Carlos Nolasco, MD, FACP, AHSCP-CHS

The New England Journal of Medicine Home-Based Care for Hypertension in Rural South Africa A Research Summary based on Siedner MJ et al. | 10.1056/NEJMoa2509958 | Published on September 1, 2025 Visual representations of the patients in the trial and the treatments they were assigned. Read the full Research Summary at NEJM.org.

In rural South Africa, home-based hypertension care — delivered by community health workers and supported by remote nurses — led to a lower mean systolic blood pressure than clinic-based care. Full IMPACT-BP trial results and Research Summary: nej.md/4lHJ4ek

#MedSky #CardioSky

Fwd: Fwd: “I hope this email finds you well”

🩺 Knowledge is power. 🫀 On this #WorldHeartDay, empower your patients to take control of their heart health with #CardioSmart tools like this high #bloodpressure infographic.

🔗 Explore more: https://bit.ly/46I6k6F

#DontMissABeat #WorldHeartDay

Subclinical primary aldosteronism is an under-recognized driver of cardiovascular risk. Could it be a new target for CV prevention? Read our Circulation editorial —>

Diagram from JAMA, Sept 15, 2025, titled "Superficial Vein Thrombosis: A Review." It shows common sites and pathophysiology of SuVT in upper and lower extremities, detailing vein names, thrombus formation, inflammation, and impeded blood flow.

Superficial vein thrombosis (SuVT) is characterized by thrombus in the superficial veins, typically in the lower or upper extremities.

This Review summarizes the diagnosis and treatment of SuVT.

ja.ma/46CnGlh

*At grandson's birthday*

Me: ...so that's why you should get your kid enrolled in swim lessons.

Son: MOM ARE YOU TELLING DROWNING STORIES TO THE GUESTS AT MY SON'S BIRTHDAY PARTY?

Me:

Son:

Me: I can change.

CDC to recommend looking only one way before crossing street

This is addressed in the most recent guideline, the 2025 AHA/ACC Multisociety Guideline on Hypertension.

In the guideline, these cases are renamed as “severe hypertension.”

See www.jacc.org/doi/epdf/10...., page 76 (Figure 9).

#TWDFNR: Primary/essential hypertension? Or...primary aldosteronism? JHM Digital Media Fellow Eric Burnett discusses why we might not be screening our patients with elevated blood pressures, and why we should!

https://bit.ly/4pymLv7
#VisualAbstract: Sophie Sun
📹: @Eric

Referring to ER for severely elevated BP readings without any symptoms.

For example, sending to ER for consistent BP 200/100 mmHg at home without any symptoms.

In almost all cases, these patients should receive titration of their BP-lowering therapy in the outpatient setting.

📢 New in #JACC: ACC/AHA methodology statements on:
🔹 Core Principles & Development
🔹 Cost/Value (update)
🔹 FDA Processes

Together with Circulation, they provide the framework to keep guidelines rigorous, transparent & responsive.

🔗 Explore the statements: https://bit.ly/3IE4EDc #CardioSky #MedSky

Early identification is 🔑 for FH. Use #CardioSmart’s FH infographic to explain types of FH & support patient conversations. To celebrate #FHAwarenessDay, CardioSmart is offering free handouts & posters for a limited ⏰.

Learn more & order now ➡️ https://bit.ly/4gKKlRk #KnowFH #CardioSky #MedSky

Help your patients better understand #AFib with #CardioSmart’s Spanish infographic! 👇

CardioSmart offers infographics and decision aids in multiple languages to support patient–clinician conversations. Explore the resources: https://bit.ly/4pxad6Y

#AFibAwarenessMonth #ACCLATAM #CardioSky #MedSky

You say "happy birthday," I say "Another year older, another loss of 0.9 ml/min of eGFR"

Some information (still not primary data, more like marketing speak) about the Apple Hypertension detection.

>2,000 adults wore the watch ~12 hours/day for a month and took BID cuff BP; The watch was “as accurate as the cuff” for detecting signs of HTN what ever that is

time.com/7316725/appl...

ACOG reaffirms that acetaminophen is safe for managing pain and fever during pregnancy. No reputable studies support suggestions like those in HHS’s recent announcement linking acetaminophen use in pregnancy to autism; in fact, high-quality studies show no such risk. https://bit.ly/47Wxc59

New in #ASNJASN and at #Hypertension25: In a randomized, double-blind, placebo-controlled trial, Baxdrostat reduced systolic blood pressure in patients with CKD and uncontrolled hypertension. Read more about its safety and efficacy in patients with CKD here: kidney.pub/JASN0849

The New England Journal of Medicine Low-Dose Aspirin for PI3K-Altered Localized Colorectal Cancer A Research Summary based on Martling A et al. | 10.1056/NEJMoa2504650 | Published on September 18, 2025 Visual representations of the patients in the trial and the treatments they were assigned. Read the full Research Summary at NEJM.org.

In patients with localized colorectal cancer and PIK3CA hotspot mutations in exon 9 or 20, daily low-dose aspirin resulted in a significantly lower recurrence rate than placebo. Full ALASCCA phase 3 trial results and Research Summary: nej.md/4mpKXNp

#MedSky #Oncology

It’s a beautiful day to go get vaccinated!

T1h

Next up – Secondary HTN. The guideline provides a thorough table including 15 causes of secondary HTN with indications for additional testing and diagnostic screening tests for each.
#NephJC

T4g
7️⃣Pregnancy thresholds updated - Treat chronic HTN in pregnancy to <140/90 and acute severe HTN ≥160/110 within 30–60 min (COR I, LOE B-R).
📝Are you routinely consulted for hypertension in pregnancy? #NephJC

T4e
5️⃣Primary aldosteronism screening – screen all adults with resistant HTN regardless of potassium level (COR I, LOE B-NR). Continue most antihypertensives except MRA before testing (COR I, LOE C-EO).
📝Is screening worthwhile or should we just be using MRAs earlier? #NephJC

T4i
9️⃣Cognitive protection🧠 - treat to SBP <130 to prevent mild cognitive impairment/dementia (COR I, LOE B-R).
📝Do you think BP control has a significant role in dementia? #NephJC

T3a

1️⃣3️⃣Terminology change – Hypertensive Urgency (BP > 180/120 without target organ damage) is now referred to as Severe HTN. No need for parenteral therapy, best to treat in the outpatient setting.
📝What’s in a name (renal, nephro, kidney)? #NephJC

Proposed mechanism in Nature #NephJC
www.nature.com/articles/s41...

T4b
2️⃣Risk-based treatment threshold – Use PREVENT 10-yr CVD risk ≥7.5% to guide drug initiation at ≥130/80; if risk <7.5%, try lifestyle first for 3–6 mo, treat if still ≥130/80 (COR I, LOE B-R).
📝How effective is lifestyle modification in your practice? #NephJC

Interesting study from 2019! #NephJC

8.9% of OSA have PA.
Almost 70% of PA have OSA!

www.ahajournals.org/doi/10.1161/...

T4a
1️⃣BP categories unchanged - normal <120/80, elevated 120–129/<80, stage 1 130–139/80–89, stage 2 ≥140/90 (COR I, LOE B-NR).
📝You know we love to categorize things. Were you hoping for a change? #NephJC

9:39
So ACC/AHA hasn’t updated their guidelines since 2017. Let’s break down what’s different and new! Lots to discuss #NephJC

T2o

To round out the discussion on HTN management: Renal Denervation (RDN)

Class 2b (weak) recommendation for renal denervation in carefully selected patients with resistant HTN. Initial studies were promising, however in the end RDN only had modest effects (equivalent to adding 1 BP med) #NephJC