressing a fist against the center of their chest
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One in three patients with chest pain and clear arteries had a hidden circulation problem

An angiogram showing open arteries is usually treated as reassurance. Measuring the smaller vessels in 1,003 patients found a third had dysfunction, and it tracked worse outcomes.

Sep 8, 2026

A pulse oximeter clipped onto a fingertip showing a reading
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Pacemakers outperformed catheter ablation for irregular heart rhythm in patients over 75

Catheter ablation is the standard offer for persistent atrial fibrillation, and it works less well the older the patient. Randomizing 196 people with a median age of 82 tested the blunter alternative.

Sep 8, 2026

A paper electrocardiogram printout showing heart rhythm traces
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A newer heart rhythm ablation method carried a higher 30-day stroke risk than the older one

Pulsed field ablation spread fast on the promise of being safer than burning tissue. A single-center registry comparing it against radiofrequency found more strokes and mini-strokes at 30 days.

Sep 8, 2026

A moulded walking boot resting beside a pair of crutches
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Hip fractures were five times more common in type 1 diabetes, peaking in people in their forties

Bone is not on the checklist for type 1 diabetes, and fracture screening is aimed at people decades older. Comparing 5,035 patients against 12,286 controls found the excess risk starts early.

Sep 8, 2026

A blood pressure cuff fastened around the arm of a patient lying in a hospital bed
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A newer drug slowed kidney decline in people whose damage came from blood pressure, not diabetes

Kidney trials are built around diabetes, so the second-largest group has been treated on borrowed evidence. Within a trial of 1,584 patients, the 459 with blood-pressure-driven damage were examined on their own.

Sep 7, 2026

The control panel of an ultrasound machine, with trackball and dials
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Liver stiffness readings used to judge fatty liver treatment were checked against biopsy for the first time

Guidelines already accept a 30% drop in liver stiffness as evidence a treatment is working. In 160 patients who had both the scan and the biopsy, someone finally tested whether that holds.

Sep 7, 2026

Electrocardiogram electrodes and a recorder resting on a printed heart trace
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After a heart valve replacement, a blood thinner beat aspirin by nearly half

Aspirin is the default after a valve is fitted through a catheter, on the reasoning that anything stronger bleeds. Randomizing 360 patients found the stronger drug both worked better and did not bleed more.

Sep 7, 2026

A person walking along a pavement, seen from behind at knee height
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A statin alternative cut serious leg artery events by 36% in people who cannot take statins

Peripheral artery disease ends in amputation often enough that limb outcomes are the ones patients care about, and cholesterol trials rarely report them. This one did, in 1,624 patients who could not tolerate statins.

Sep 6, 2026

A ring-shaped treatment scanner with an empty patient table
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Left-side breast radiotherapy raised heart risk only in women who already had three risk factors

Radiotherapy to the left breast puts the heart in the field, and modern technique was supposed to have solved it. Across 23,305 women, the residual harm turned out to sit almost entirely in one group.

Sep 6, 2026

A gloved clinician taking blood from a person's inner wrist
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A cholesterol drug cut deaths from any cause by 20% in people who had never had a heart attack

Cholesterol drugs are judged on heart attacks and strokes, and rarely move the count of deaths at all. Across 12,301 people with no prior event, this one moved it, and moved deaths that had nothing to do with the heart.

Sep 6, 2026

Hands using a glucose meter surrounded by test strips
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Children exposed to diabetes in the womb developed it five times as often

Gestational diabetes is described as ending at delivery. Following 2.85 million children to a median age of 16, exposure before birth tracked far higher diabetes rates, and control around conception shifted the odds.

Sep 6, 2026

A clinician holding an ultrasound probe in a scanning room
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Losing a tenth of body weight tracked seven times the odds of cirrhosis recovering

Decompensated cirrhosis is treated as one-way: once the liver fails, the list is transplant or palliation. Among 344 patients, 64 climbed back out, and weight loss was the strongest thing separating them.

Sep 6, 2026

A woman holding her eyelids open to put in eye drops
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Eye drops improved vision in diabetic macular swelling, a condition normally treated by injection

Treatment for diabetic macular edema means a needle into the eye, repeatedly, for years. Drops had never been considered effective. In 148 patients, a steroid suspension beat placebo drops on reading-chart letters.

Sep 4, 2026

A city skyline and hilltop observatory almost lost in thick gray haze
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Heat and wildfire smoke together tracked more heart deaths than either alone

Heat waves and smoke days are studied as separate hazards and increasingly arrive on the same day. Across 5.9 million cardiovascular deaths in six countries, the overlap was worse than adding the two together.

Sep 4, 2026

A clinician taking a blood pressure reading from a cuff on a patient's upper arm
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Each 20-point drop in blood pressure tracked 24% fewer kidney failure deaths

Kidney disease kills more people in Mexico than almost anywhere, and blood pressure was suspected rather than measured. Following 133,470 adults in Mexico City, the relationship ran in a straight line with no threshold to hide under.

Sep 2, 2026

A clinician in a white coat fitting trial lenses to an adult man's eye in a clinic
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Fenofibrate tracked 68% less diabetic macular edema across 4,571 matched patients

A cheap old cholesterol drug has been tied to slower diabetic eye disease since two trials noticed it by accident. Across matched patients with early retinopathy, fenofibrate users developed less of every problem studied but one.

Sep 2, 2026

A shared table spread with small dishes as several people serve themselves
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Mediterranean living tracked half the heart deaths in adults with type 2 diabetes

The Mediterranean diet is sold as a shopping list. This index scored the rest of it too, including naps and eating with other people, and all three parts of the score pulled in the same direction.

Sep 2, 2026

Gloved hands giving an injection into a person's upper arm
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Flu vaccination tracked 20% less new atrial fibrillation across 276,888 matched adults

Flu is known to trigger heart events, but whether the shot affects heart rhythm was untested. A European Heart Journal team matched 276,888 adults on 65 characteristics and found the vaccinated developed less irregular heartbeat.

Sep 1, 2026

An older couple walking arm in arm along a city street
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Semaglutide and tirzepatide tracked half the femoral fractures of another diabetes drug

The worry about weight-loss drugs is that fast loss costs muscle and bone, which should show up as broken hips. Comparing 27,896 matched over-65s against a rival diabetes medicine, fractures and falls both ran lower over a year.

Sep 1, 2026

The lit display of a digital bathroom scale glowing in a dark room
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Sitting at the top of the 'normal' BMI range carried 78% more type 2 diabetes across 1.8 million people

Guidelines draw the risk line at a BMI of 25 and treat everything below it as fine. Pooling 11 cohorts, researchers found people at 22.5 to 24.9 already carried substantially more diabetes than people lower in the same band.

Aug 31, 2026

Electrode leads and clips laid across a printed heart rhythm trace
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Pushing potassium to the top of the normal range cut atrial fibrillation events by a third in a trial

A low-normal potassium level is usually left alone. In 1,200 patients with implanted defibrillators, deliberately raising it by 0.3 mmol/L cut hospital admissions and treatments for atrial fibrillation over three years.

Aug 31, 2026

A stethoscope, a tape measure and small glass vials laid on a white surface
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A third of people with 'preclinical' obesity crossed into the clinical kind within five years

A Lancet commission split obesity into two conditions: one that is only a body measurement, one that has started causing harm. Nobody had counted how often people move between them. In 92,396 US adults, 26% did in under three years.

Aug 31, 2026

Hands typing a message on a phone showing a thread of chat bubbles
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Digital nudges lifted statin refills from 12% to 14%, and a second nudge worked as well as the first

Health systems send reminders constantly and rarely test them. A JAMA trial randomized 20,604 patients who had stopped refilling statins, then re-randomized everyone who ignored the first message, and found repeating beat switching channel.

Aug 31, 2026

A clinician listening to an older man's chest with a stethoscope
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A raised heart-strain marker that came back down carried no extra risk eight years later

Most risk markers are measured once and treated as a verdict. An Annals of Internal Medicine analysis of 8,454 adults measured one twice, three years apart, and people whose reading normalized ended up where those who never had it did.

Aug 30, 2026

A clinician pointing at brain scans displayed on a lightbox
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Stroke patients who hit the cholesterol target but had not halved it still had 12% more repeat events

Stroke guidelines set an absolute cholesterol target and stop there. A Neurology analysis of 89,414 Korean patients found the size of the fall from baseline mattered independently, and only about 30% achieved a 50% reduction.

Aug 30, 2026

A radiographer positioning a patient at the mouth of an MRI scanner
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Lean people with fatty liver and no risk factors still faced 2.5 times the liver death rate

Fatty liver is treated as a consequence of obesity and metabolic problems. A Gut analysis of 30,847 MRI-scanned UK Biobank participants found a slim group with none of those markers, and followed it to a higher rate of liver-related death.

Aug 30, 2026

An aged hand tipping white tablets from an amber bottle into an open palm
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A diabetes drug tracked a third fewer deaths in over-75s, alongside a stroke signal nobody can explain

Trials of SGLT2 inhibitors barely recruited the very old. A Japanese target trial emulation of 8,486 people aged 75 and over found lower death and dialysis rates than a rival drug class, and more strokes.

Aug 30, 2026

Gloved hands pressing a dressing onto a bare upper arm after an injection
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People given the newer shingles vaccine had 9% less heart disease over the next seven years

A Nature Medicine team used America's abrupt switch from the live to the recombinant shingles vaccine as a natural experiment in adults over 60. Heart disease, heart failure and atrial fibrillation were all lower seven years on.

Aug 30, 2026

A close-up of an eye lit by a narrow band of light, iris and lashes in sharp detail
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Sudden vision loss hit 3 more GLP-1 users per 10,000 over 18 months than two rival diabetes drugs

An Annals of Internal Medicine target trial emulation compared GLP-1 users against two other diabetes drug classes. Ischemic optic neuropathy was more common on GLP-1s, concentrated in men, over-50s and those with eye or heart disease.

Aug 28, 2026

A dentist in blue gloves examining a patient's open mouth with a mirror and probe
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Gum disease tracked 18 to 25% more new diabetes across 28 studies and 300,000 people

A WHO-funded Lancet Public Health review found the link between oral disease and diabetes runs both ways. Periodontitis predicted later type 2 diabetes, and so did tooth loss. The reverse direction was real but less consistent.

Aug 28, 2026

A gloved hand holding a dental instrument, with a reclining patient blurred behind
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Treating gum disease lowered blood pressure by 4.64 mmHg across 12 randomized trials

A Journal of Periodontology meta-analysis pooled 12 randomized trials of periodontal therapy. Systolic pressure fell 4.64 mmHg, diastolic 1.84, and C-reactive protein dropped alongside them. Evidence certainty was moderate to low.

Aug 28, 2026

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Squeezing a handgrip for 12 weeks lowered blood pressure in medicated hypertensive women

Isometric handgrip training is already in clinical guidelines, but its effect during physical stress was untested in women. A Journal of Human Hypertension trial found 12 weeks lowered resting pressure and the pressure reached under strain.

Aug 26, 2026

A bowl of yogurt topped with strawberries and blueberries on a wooden table
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Probiotics trimmed waist size in adults with metabolic syndrome, but left blood pressure alone

An Obesity Reviews analysis of 19 randomized trials in adults with metabolic syndrome found probiotics, prebiotics and synbiotics reduced waist circumference and body weight. Blood pressure did not move, and neither did body mass index.

Aug 26, 2026

A low shot from behind of a walker's legs and white trainers mid-stride on a tree-lined tarmac park path
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Brisk walking lowered blood pressure, but the benefit peaked near 460 MET-minutes a week

17 trials and 1,493 people with high blood pressure. Brisk walking lowered both numbers, and the systolic dose-response curve turned back on itself: around 460 MET-minutes a week was the peak, and more did less.

Aug 25, 2026

A person curled on their side on a sofa with both hands pressed to their abdomen
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Endometriosis tracked more blood clots, from a low base

A Danish registry compared 63,999 women with endometriosis against 255,996 matched women. Clots ran at 2.18 per 1,000 women a year against 1.54, which is about one extra clot a year for every 1,500 women.

Aug 17, 2026

A person using a blue floss pick between their front teeth in a bathroom
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Flossing tracked 23% fewer strokes in 98,866 Korean adults followed for nine years

A Korean study followed 98,866 adults for nine years. Those who brushed twice daily and used floss and interdental brushes had 23% fewer ischemic strokes. Nobody has ever run a trial that randomizes people to floss.

Aug 17, 2026

An overhead view of people crossing a city street at a marked crosswalk
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Walkable streets tracked lower diabetes risk, but clearly only in richer areas

Diabetes Care followed 12,403 New York women who had gestational diabetes. One in five developed type 2 diabetes within 12 years. Walkable streets tracked lower risk, and clearly so only in the most affluent neighborhoods.

Aug 17, 2026

A pair of feet in dark socks standing on a digital bathroom scale on a wooden floor
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Weight lost early in prediabetes still counted 34 years on

The Da Qing study followed 540 Chinese adults with impaired glucose tolerance for 34 years. Those who lost at least 5% of their weight in the first six years later had a third fewer deaths and half as many heart failure admissions.

Aug 14, 2026

White tablets and an open bottle on a yellow background
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Melatonin worsened blood sugar, but only in gene carriers

A tightly controlled Diabetes Care trial gave the same 21 adults both 5 mg of melatonin and a placebo. Glucose tolerance worsened in the 10 who carry a common diabetes risk variant, and not in the 11 who do not.

Aug 6, 2026

Two small white tablets on a plain pink background
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An oral GLP-1 pill cut weight 9% in a phase 2 trial

A trial in Nature Communications tested a once-daily GLP-1 tablet in 235 Chinese adults with obesity. The top dose beat placebo by about 7 percentage points over 26 weeks, with the usual gut side effects.

Aug 4, 2026

Two parents and two children preparing vegetables together at a kitchen counter
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Adding family coaching to GP care worked for child obesity

A randomized trial across 41 US primary care practices gave 730 children either enhanced usual care or that plus family behavioral treatment. The families who got the coaching saw more than double the reduction in relative weight.

Aug 3, 2026

A glowing blue heart rate trace running across a grid
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Heart deaths halved since 1990. The causes swapped places.

A JAMA Cardiology analysis of US deaths from 1990 to 2023 found the heart disease death rate down 58.7%, with smoking and air pollution receding as causes while high body weight and blood sugar climbed.

Aug 3, 2026

A woman running a hand through her hair and looking toward the camera
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GLP-1 drugs carried higher hair loss risk than two rivals

Comparing 12,004 people starting a GLP-1 drug against those starting other diabetes medicines, researchers found more diagnosed hair loss. The absolute risk stayed low.

Aug 2, 2026

An older couple walking together through a meadow of wildflowers
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Lifestyle cut chronic disease. Metformin did not.

Two decades after the Diabetes Prevention Program, 1,173 participants were checked for accumulated illness. The lifestyle arm came out ahead. The drug arm matched placebo.

Aug 2, 2026

Broken sheets of ice floating at the edge of dark cold water
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Mild cold lowered blood sugar. Colder did nothing.

A Diabetologia trial put people in a water-cooled suit until they shivered. In type 2 diabetes, the gentler cold cut 24-hour glucose. The harder cold did not.

Aug 1, 2026

A person sitting alone on a chair beside a curtained window in a dim room
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Loneliness tracked heart and metabolic disease across 33 countries

Pooling six aging cohorts covering 81,978 people, researchers found loneliness preceded cardiometabolic disease, and unhealthy habits explained only 5% of the link.

Aug 1, 2026

Two clinicians examining spine X-rays displayed on a lightbox
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GLP-1 drugs tracked with fewer fractures, but only with diabetes

A JAMA Network Open study of 133,606 matched patients found GLP-1 drugs linked to lower fracture risk in type 2 diabetes, and higher risk in people without it.

Jul 29, 2026

A patient in a hospital gown standing at a clinic weighing scale
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Mazdutide took off 16.7% of body weight in a phase 3 trial

A JAMA phase 3 trial of 461 Chinese adults with obesity found the dual glucagon and GLP-1 drug mazdutide cut body weight by 16.65% over 60 weeks against 1.50% on placebo.

Jul 29, 2026

A person standing on a bathroom scale, seen from behind
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The weight came back. The visceral fat loss didn't.

A Circulation follow-up scanned 366 people 5 and 10 years after two diet trials and found that despite complete weight regain, visceral fat stayed partly down, and 10% less of it cut diabetes risk 28%.

Jul 29, 2026

A gloved clinician giving an injection into an upper arm
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COVID vaccine tied to fewer heart events in over-75s

A JAMA Internal Medicine study of 1,039,659 US veterans found the 2024-2025 COVID vaccine tracked with fewer heart attacks, strokes and cardiovascular deaths, with the benefit concentrated in the oldest.

Jul 28, 2026

Two teenagers playing on an outdoor running track
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Weight-loss drugs worked better with lifestyle, not without

A JAMA Pediatrics network meta-analysis of 42 trials in 3,835 adolescents found every obesity drug performed better paired with lifestyle treatment than on its own.

Jul 28, 2026

A person sitting on the edge of a bed with hands on their knees
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Stopping GLP-1 drugs tracked with more anxiety after

A Nature Metabolism study of Shanghai health records found GLP-1 drugs carried no extra psychiatric risk during treatment, but higher risk of depression and anxiety after people stopped.

Jul 28, 2026

Overlapping blister packs holding many different coloured tablets and capsules
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Semaglutide led the field for antipsychotic weight gain

A JAMA Psychiatry network meta-analysis of 95 trials ranked 39 drugs for reversing antipsychotic weight gain, and semaglutide came out well ahead at nearly 11 kg.

Jul 27, 2026

Masked surgeons working under theatre lights during an operation
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Bariatric surgery cost less downstream than GLP-1 drugs

A JAMA Network Open study matched 2,721 pairs of Israeli patients over up to 12.5 years and found those on GLP-1 drugs ran up $109 more per month in other health costs than surgery patients.

Jul 27, 2026

An empty residential street lined with terraced houses under a grey sky
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Black women developed high blood pressure 9.6 years earlier

A JAMA Network Open study of 15,313 US women found Black women developed hypertension nearly a decade earlier than White women, and the gap persisted regardless of neighborhood conditions.

Jul 27, 2026

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Survodutide cleared liver fat in 84% of patients

A Nature Medicine phase 3 trial of 216 adults found survodutide cut liver fat by at least 30% in 84.2% of those treated, against 24.3% on placebo, alongside 12.2% weight loss.

Jul 27, 2026

A close-up of a blood glucose meter beside a fingertip blood sample
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Losing 15% early after a diabetes diagnosis cut complications

A Diabetes Care study of 72,480 UK patients found those who lost at least 15% of their weight within two years of a type 2 diabetes diagnosis had fewer heart and kidney complications later.

Jul 26, 2026

A healthcare worker measuring her blood pressure with an arm cuff
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Obesity's metabolic risk gap has narrowed in older adults

A Lancet analysis of 978,425 people across seven countries found blood pressure and cholesterol in older adults with obesity now often match those at normal weight, largely because more of them are medicated.

Jul 26, 2026

A single white oval tablet on a pale blue background
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Oral GLP-1 pill elecoglipron hit 10% weight loss in a trial

A Lancet phase 2 trial of 310 adults found the oral GLP-1 drug elecoglipron produced up to 10.5% weight loss in 26 weeks against 0.6% on placebo, with no injections and no food restrictions.

Jul 26, 2026

A man measuring his waist with a tape measure
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Sarcopenic obesity tripled type 2 diabetes risk

A Diabetes Care analysis of 479,607 UK Biobank participants found people with both low muscle strength and high body fat had over three times the type 2 diabetes risk, far above either problem alone.

Jul 26, 2026

A young girl smiling at a table behind a glass of juice, with whole oranges in the foreground
News

Childhood fruit juice tracks with high blood pressure at 36

A Circulation study followed 25,749 Americans from age 12 to age 36 and found daily sugary drinks and daily fruit juice both tracked with higher rates of high blood pressure, while whole fruit did not.

Jul 25, 2026

A person holding a blue medical injection pen indoors
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Apitegromab kept muscle on during tirzepatide weight loss

A Nature Medicine trial of 102 adults found adding the antibody apitegromab to tirzepatide cut lean-mass loss by 1.9 kilograms over 24 weeks, without slowing total weight loss.

Jul 25, 2026

A person holding a cardboard box filled with fresh vegetables
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Food-as-medicine groceries improved blood sugar in diabetes

A Circulation randomized trial gave 460 Medicaid-insured adults with type 2 diabetes six months of weekly grocery deliveries and saw a modest but real improvement in long-term blood sugar.

Jul 25, 2026

An older woman standing alone at a window, holding the sheer curtain and gazing out
News

Loneliness was tied to a higher risk of heart valve disease

Across 462,917 UK Biobank adults tracked for about 14 years, those who felt lonely had a higher risk of degenerative heart valve disease. Living alone or being socially isolated did not carry the same risk.

Jul 23, 2026

Plastic waste and debris strewn along a polluted riverbank
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Heart attack patients carried more microplastics in blood

Italian researchers measured plastic particles in the coronary blood of 61 angiography patients. They turned up far more often in heart attack patients, though smoking history predicted their presence better than the heart attack.

Jul 23, 2026

A fork wound with a blue measuring tape, held in one hand
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Yo-yo dieting was tied to muscle loss on body scans

Researchers at UC San Francisco tracked 1,433 middle-aged adults with repeat MRI scans and found that people whose weight kept swinging lost more thigh muscle than those who stayed stable.

Jul 23, 2026

Blood sample vials in a laboratory rack
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Why apoB may be a better cholesterol test than LDL

A Northwestern simulation of 250,000 statin-eligible US adults found guiding treatment by apoB, a count of harmful cholesterol particles, prevented more heart attacks and strokes than standard LDL goals. It is a projection, not a trial.

Jul 22, 2026

A close-up of ridged potato chips inside an open snack bag
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Ultra-processed food tied to 19% higher heart-death risk

An Australian study followed 39,544 adults for a median of 25 years. Those eating the most ultra-processed food were more likely to die of cardiovascular disease, even after accounting for sugar, salt and diet quality. A link, not proof.

Jul 21, 2026

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