Yet, sometimes, the most straightforward path forward emerges far from where one expects. A clinical field initiative unfolding in Ghana is demonstrating that with the right technology and training, frontline physicians can step into the widening gap and save lives.

AISAP, an emerging voice in AI-supported point-of-care diagnostics, announced a landmark deployment of its Food and Drug Administration-cleared cardiac diagnosis platform across Ghana. The initiative powers the country’s first nationwide program to train cardiac sonographers and is being deployed in partnership with the G-ACT Foundation. What is unfolding across this West African nation may well offer the most compelling and implementable model for tackling America’s growing cardiology deserts.

When Specialists Are Scarce, Technology Becomes the Essential Partner

Ghana’s health system faces an extraordinary shortage, with fewer than 30 cardiologists serving a population of approximately 35 million. For years, this scarcity placed extraordinary weight on general practitioners, nurses, and emergency teams who lacked the tools or training to perform early cardiac assessments. The AISAP initiative changes that.

“AISAP brings world-class AI diagnostic capability that accelerates training, safeguards quality, and ensures every scan counts,” said Alexis K. Okoh, MD, Executive Chairman of the G-ACT Foundation. “This partnership sets a new standard for accessible cardiovascular care across Ghana, empowering local clinicians to become the new frontline of heart health.”

Clinicians can now access specialist-level interpretation at the bedside. This is more than a clinical advance; it’s a rebalancing of access within care systems. When the tools of expertise reach the people closest to patients, whole nations shift from reactive care to proactive health creation.

A Proven Model for the U.S. Rural Challenge

While the headlines may focus on Ghana now, the unspoken message is aimed squarely at the United States. America’s rural hospitals increasingly rely on traveling specialists, overburdened telecardiology services, or simply do without. AISAP CEO, Adiel Am-Shalom, makes the connection:

“This project represents the heart of our mission, ensuring that access to advanced cardiac care should not depend on geographic location. We are deploying the same FDA-cleared technology trusted by major US hospitals across remote frontlines in Ghana. The model is clear – our cloud-based platform delivers specialist-grade insights to frontline physicians. This deployment is the ultimate proof of concept that AISAP can help solve the diagnostic gap for U.S. rural hospitals facing critical cardiologist shortages.”

Proof of concept is often clinical. Here, it is also a moral imperative. If a middle-income country with constrained resources can deploy expert-level diagnostic capability at scale, what excuse remains for wealthier nations struggling to bridge gaps only widened by geography and policy inertia?

Inside the Technology: When Data Becomes Diagnostic Power

The AISAP Point-of-Care Assisted Diagnosis (POCAD™) platform represents a new generation of applied AI, built not to replace clinicians, but to enable them.

Developed in collaboration with Sheba Medical Center, one of the world’s top hospitals, POCAD has been trained on more than 300,000 echocardiogram studies and 24 million video clips. The platform provides real-time, expert-grade interpretation, along with high-quality guidance for non-specialists. It also provides an Urgency Score that helps clinicians prioritize the sickest patients immediately.

The system does not require proprietary equipment. Almost any portable ultrasound device with an internet connection can transmit images to the secure, HIPAA-compliant cloud.

This accessible specialist knowledge has already made inroads in leading U.S. systems, including Mass General Brigham, Mayo Clinic, Jefferson Health, and Stanford. What makes Ghana’s deployment so compelling is the scale at which the technology is being integrated into clinical pathways, starting with training.

Building an Ecosystem of Capability: The BEAT Program

The Ghana initiative operates through the G-ACT Foundation BEAT Program (Building Echo-Capacity for Access & Triage). It is the nation’s first structured and internationally benchmarked cardiac sonographer training curriculum, developed in collaboration with Ghanaian cardiologists and global academic partners.

“The ability to deploy advanced, life-saving diagnostic capacity directly to our citizens is a monumental step forward for our healthcare system,” said Prof. Yaw A. Wiafe, Associate Professor of Clinical Ultrasound and Echocardiography at Kwame Nkrumah University of Science and Technology. “AISAP’s technology removes traditional barriers to care and offers immediate, tangible results for our population.”

Training programs tend to succeed or fail on three pillars: quality, consistency, and clinical reinforcement. By providing specialist-level diagnostic support directly to trainees, the BEAT Program bypasses traditional barriers and accelerates the development of a new cadre of cardiac professionals. It creates not only capability but confidence.

A Future Defined by Shared Solutions

Ghana’s experience is a striking reminder that innovation need not follow wealth. It follows will, collaboration, and a refusal to accept that a shortage of specialists must translate into a shortage of care.

In many ways, AISAP efforts reflect a shift taking shape across global health: solutions once designed for high-resource environments are being refined in low-resource settings and then reapplied to mature health systems that need new pathways to scale.

“The very first patient we scanned in Ghana was a 46-year-old woman, and her life was immediately changed when our platform quickly identified severe heart failure and multiple valve diseases. She was transferred for urgent care. This outcome is exactly why we built this technology,” shares Adiel Am-Shalom, AISAP co-founder and CEO of AISAP.  “We are now focused on scaling US implementations to ensure our proven, FDA-cleared technology helps even more people and provides access to critically needed care nationwide.”

For the United States, where rural communities are growing older, sicker and more medically isolated, the lesson is unmistakable. Technology that equalizes expertise is no longer optional. It is central to ensure that ZIP codes do not determine survival.

As Ghana builds its next generation of cardiac frontline clinicians, the implications stretch far beyond national borders. This initiative demonstrates what is possible when innovation and intention align, and when the goal is not just to advance diagnostics, but to advance equity.

Ghana is charting a course that others, including the U.S., can follow. AISAP deployment is not just a technology story. It serves as a reminder that health is a shared human endeavor and that the most effective ideas in medicine are those that bring care closer to those who need it most.

The post AISAP Rural Health Breakthrough in Ghana is a Blueprint for Solving Cardiology Deserts appeared first on Medika Life.

The FemTech Foundation—and Fault Lines

In 2015, fewer than 300 ventures focused on women’s health existed. That number has tripled to 942, according to the Galen Growth HealthTech Alpha™ platform. These ventures now span the female health continuum—gynecology, menopause, oncology, cardiovascular disease, mental health and beyond.

Yet the investment tide has not fully turned in FemTech’s favor. While partnerships have risen 15.3-fold during the past decade, capital deployment has grown only 1.4 times. Compare that to the 2.6x expansion of digital health investments. In 2024, FemTech secured $2.2 billion in funding, a sliver of the $26 billion digital-health pie.

This disparity isn’t due to a lack of innovation—quite the opposite. The problem is systemic: funding gaps, policy voids, and clinical blind spots that overlook the $360 billion “ghost market” of women’s health. That phrase— “ghost market”—is the report’s haunting term for the opportunities left untouched by current investors and providers alike.

From Fertility to Full Spectrum

One of the report’s most critical takeaways is how much the FemTech category is maturing. Fertility tracking and pregnancy apps put the field on the map. But FemTech today is far more.  It recognizes the vast need for medicine to engage with women’s unique health needs, long unaddressed.

The Galen Growth data shows that while gynecology and oncology account for more than half of all FemTech ventures, menopause, chronic pain, autoimmune conditions, cardiovascular disease and mental health are surging into the investment and innovation spotlight. These are not “niche” categories—they represent common, often underdiagnosed or misdiagnosed conditions that disproportionately affect women and impair their quality of life.

This expansion reflects a growing recognition that women’s health is not a subset—it’s a central pillar of public health. As de Salaberry writes in a soon-to-appear Health Tech World byline: “To be transformative, FemTech must address the entirety of the women’s health continuum, including those therapeutic areas that are not traditionally branded as female-specific but affect women in distinct ways.”

Twice the Clinical Evidence—But Still Under Scrutiny

Perhaps the report’s most sobering—and telling—data point is that FemTech ventures generate nearly twice the volume of clinical trials, peer-reviewed research, and regulatory filings as their digital health peers. Twice. That’s not due to past scientific rigor; these companies are held to a higher standard. Founders and advocates must go the extra mile to validate the clinical value of their solutions.

Despite this, systemic barriers remain. The report shows 71 percent of early-stage FemTech ventures struggle to raise a Series A round. Funding the “middle”—those post-seed but pre-scaleup companies—is an urgent priority. Without it, too many promising solutions will stall before reaching the women who need them.

Let’s be clear: this isn’t just about meeting investor milestones. It’s about delivering equity in care. Cardiovascular disease is the leading cause of death among women, yet it remains underrepresented in FemTech portfolios. Alzheimer’s and autoimmune conditions disproportionately affect women, yet receive comparatively little innovation focus.

Those are not oversight gaps. They are deep, systemic failures – disparities in our health innovation system.

From Direct-to-Consumer to Deep Health Integration

Another significant signal of maturity is the shift away from pure direct-to-consumer (DTC) models. In 2024, 42 percent of FemTech partnerships involved health systems, up from just 10 percent in 2020. That’s a tectonic shift from point solutions to systemic integration.

As de Salaberry puts it, “DTC strategies alone cannot reach underserved populations or secure the reimbursement pathways necessary for scale.” Systemic integration—through payers, providers, and public institutions—is essential for sustainability and access. FemTech must live where care happens, not just on consumers’ cell phones.

Regionally, the picture is just as telling, with Europe leading in clinical rigor, with 50 percent of FemTech ventures demonstrating proven clinical strength. North America leads in funding ($1.3B), while Asia-Pacific remains a hub of AI-driven diagnostics, even amid a dip in capital investment. These trends point to what’s next: a future driven by localization, clinical excellence and technology convergence.

Forces Shaping the Future of FemTech

The report outlines five key factors shaping the FemTech evolution during the next five years. They’re worth noting for anyone investing, innovating or advocating for equitable care with an eye toward return on investment:

• Redefining the Scope: FemTech must look beyond reproductive health to address chronic diseases, aging, and behavioral health.
• Breaking the DTC Mold: Success will be defined by integrated partnerships with employers, insurers, and health systems.
• Balancing Rigor and Agility: Regulatory requirements must support innovation without stifling it.
• Funding the Growth Gap: Series A and B support is critical to help early innovators scale.
• Smart Consolidation: M&A isn’t just about exits—it’s about building category leaders with breadth and credibility.

Infrastructure, Not Hype

The key here is infrastructure. FemTech is not a trend—it’s the scaffolding of women’s health innovation. Investors need to hear that message and invest to make this population health category viable.

With nearly half the global workforce made up of women, the ROI on women’s health is not just moral—it’s macroeconomic. The health ecosystem can no longer afford to treat women’s health as an edge case. It is, in fact, the core of population health.

FemTech’s next chapter will be shaped by evidence, equity and integration. It must also be underpinned by trust from payers, providers, and patients. That trust is earned through data, outcomes and the bold assertion that women’s health is health, full stop. This Galen Growth Report goes a long way to demonstrating the positive outcomes when innovation and investment converge.

As Julien de Salaberry wisely states: “The next generation of Femtech isn’t about visibility—it’s about value, integration, and health systems impact.” That’s not just a forecast—it’s a framework for what’s next.

[Editor’s Note: For a deeper dive into the Galen Growth FemTech 2025 report, visit galengrowth.com. The full report and press release, are available now.]

The post Galen Growth FemTech 2.0 Report: Elevating Women’s Health from Niche to Necessity appeared first on Medika Life.

I stepped outside, tea still warming my throat, and began walking past the hedge that always rustles without wind, past the tree that leans like it’s listening.

I do this twice a day, sometimes more.

Not because I’m chasing steps or closing rings, but because walking calms the static inside me.

It’s a quiet ritual stitched into my hours.

And lately, I’ve learned it may be doing more than soothing my mind — it might be rewriting the rhythm of my heart.

Heart Arrhythmias

Your heart beats in a steady, coordinated rhythm — about 60–100 times per minute at rest — thanks to an internal electrical system that keeps everything in sync.

What is the heart’s natural pacemaker?

www.medicalnewstoday.com

In an arrhythmia, the electrical system misfires, and the heart can:

• Beat too quickly (tachycardia)
• Beat too slowly (bradycardia)
• Beat irregularly (like a flutter or with pauses)

Common types

Here are the most common types of arrhythmia:

• Atrial fibrillation (AFib) is the most common type, where the upper heart chambers (atria) quiver instead of beating properly.
• Ventricular tachycardia is a dangerously fast rhythm from the lower chambers.
• Premature beats are usually harmless and feel like a skipped beat or a flutter.
• Heart block is a condition in which electrical signals are delayed or blocked.

Why It Matters

Some arrhythmias are harmless and cause no symptoms.

Others can lead to stroke, heart failure, or sudden cardiac arrest.

Symptoms may include:

• Palpitations (fluttering or pounding)
• Dizziness or fainting
• Shortness of breath
• Chest discomfort

Fortunately, a healthy lifestyle can reduce our risk, including a heart-healthy diet, physical activity, maintaining a healthy weight, not smoking, and managing stress.

A New Study

A new study led by researchers at the University of Glasgow (United Kingdom) reports this:

Walking briskly (more than 4 miles per hour) can reduce the risk of heart rhythm abnormalities or atrial fibrillation by as much as 43%.

The study, published in Heart, suggests that brisk walking could be a safe and effective way to reduce heart rhythm abnormalities, particularly in those at higher risk of developing them.

Study Details

Researchers analyzed data from the UK Biobank, focusing on 420,925 adults with an average age of 56 years.

Among them, 80,773 participants wore accelerometers (such as smartwatches) to track their walking time and speed.

Walking pace was self-reported and grouped into three categories:

• Slow: Less than three mph
• Average: 3 to 4 mph
• Brisk: Over four mph

Of the participants, 7% identified as slow walkers, 53% as average, and 41% as brisk walkers.

Results in Detail

Over a median follow-up of 13.7 years, 9 percent developed some form of cardiac arrhythmia, including atrial fibrillation, bradyarrhythmias (abnormally slow or irregular heartbeats), and ventricular arrhythmias.

After adjusting for factors like age, sex, alcohol intake, ethnicity, existing health conditions, and socioeconomic status, the results were striking:

• Average pace. Compared to slow walkers, those who walked at an average pace had a 35% lower risk of developing arrhythmias.
• Brisk walking. Brisk walkers had an even greater benefit, with a 43% lower risk.

My Take

This study is the largest to show that physical activity can lower the risk of arrhythmias, including atrial fibrillation.

The article also highlights this:

Exercise quality — not just quantity — matters. The faster the pace, the greater the benefit.

Of course, the study does not prove a causal relationship exists between brisk walking and reduced AFib risk.

Nevertheless, these findings provide stronger evidence to guide my conversations with patients, encouraging them to exercise regularly and with enough intensity to protect their hearts.

The post This 5-Minute Habit Could Help Prevent a Dangerous Heart Condition. appeared first on Medika Life.

Expanding Beyond Traditional Lipid Markers

While LDL cholesterol remains a crucial target in cardiovascular prevention, Dr. Natarajan highlighted the importance of looking beyond this traditional marker. He emphasised the value of measuring ApoB, which provides a more accurate count of atherogenic particles and can be particularly useful in patients with features of insulin resistance.

Dr. Natarajan suggests aiming for an ApoB level about 10% lower than the LDL cholesterol target. He explained, “If we’re aiming for about 40 [mg/dL for LDL], that’s like 36 [mg/dL for ApoB], so relatively similar. If it’s not and it’s higher, then obviously increase the LDL cholesterol-lowering medicines because lower the ApoB and then follow the ApoB with the lipids going forward.”

The Role of Inflammation in Heart Disease

The conversation touched on the often-overlooked role of inflammation in cardiovascular disease. Dr. Natarajan discussed the CANTOS trial, which demonstrated that targeting inflammation with canakinumab, an IL-1β antibody, could reduce cardiovascular events. He also mentioned the potential of colchicine, an inexpensive anti-inflammatory drug, in secondary prevention of cardiovascular events.

Regarding colchicine, Dr. Natarajan stated, “I do really think about it particularly for patients who have had recurrent events. The people who market the medicine and do research do remind us that C-reactive protein was not required in the inclusion, but nobody has done that secondary assessment to see if measuring C-reactive protein would be helpful in identifying the beneficial patients.”

Clonal Hematopoiesis of Indeterminate Potential (CHIP)

Dr. Natarajan, a leader in CHIP research, explained how these acquired mutations in blood stem cells can significantly increase cardiovascular risk. Despite strong evidence linking CHIP to adverse cardiovascular outcomes, routine testing is not yet implemented due to cost and insurance considerations.

He noted the potential for future screening: “There are research tests that are kind of in the $10 to $20 range right now for CHIP. And if flipped over to the clinical side will also be reasonably low cost. And so, for the paradigm for clinical implementation, that cost part is necessary.”

The Promise of Polygenic Risk Scores

Both doctors expressed frustration at the slow adoption of polygenic risk scores (PRS) in clinical practice. These scores, derived from hundreds of genetic variants, can identify individuals at high risk for coronary artery disease much earlier than traditional risk factors.

Dr Natarajan emphasised the potential impact: “By polygenic risk score, you can find 1 in 5 individuals with that same risk [as familial hypercholesterolemia]. If you go higher than that, it’ll be even higher risk related to that. And that is noble information very early in life.”

Emerging Drug Classes: GLP-1 Agonists and SGLT2 Inhibitors

The podcast highlighted the expanding role of drugs originally developed for diabetes in cardiovascular prevention. GLP-1 receptor agonists have shown remarkable benefits in weight loss and cardiovascular outcomes, while SGLT2 inhibitors have proven effective in heart failure management, particularly in patients with preserved ejection fraction.

Dr Natarajan expressed enthusiasm about these developments: “I feel like every week I’m reading a new clinical trial about a new clinical outcome benefit as it relates to GLP-1 receptor agonists… The fact that we have medicines that are safe and effective for lowering weight that also have real strong effects on clinical outcomes is tremendous.”

Looking to the Future

Dr. Natarajan emphasised the need for continued innovation in cardiovascular prevention. He pointed out that as traditional risk factors are better managed, new factors like insulin resistance and obesity are becoming increasingly important.

Reflecting on the future, he said, “There is a dramatic potential for these kinds of therapies in reducing the residual risks that we see related to cardiovascular disease. So I’m enthusiastic and excited. I think a lot more biology needs to be understood of how much of this is being influenced specifically through this pathway versus a very effective weight loss medicine.”

In conclusion, the conversation between Dr. Topol and Dr. Natarajan painted a picture of a field on the cusp of significant advancements. The tools for preventing cardiovascular disease are expanding rapidly, from novel biomarkers and genetic risk assessment to innovative drug therapies. However, the challenge remains in translating these scientific advancements into widespread clinical practice, particularly in healthcare systems not optimised for preventive care.

The post The Future of Cardiovascular Disease Prevention: Insights from Drs. Eric Topol and Pradeep Natarajan appeared first on Medika Life.

I am constantly amazed at the role of luck (and an astute observer) in scientific advancement. You will be surprised how researchers discovered nitroglycerin, an important coronary artery disease management drug.

I’ll explore the remarkable nitrate discovery story. Then, I look forward to examining the contributions of Dr. Murad. We’ll end with five top tips for reducing your chances of suffering from cardiovascular disease.

“Diseases desperate grown,
By desperate appliance are relieved,
Or not at all.”

― William Shakespeare, Hamlet

Museums and Medicine

You might wonder why I notice connections such as heart medicines and dynamite.

My dear mother had something to do with my inclinations. When I was young, she took me to a museum every month. New York’s Museum of Modern Art, the Metropolitan Museum of Art, and the Yale Gallery.

When I visited New York last week, my first destination? The Whitney Museum in Manhattan’s Meatpacking District.

Why do I bring this up? My former school, Yale School of Medicine (USA), has an observational skills training workshop for first-year medical students.

The workshop is an exercise in visual training that allows students to look at something foreign to them early in their medical careers ‒for instance, an 18th-century British painting‒and extract the relevant information.

Why Yale Medical Students Go to a Museum

Here’s course creator Irwin M. Braverman, M.D. ’55, professor emeritus of dermatology:

“[Looking at art works] is a far cry from what we had,” said Braverman, recalling his medical education. “We were taught to look for patterns that were already known to exist.”

Shadows on an X-ray are this kind of problem. But what happens when a doctor encounters a situation they were not exposed to in medical school? They have no pattern on which to fall back.

According to Braverman, it takes about ten years to develop the skills to solve medical puzzles, and he wanted to give his students a head start.

“In essence, [examining art] is a physical examination of a patient,” said Braverman. The exhibit hall is the examination room, and the painting becomes the patient.

You Should Consider Going to a Museum

Examining great works of art teaches us observational skills. At Yale, students have 15 minutes to observe an assigned painting individually and gather as much detail as possible.

Based on their observations, the medical students discuss what may occur in each painting as a group.

Braverman explains that 18th- and 19th-century British paintings are perfect for this exercise because many offer stories about a real historical event. However, similar to patients with unexplained symptoms, they often contain ambiguous or contradictory information.

Trekking to your local museum or gallery might improve your observational skills.

Looking at paintings, sculptures, and performance art slows me down. It forces me to stand (or sit, a phenomenon more necessary as I age) and observe.

This year, for the first time, Braverman replaced the standard post-workshop evaluation with a specific question: what have you learned about yourself as an observer?

Nearly every medical student explained that, though they considered themselves adequate observers before the art workshop, they realized they previously looked at things superficially.

The course helped them learn to look at the world and their patients more in-depth.

Finally, I think of my museum times as ones of mindfulness. (And, it’s easier than vinyasa flow yoga for me.)

The Remarkable Discovery of Nitroglycerin

Have you heard of nitroglycerin? Nitroglycerin prevents angina (chest pain) caused by coronary artery disease.

This medicine is also used to relieve an angina attack that is already occurring.

Nitroglycerin belongs to a class of drugs known as nitrates. Angina happens when the heart muscle is not getting enough blood.

The drug works by relaxing and widening blood vessels to allow blood to flow more easily to the heart. Nitroglycerin will not relieve chest pain once it occurs.

It is also not intended to be taken just before physical activities (such as exercise or sexual activity) to prevent chest pain. Other medications may be needed in these situations.

The Nobel Prize

What do you think of when I mention Aldred Nobel? My mind immediately goes to the Nobel Prize.

I’m speechless! — Maria Ressa’s reaction when Olav Njølstad, Secretary of the Norwegian Nobel Committee, awarded her the 2021 Nobel Peace Prize for her “efforts to safeguard freedom of expression, which is a precondition for democracy and lasting peace.”

For over a century, Nobel Prizes have recognized extraordinary human achievements, ranging from literature to science.

The Nobel Prize is gifted “to the person who shall have done the most or the best work for fraternity between nations, the abolition or reduction of standing armies and for the holding and promotion of peace congresses,” according to the last will of founder Alfred Nobel.

The 2023 Nobel Prize announcements will occur from October 2nd through the 9th.

Alfred Nobel, Dynamite, and More

But our tale has a dark side, including death and mayhem. Let me back up a bit to talk about Alfred Nobel’s father.

Immanuel Nobel created the first truly usable sea mines on behalf of the Russian Czar. This development occurred in the mid-19th century during the Crimean War.

Alfred Nobel developed dynamite. He did not plan on its being used in war. Of course, you know the rest of the story.

Dynamite was soon used in the Franco-Prussian War. The Prussians used it first, followed by the French.

Alfred Nobel, Merchant of Death?

While many associate Nobel with pacificism, whether he approved dynamite’s military use is unclear.

In 1888, Alfred Nobel’s brother Ludvig died. A journalist erred and printed Alfred’s obituary. The piece scorned the living brother as a man who made millions through the deaths of others.

A French newspaper wrote, “Le marchand de la mort est mort,” or “The merchant of death is dead.” The obituary described Nobel as a man “who became rich by finding ways to kill more people faster than ever before.”

Stunned by what he read, Nobel was determined to improve his legacy. One year before he died in 1896, Nobel signed his last will, which set aside most of his vast estate to establish the five Nobel Prizes, including one awarded for pursuing peace.

Nitroglycerin Discovery

Let’s return to the strange story of heart and erectile dysfunction medicines. First, did you know that nitrate medications can trigger airport bomb detection scanners?

Nitrate-containing drugs also get the attention of explosive-sniffing dogs, a reminder of the origins of this extremely useful medication.

Ascanio Sobrero in Turin discovered nitroglycerin in 1847, following work with Theophile-Jules Pelouze.

Alfred Nobel joined Pelouze in 1851 and recognized the potential of nitroglycerin. Nobel began manufacturing the substance in Sweden, overcoming handling problems with his patent detonator.

Interestingly, Nobel suffered acutely from angina (chest pain) and refused nitroglycerin as a treatment.

Nitroglycerin in Medicine: Innovation from Tragedy

Today, nitroglycerin is a drug that dilates blood vessels.

The potent medicine is typically administered under the tongue to relieve and prevent angina (chest pain caused by reduced blood flow to the heart) attacks.

Dr. Ferid (“Fred”) Murad (1936–2023), a pharmacologist who shared a Nobel Prize in 1998 for discovering nitric oxide — an air pollutant and byproduct of nitroglycerin— played a key role in relaxing blood vessels.

Dr. Murad’s discovery dates to the 1970s, when he began studying nitroglycerin, the substance that Alfred Nobel, the namesake of the annual awards given in medicine and other disciplines, used to invent dynamite in 1867.

Our story of nitroglycerin as a medicine goes back to the 1900s. Alfred Nobel’s factory workers noticed a curious side effect of the explosive substance.

The workers’ labor-induced chest pains disappeared when they inhaled nitroglycerin fumes inside the factory. Soon, doctors began trying it to remedy angina, high blood pressure, and other cardiovascular disorders.

Nitroglycerin became a common treatment for heart problems, but until Dr. Murad began studying it at the University of Virginia (USA), nobody understood how it worked.

Through elegant experiments, Dr. Murad discovered that nitroglycerin releases nitric oxide, which relaxes smooth muscle cells.

Nitric Oxide and Male Erectile Dysfunction

Dr. Murad’s discovery contributed to the development of Viagra, which helps produce erections by dilating blood vessels.

Viagra facilitates erections by increasing penile blood flow. Murad’s finding of the role of nitric oxide has also helped numerous premature babies (whose underdeveloped lungs need stimulation).

Dr. Murad died September 4th at his Menlo Park, California (USA) home. He was 86.

The post The Strange Story of Heart and Erectile Dysfunction Medicines appeared first on Medika Life.

High blood pressure.

High cholesterol.

Excess weight.

These are the risk factors for heart disease that your doctor typically talks to you about.  Yet, there is a risk factor that most doctors never discuss that can have as much impact as the ones I just listed — Depression.

Your mood plays a significant role in whether or not you get heart disease.  Study after study shows that the biological changes involved with depression– increased cortisol, elevated adrenaline, and decreased serotonin – causes changes in how well your heart functions.  It directly impacts how well your heart pumps as well as how much plaque develops in your arteries. Intense emotions and acute anxiety can literally change the shape of the heart. It’s a condition called Takotsubo cardiomyopathy and often referred to as “broken heart syndrome.”

Why is no one talking about this?

Even though we have made progress in recent years around the mind-body connection, we often don’t implement it in clinical practice. We create silos with physical health managed by physicians trained in internal and family medicine and mental health largely managed by psychiatry.  We need to be integrating and acknowledging there is no physical health without mental health, and there is no mental health without physical health.  It doesn’t make sense to only address risk factors such as blood pressure, cholesterol and weight – and then have mood as some time of afterthought.

If you follow some of my writing, you know I’m a big fan of risk calculators. Perhaps it’s time to update those that help calculate risk of cardiovascular disease and add depression/anxiety in the calculation of the risk score. That might force folks to be more explicit and proactive about managing mood as part of a primary prevention program.

Like many other aspects of heart disease, we wait until someone has a heart attack to adequately address it.  We talk about the need to reduce stress after patients experience chest pain – we should be talking about mood before they get to that point!

We have made amazing advances in the treatment of heart disease but sometime still dies of a heart attack every thirty- five seconds. Given the mental health challenges that many people have experienced during the past two years, I expect deaths from heart disease will increase unless we take proactive steps in reducing risk.  Addressing depression and other mental health conditions must be an important part of plan.

The post Heart Disease and Depression appeared first on Medika Life.

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Medika Life has obtained these exclusive comments from Resolve to Save Lives CEO and President Dr. Tom Frieden. Dr. Frieden is the former director of the U.S. Centers for Disease Control and Prevention.

Since WHO first called for the global elimination of industrially produced trans fat in 2018 – with an elimination target set for 2023 – population coverage of best-practice policies has increased almost six-fold. Forty-three countries have now implemented best-practice policies for tackling trans fat in food, with 2.8 billion people protected globally.

Despite substantial progress, however, this still leaves 5 billion worldwide at risk from trans fat’s devastating health impacts with the global goal for its total elimination in 2023 remaining unattainable at this time.

Industrially produced trans fat (also called industrially produced trans-fatty acids) is commonly found in packaged foods, baked goods, cooking oils and spreads. Trans fat intake is responsible for up to 500 000 premature deaths from coronary heart disease each year around the world.

“Trans fat has no known benefit, and huge health risks that incur huge costs for health systems,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “By contrast, eliminating trans fat is cost effective and has enormous benefits for health. Put simply, trans fat is a toxic chemical that kills, and should have no place in food. It’s time to get rid of it once and for all.”

Currently, 9 of the 16 countries with the highest estimated proportion of coronary heart disease deaths caused by trans fat intake do not have a best-practice policy. They are Australia, Azerbaijan, Bhutan, Ecuador, Egypt, Iran (Islamic Republic of), Nepal, Pakistan and Republic of Korea.

Best-practices in trans fat elimination policies follow specific criteria established by WHO and limit industrially produced trans fat in all settings. There are two best-practice policy alternatives: 1) mandatory national limit of 2 grams of industrially produced trans fat per 100 grams of total fat in all foods; and 2) mandatory national ban on the production or use of partially hydrogenated oils (a major source of trans fat) as an ingredient in all foods.

“Progress in eliminating trans fat is at risk of stalling, and trans fat continues to kill people,” said Dr Tom Frieden, President and CEO of Resolve to Save Lives. “Every government can stop these preventable deaths by passing a best-practice policy now. The days of trans fat killing people are numbered – but governments must act to end this preventable tragedy.”

While most trans fat elimination policies to date have been implemented in higher-income countries (largely in the Americas and in Europe), an increasing number of middle-income countries are implementing or adopting these policies, including Argentina, Bangladesh, India, Paraguay, Philippines and Ukraine. Best-practice policies are also being considered in Mexico, Nigeria and Sri Lanka in 2023. If passed, Nigeria would be the second and most populous country in Africa to put a best-practice trans fat elimination policy in place. No low-income countries have yet adopted a best-practice policy to eliminate trans fat.

In 2023, WHO recommends that countries focus on these four areas: adopting best-practice policy, monitoring and surveillance, healthy oil replacements and advocacy. WHO guidance has been developed to help countries make rapid advances in these areas.

WHO also encourages food manufacturers to eliminate industrially produced trans fat from their products, aligning to the commitment made by the International Food and Beverage Alliance (IFBA). Major suppliers of oils and fats are asked to remove industrially produced trans fat from the products sold to food manufacturers globally.

The report, called Countdown to 2023 WHO Report on global trans fat elimination 2022, is an annual status report published by WHO in collaboration with Resolve to Save Lives, to track progress towards the goal of trans fat elimination in 2023.

For editors:

The World Health Organization has partnered with Resolve to Save Lives, a not-for-profit organization, to support the development and implementation of the REPLACE action package. Launched in 2018, the WHO’s REPLACE action package provides a strategic approach to eliminating industrially produced trans fat from national food supplies.

Since 2017, Bloomberg Philanthropies has supported Resolve to Save Lives’ global efforts to save lives from cardiovascular health disease.   

To find out more, visit: https://www.resolvetosavelives.org or Twitter @ResolveTSL  

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America’s changing diet and physical fitness

How we eat looks a lot different today compared to 40 years ago in terms of how much and what we consume. The Pew Research Center analyzed data from the U.S. Department of Agriculture (USDA) and found that in 2010, Americans ate around 23% more calories than in 1970. That adds up to about 2,481 calories a day, more than the suggested 1,850 to 2,000 calories adults need to maintain their current weight. The Pew report also shows that we are eating less meat, dairy, sweeteners, fruits, and vegetables today than in 1970.

Along with diet, exercise has also changed over the years. The field of exercise science began in the 1800s to better the health of working-class people using dance and sports. By the end of World War II, more Americans worked in factories, resulting in less strenuous activity than farm work. The sedentary lifestyle culminated in the invention of the television, which kept more people at home and less active.

In the 1950s, a global study revealed that American children were less fit than their counterparts in other countries. The study prompted the establishment of the President’s Council on Youth Fitness. The council began to take shape under the John F. Kennedy administration, launching a national campaign on physical fitness and physical education curriculum for schools across the country. The council and its programs are credited with changing public attitudes and improving fitness nationwide.

Does exercise work for weight loss?

You may wonder how exercise fits into a weight loss program. Unfortunately, you probably will not see significant weight loss from exercise alone. Many people overestimate the number of calories they burn by exercising, which can lead to misjudging the number of calories they can consume. Exercise may also trigger hunger or the idea that you can splurge calories on a treat because you went to the gym. Research shows that changes to your diet – eating fewer calories and more nutrient-dense food – are a better strategy for long-term weight loss.

While it may not help you lose weight, exercise still offers many potential health benefits, like better sleep, lower anxiety, and weight maintenance. In recent years, Marissa Quinones of Grand Prairie, Texas, has prioritized exercise as part of her daily life. Quinones, the director of medical affairs strategy for a biopharmaceutical company, began participating in fitness challenges through Women of Color in Pharma (WOCIP), a network of more than 900 female professionals working in the pharmaceutical industry. Each season, WOCIP hosts the Nike Run Club, an 8-week challenge that encourages members to log at least 25 hours of walking, running, or jogging miles per month. The challenges have fostered a spirit of friendly competition in Quinones, and a love of walking, hiking, and the outdoors.

“I prefer to be out in nature. It helps to clear my mind and get ready for the day,” she says. Compared to indoor exercise, walking outdoors also helps her focus more on enjoying exercise and less on the time spent doing it. ”I’m not really good at the treadmill. It wasn’t fun for me.”

Quinones walked almost 250 miles in 2021; by September 2022, she had already surpassed that number, with the goal of reaching 300 miles by the end of the year. Beyond the physical benefits, she views walking and other exercise like yoga as self-care for her mental health. Science confirms this idea – an extensive study of 1.2 million people living in the U.S. published in The Lancet Psychiatry found a meaningful link between physical exercise and improved mental health, depending on the type, duration, and frequency of the exercise.

What are the different types of diets, and do they work?

Despite gains in physical activity, more Americans have become overweight or obese over nearly 50 years, which has led to the rise of a culture of dieting. An imbalance between the calories you consume and the number your body burns causes obesity. Losing 5% to 10% of your body weight can lower blood pressure, triglycerides, and blood sugar. Dieting for weight loss usually involves including more of a particular food or food group while excluding others. We use a wide variety of methods to shed pounds, from low-carb, high-protein diets, to fasting and cutting out all animal products. But which ones actually work to lose weight and keep it off? First, it may be helpful to look at the different types of diets. Most fit into one of three categories:

Controlling macronutrient content. This involves managing the nutrients you consume. For example, eating more protein and fewer carbohydrates on the Atkins diet. Or diets that require you to cut back on certain types of fat.

Restricting or eliminating certain foods. Vegan, paleo, gluten-free, and Mediterranean diets fall into this category. They all require you to stop eating specific foods or food groups.

Controlling the timing of when you eat. Many people use intermittent fasting as a way to lose or control weight. This is when you stop eating and drinking for a certain period. Common types of intermittent fasting include periodic fasting, alternate day fasting, time-restricted feeding, and religious fasting.

Scientists have examined whether these diets are effective for weight loss and maintenance. A 2019 study from a researcher at Harvard Medical School looked at several popular diets and eating methods. In the short-term, high-protein, low-carb diets and intermittent fasting could help “jump start” weight loss and boost the amount of weight you lose, according to the study. But researchers caution that these diets may come with side effects such as weakness and headaches.

Over an extended period, the type of diet you choose may not matter as much. Research shows that different diets resulted in similar amounts of weight loss. The bottom line is that no one way of eating works universally for weight loss. What matters most is the quality of your food, burning more calories than you consume, and sticking with a diet for the long term.

To lose weight and keep it off, experts recommend lifestyle changes such as eating fewer calories, more nutritious foods, and participating in physical activity. It may also require things like therapy, medication, or even weight loss surgery.

A note on BMI

It’s also important to note that although many doctors and scientists use body mass index (BMI) to measure whether a person is overweight or obese, it’s not a definitive test. It is a single measure in a larger picture of your overall health.

Plus, BMI definitions are based on white bodies. Race and ethnicity can determine the makeup of your body, including body fat percentage and amount of muscle mass. This means BMI may be a less accurate measure for some people of color. Your doctor should also look at other things like blood pressure, cholesterol, and blood sugar to get a more detailed view of your health.

The post Will I lose more weight through diet or exercise? appeared first on Medika Life.

If current trends persist, nearly one in three Americans will develop type II diabetes alone in their lifetime. In addition to diabetes, the prevalence of other chronic lifestyle conditions such as obesity, heart disease, inflammatory bowel disease, chronic kidney disease and arthritis are growing exponentially. An equally daunting mental health crisis has emerged exacerbated by the Covid-19 pandemic. Significantly, neuropsychiatric disorders and inflammation have been closely intertwined, powering each other in a bidirectional loop. Thus, these two terrible epidemics may have compounding effects wreaking havoc on our societies.

Coupling this grim outlook with research findings showing that just 10 minutes of daily exercise will save an additional 110,000 lives each year in the US and just 30–60 minutes of strength training per week reduces all-cause mortality by 20%, you soon realize that a sick care system which relies mainly on medical interventions is grossly inadequate for improving health outcomes. And it runs counterintuitive to literature, and factors beyond medical interventions drive public health experts that suggest upwards of 70% of health outcomes are driven by factors beyond medical interventions.

With sick care spending having grown to nearly 20% of US GDP, we cannot afford to manage, let alone conventionally treat, chronic inflammatory conditions, the bulk of which remain preventable. At the same time, two-thirds of all personal bankruptcies in the US cite medical issues as the main reason.

Why have we found ourselves here? An oft-cited reason is that approximately 90% of the US health budget is spent via a fee-for-service reimbursement structure, which incentivizes volume and complexity of interventions. At the outset, this logic seems reasonable: one should only receive, and therefore pay for, an intervention if needed.

The problem, of course, is this system does not account for, nor incentivize approaches to prevent the disease from happening in the first place, thus preventing the need for these costly interventions. Given incentives drive decision making; it should come as no surprise that prevention has fallen short of becoming a viable business model, let alone one that can scale. But there is a recognizable paradox that has historically challenged preventative care: how can one distinguish the need for and, therefore, the outcomes and value of a preventive method?

The answer to resolving the prevention paradox is linking small behavioral changes to changes in personal health status (positive and negative) which can then be connected to economic value (creation and destruction). Such a capability has not existed to date. Yet, rapid developments of the internet of things, the cloud and AI/ML have given rise to the behaviorome (quantified characterization of behaviors) and environmentome (quantified characterization of social determinants of health), yielding nuanced insight into how daily decisions and behaviors in a given environment impact a person’s health.

As the behavioromes and environmentomes of a population become better characterized over time and linked to outcomes, a personal, dynamic health score could be calculated for individuals in that population. This dynamic health score could enable the prediction and assessment of a preventative intervention for an individual, potentially before the onset of detectable symptoms of chronic conditions, ultimately paving the way for a sustainable Prevention-as-a-Service (PaaS) business model. This new paradigm would aim to keep people healthy and dramatically alter the unsustainable course of the current healthcare model by bringing about significantly better outcomes at a lower cost.

The scalability of PaaS relies on modern data analytics methodologies such as machine learning that are well-suited for analysis, pattern recognition, and adaptive recommendations based on individual and population aggregate-level data. One can now begin to (a) create genuinely ‘personalized’ preventive programs and incentives that are more effective and (b) link small changes in an individual’s health status to value through a meaningful health score, which correlates with the value of prevention on an individualized basis.

If one can do this, then Prevention-as-a-Service becomes a sustainable business where there is an agreed-upon value creation standard through health score changes. Created value can then be shared between the person and all stakeholders dependent upon said individual staying healthy, such as healthcare paying entities. Moreover, this approach could employ behavioral economic models to support behavior change more effectively than today’s population-level best practices.

We believe that the infrastructure for PaaS is already here and that value creation through a dynamic health score will deliver, for the first time, a viable business model for prevention which is both scalable and sustainable. A platform dedicated to PaaS will empower citizens with health education and literacy, ensure inclusivity & health equity, and deliver convenience and community, all while leveraging behavioral economic models based on individualized health scores to incentivize each person’s health journey.

Preventing citizens from falling sick to lifelong chronic conditions may have sounded utopian in the past — it no longer is. Now is the time to do something about it.

It’s time to unleash health.

Credits: This article is a collaboration between Dr. Ramin Rafiei, CEO and Co-Founder of Reformulate Health and Dr. Jacob LaPorte, Co-Founder and Global Head of the Novartis Biome with equal contributions by both authors.

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Consider my great, great grandparents. They lived on a small farm and were largely self-sufficient. They ate two or three meals a day and never snacked. Food was locally sourced; vegetables and fruits were fresh and ripe; chickens spent the day in the fields. Fish came out of nearby streams and rivers, and meat came from animals hunted in the forests or grazed on the farm.

There were no pesticides, no foods shipped thousands of miles, no meat from animals fattened with corn and soybeans, no fish from fish farms. Candy, soda, and junk foods were almost unknown. There were no processed and packaged foods as we know them, and there were no fast-food restaurants — foods that are all heavily marketed today yet are inherently unhealthy but tasty with their ingredients of white flour, fat, sugar, and salt.

Everyone moved all day long, mostly outdoors; that was just natural. And much of that movement was hard work, the kind that kept muscles strong from lifting, bending, digging, or hoeing. The kids were sent out, if not helping with farm chores, to play, play that included lots of movement.

Of course, stress was present, but somehow, they dealt with it, allowing it to “run off their backs.” After a day of good food and plenty of movement, they slept easily and soundly from when the sun went down until the sun came up. Very few people smoked; cigarettes were not available. Alcohol was abundant, mostly homemade cider, beer, and wine, but most did not drink excessively.

Life was a constant challenge to the mind as well as the body. Families worked and played together and interacted with their neighbors. There were no radios, TVs, or video games; families interacted with each other, and grandparents were honored and part of the family.

Many people, of course, died early, especially of trauma, childbirth, and infectious diseases. Still, many also lived to a “ripe old age” yet rarely developed the chronic diseases of today — obesity, diabetes, lung cancer, stroke, Alzheimer’s, or heart disease.

We do not live like that today and there is no reason to try to go back. But is there anything you can do directly to avoid developing a chronic disease now or in the future? Yes. It is all about modifying your lifestyles.

There are seven key steps.

• Eat a healthy diet every day
• Get adequate exercise at least 6 days per week
• Manage your chronic stress
• Enhance your sleep
• Don’t smoke or overdrink alcohol; don’t get hooked on drugs
• Challenge your brain regularly
• Stay socially engaged.

Be sure to take good care of your teeth, don’t drink or text and drive. Develop a positive attitude and be sure you have thought about your purpose in life.

According to the Centers for Disease Control (CDC,) Americans consume an average of 57 pounds of added sugar annually! Packaged in 4-pound bags, imagine 14 bags on your kitchen table — four times that for a family of four. Of course, you are sure you don’t eat that much added sugar, but someone else is consuming even more to make it average out. To top it off, we eat an excessive number of foods made from white flour (e.g., cereal, cakes, pies, cookies, pastries, and pizza) — which is digested directly into sugar. And, of course, many of those foods are high in added sugar and often fats and salt.

Here is a bit more detail: For adult Americans, men consume about 19 teaspoons (76 grams) of sugar per day; women 15 (60 grams), both well above the recommendations of the American Heart Association of 9 teaspoons (38 grams) for men and 6 tsp (25 grams) for women. In addition, the World Health Organization recommends no more than 5% of a 2000-calorie diet be from added sugars (including honey, fruit juices, etc.) or 25 grams per day.

Lack of exercise and an unhealthy diet go together. Today we drive to work, stop for a pastry and latte, sit at a desk most of the day, eat a fast-food lunch, enjoy an afternoon snack, drive home, call out for pizza, watch television, and go to bed.

Stress is everywhere — you need to check your emails and texts right up to bedtime. Your stress levels are off the charts. You probably don’t smoke and that is good. You have all too little time for socializing with true friends. The alarm rings all too early, and you are up and at it again.

What can you do? Will it really make a difference? Yes, focus on these 7 keys of lifestyle modifications.

1-Prepare meals from scratch; it does not take much time. Think of it not as a diet that eliminates something but one that includes abundant nutrient-dense foods. Eat locally sourced, preferably organic vegetables and fruits in abundance.

Vegetables should be the major components of your diet with a wide variety of types, colors, and textures to obtain all of the primary nutrients. Include dark green leafies daily — spinach, collards, arugula, and kale are good choices. Nuts, seeds, and foods like avocados and olives have healthy oils, and omega-3 fatty acids are in wild-caught finfish like salmon, mackerel, and sardines. Avoid vegetable oils; use cold-pressed virgin olive oil instead.

Don’t forget to have plenty of fresh fruits every day.

Choose chickens and eggs from hens that have been free-ranged. Eat red meat sparingly and choose cuts from range-fed animals that never saw a feedlot. Finally, and very importantly, avoid sugars like the plague and dramatically reduce your intake of foods made from white flour. It follows that you will cut back on processed foods and meals from fast-food restaurants. The Mediterranean Diet is the prototype for this type of eating.

2-Get up and move. Get 30 minutes of walking every day. That alone will have a massive impact on your immediate and long-term health. Add in a few sessions per week of strengthening (“resistance”) exercises. Remember that “sitting is the new smoking.” Park your car a distance from the building entrance. Take the stairs a few flights instead of the elevator. Get up from your computer and move around for five minutes at least every half hour. Consider a stand-up desk. Spend less time sitting in a reclining chair watching TV at night.

3-We all have chronic stress, but many don’t recognize or admit it. Give some serious thought time to your pressures. Eliminate the causes where possible and, for the remainder, consider ways to tamp them down. In addition to good food and regular exercise along with adequate sleep, add in perhaps yoga, meditation, Tai Chi, coherent breathing, or just a few moments every so often to take a couple of deep breaths with the exhalation longer than the inhalation (I will explain the rationale for longer exhales in a later article.)

4-To enhance sleep, allot at least three hours between finishing dinner and bedtime so that your meal has been largely digested. This, of course, means no late-night snack before bed. No caffeine after noon. Avoid reading or watching action or horror books, TV shows, and movies before bedtime. Early in the evening, please turn off your smartphone and the texts, emails, and Facebook with it. Instead, consider some soothing music before bed. Your bedroom needs to be pitch black with all your devices turned off. Keep to a schedule, and remember that you need 7 ½ to eight hours of sleep each night. Please don’t listen to the friend that claims they can get by on 5 or 6 hours; that person is only fooling themself.

5-No tobacco. None, including vaping. And keep alcohol consumption limited.

6-Stimulate and challenge your brain. It needs to be used just like your muscles. Learn a new language or play an instrument. Learn a dance routine. Do something creative like art or writing.

7-Social engagement is critical to slow aging, prevent disease, and enhance a sense of wellness. Maintain connections with close friends and relatives.

Does all of this make a difference? Yes.

In the Nurse’s Health Study and the Health Professionals Follow-up Study totaling over 100,000 participants and observed for more than 30 years, those who followed the five “low-risk lifestyles” lived substantially longer than those who followed none. For example, a 50-year-old female could expect to live 14 added years (life expectancy rose from 29 to 43 additional years), and for a male, 12 additional years (26 rose to 38 additional years.) I will explore this and similar studies in-depth in a later article.

Whatever the exact number of added years, the direction is clear. Healthy lifestyles mean more years of healthy life. And remember, it was not just more years of life but fewer chronic illnesses for a longer “health span.” Definitely worthwhile.

Does this seem like a tall order? Perhaps, but pick one or two areas to work on at a time. Don’t try to do it all at once. Don’t set the goal too high to start. Set some intermediate goals, ones that you can achieve. Then move up to a more comprehensive goal. After a while, you’ll be doing great; you’ll have more energy, more enthusiasm for life, much better health, and a longer, healthier lifespan. And as a bonus, if you get started early in adult life, you will reap the added benefits of compounding, just like saving for retirement. What could be better than that?

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