Why aren't we doing better on cardiovascular health? And why aren't women winning Nobels?

Plus: Study of GLP-1s and suicidality in youth show promising results

October 15, 2024 Check out STAT+

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By Theresa Gaffney Morning Rounds Writer and Podcast Producer

It's the most wonderful time of the year — STAT Summit week! I love when my colleagues come into town, and not only because it means we're more likely to get free lunch at the office. (Today? I heard pizza!)  There are a lot of great conversations ahead. It's not too late for you to join us, in person or virtually!

special reports Why aren't we doing better in the battle against cardiovascular disease?  Christine Kao/STAT In 2010, the American Heart Association set a decade-long goal to reduce the number of deaths from cardiovascular disease and stroke by 20%. It didn't happen. Cardiovascular disease is still the number one cause of death in the U.S., and the AHA called it a "disappointment" that the goal wasn't met. So what went wrong? It's a big question that STAT's Liz Cooney has posed to almost a dozen experts in cardiology, primary care, endocrinology, and vascular disease over the last few months. There's no easy answer, but nearly everyone she spoke to pointed to one main factor: a crisis in primary care. "We're losing ground," said FDA Commissioner and cardiologist Robert Califf. "I think the biggest single remediable issue for us is that we don't have a primary care system in the U.S. that's functional." Read more in a story by Liz about the role of the primary care system. Then, hop to the second story in this special report, on the host of additional factors that affect cardiovascular help. (And if you're feeling stressed — experts in that story also discuss some trends that give them hope.) weight loss Study of GLP-1s and suicidality in youth show promising results A new study found that adolescents prescribed GLP-1 medications for obesity had a 33% reduced risk of suicidal ideation or a suicide attempt compared to those with obesity who'd been prescribed lifestyle interventions. The paper, published yesterday in JAMA Pediatrics, is the first to exclusively focus on the mental health effects of these drugs among young people, the authors write. Researchers analyzed electronic health records from thousands of adolescents ages 12-18 with prescriptions for either GLP-1 medication or a lifestyle intervention, all of whom had diagnoses of obesity within the past year. The findings suggest that the drugs are safe for adolescents' mental health, the authors argue. But some experts are still worried that we don't know anything about other long-term side effects, such as whether the drugs might affect development.  Read more about the existing research on youth and these blockbuster drugs from STAT's Elaine Chen and Liz Cooney. cardiovascular health Aggregating Asians in health data masks big differences in heart health Last year, STAT's Usha Lee McFarling wrote movingly about the danger of grouping nearly 25 million Asian Americans — from Hmong to Laotians, and Koreans to Indonesians — together as one entity in medical and public health research. Native Hawaiians and Pacific Islanders are often lumped into the Asian category, she wrote, even though federal standards clearly state they should be separate. A study out yesterday in the Annals of Internal Medicine shows how aggregating Asians into one group can mask significant health differences, in this case cardiovascular disease. Death rates from cardiovascular disease were 1.5 times higher for Native Hawaiian and Pacific Islander adults over age 35 than for other Asian adults, ranking them third in the U.S. after Black and white adults, an analysis from 2018 through 2022 revealed. Heart disease was the cause most often noted on death certificates for NHPI adults, at 73%, while cerebrovascular disease accounted for 19% of deaths. More than a third of cardiovascular deaths occurred before age 65, something the authors call potentially premature and therefore concerning. "Collectively, these results signal a need for focused interventions to promote cardiovascular health and prevent CVD among the NHPI population," they wrote. — Liz Cooney

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research Wherefore art thou, Rosalind?  Since the Nobel Prizes were created in 1901, just 24 women have received awards in the sciences. This year, that number stayed the same: All seven laureates in physics, chemistry, and physiology or medicine were men. Experts say the disparity reflects larger barriers to success that women in science face. This year's Nobel for physiology or medicine has attracted particular scrutiny. Rosalind Lee, the wife and long-time collaborator of one of the winners, was not recognized, despite being a first author on one of the studies cited by the committee. She's the second woman named Rosalind to be snubbed in this way, after Rosalind Franklin, whose contributions to the discovery of DNA's double helix were not initially recognized. Read more on the problem from STAT's Anil Oza. (On a sort of lighter but similar note: This reminds me of the famous STAT story about the number of speakers named Michael outnumbering the number of women speakers at the J.P. Morgan Healthcare Conference one year.) science New study identifies potential brain cell targets for Alzheimer's treatments For decades, the Alzheimer's field has largely focused on the idea that clumps of a protein fragment known as beta-amyloid drive the deadly neurodegenerative disease. While this hypothesis has led to two approved therapies, scientists are eager for targets that could lead to more effective treatments. A new study suggests the key to this search could be focusing on cell types lost early in disease. A scientific team led by researchers at the Allen Institute analyzed 3.4 million cells from the brains of 84 deceased Alzheimer's patients. They found a whole set of cellular changes that happen before symptoms first appear, including a dramatic loss in a population of cells known as somatostatin-expressing inhibitory neurons. These cells are lost well before beta-amyloid or tau, another disease-related protein, build up in the brain, the authors report in Nature Neuroscience. It's unclear for now exactly what is triggering the loss of these neurons. But the researchers say the findings suggest that protecting the cells could prevent a whole cascade of events that lead to cognitive symptoms, though it will take more detailed follow-up studies to show whether that's true. — Jonathan Wosen politics Abortion rights ballots win — but pro-abortion candidates may not Montana is one of 10 states bringing abortion rights to voters this November, the latest in a stream of ballot measures since Roe v. Wade was overturned in 2022. So far, every time Americans have voted on abortion in the wake of that decision, they've favored access over restrictions.  Local advocates are optimistic about the measure. But what's still unclear is how races for Senate and the governor's office will play out. Montana's Democratic senator, Jon Tester, is falling behind anti-abortion Republican candidate Tim Sheehy in the polls. The Democratic candidate for governor is also lagging incumbent Republican Greg Gianforte. Read more from STAT's Sarah Owermohle, who traveled to Bozeman to speak with candidates and community members on the ground.

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Thanks for reading! More tomorrow,

theresa.gaffney@statnews.com

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