The hottest Cardiology Substack posts right now

And their main takeaways
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Top Health & Wellness Topics

The Missing CHIP

Ground Truths • 8223 implied HN points • 15 Mar 26
🔬 Science Cardiology
  1. CHIP (clonal hematopoiesis) is a common, age-related blood stem cell change that meaningfully raises risk for heart disease, blood cancers, clots, and inflammatory problems, with risk depending on clone size and the specific mutated gene.
  2. New research shows CHIP is actionable: drugs like low‑dose colchicine, IL‑1β blockers, inflammasome inhibitors, and other agents can reduce CHIP or its downstream risks, and genetic discoveries point to future prevention strategies.
  3. Testing for CHIP is highly informative but currently limited by high cost, complex deep‑sequencing methods, and slow guideline uptake, so cheaper targeted assays and more clinical programs could enable screening and early prevention for older adults.

The Flawed V02 Max Craze

Ground Truths • 14084 implied HN points • 23 Feb 26
🏥 Health & Wellness Cardiology
  1. Cardiorespiratory fitness (CRF) and VO2max are not the same: CRF is estimated in METs from real-world or treadmill tests, while true VO2max requires a lab gas-exchange test and smartwatch VO2 estimates are indirect and often inaccurate.
  2. Nearly all the evidence linking fitness to lower all-cause and cardiovascular mortality is based on CRF/METs, with about a 14–15% reduction in mortality risk per 1-MET improvement, not on wearable or routinely measured VO2max.
  3. For most people, don’t obsess over smartwatch VO2 numbers; prioritize increasing real-world activity, improving METs and muscle strength, and reserve lab VO2max testing for elite athletes or specific clinical cases, since AI and apps can amplify misleading wearable data.

Why All Mammograms Should Incorporate A.I.

Ground Truths • 8135 implied HN points • 08 Feb 26
🏥 Health & Wellness Cardiology
  1. AI makes mammogram reading more accurate and finds more cancers earlier, including smaller and aggressive tumors. It also significantly reduces radiologists' screening workload.
  2. AI can predict five-year breast cancer risk from a standard mammogram, letting clinicians target high-risk women for closer surveillance or preventive testing like MRI or genetic workups.
  3. AI can identify breast arterial calcification on mammograms, which signals higher heart disease risk and lets mammography serve as a two-for-one screen for cancer and cardiovascular risk.

The Lowdown on Low-Dose Aspirin for Primary Prevention

Ground Truths • 13866 implied HN points • 02 Jan 26
🏥 Health & Wellness Cardiology
  1. Low-dose aspirin for primary prevention in older adults generally causes more harm than benefit. It increases major bleeding and, in some trials, was linked to higher overall or cancer-related mortality without reducing cardiovascular events.
  2. Major guidelines now advise against routine aspirin for primary prevention in older adults, with age cutoffs varying by group. Aspirin still provides clear benefit for secondary prevention after events like heart attack, stroke, or stenting.
  3. There are hints aspirin might lower cancer incidence in specific subgroups (for example people with CHIP), but overall trial data in the elderly showed higher cancer deaths and CHIP testing isn’t part of routine care, so this is not an actionable reason to use aspirin now.

The Evidence that Established Coronary Artery Bypass Surgery is Worth Studying

Sensible Medicine • 3459 implied HN points • 22 Jan 24
🏥 Health & Wellness Cardiology
  1. Some old trials showed no significant survival advantage of coronary artery bypass surgery over medical therapy for stable coronary disease.
  2. Subgroup analyses and crossovers in these trials may have influenced the perception of bypass surgery's effectiveness.
  3. A meta-analysis combining data from these trials showed a significant mortality reduction with bypass surgery, especially in certain patient subgroups.
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A Surprising Look at the Evidence for Beta-Blockers After MI

Sensible Medicine • 2948 implied HN points • 15 Jan 24
🏥 Health & Wellness Cardiology
  1. Beta-blockers after MI have been a common practice, but recent evidence shows they may not be as crucial as previously thought.
  2. The BHAT and ISIS 1 trials from the 1980s provided insights on the effectiveness of beta-blockers after MI.
  3. These trials highlight the need to reevaluate the use of beta-blockers after MI, as current MI treatment practices have evolved significantly.

Beware The Leaky Watchman

The Skeptical Cardiologist • 412 implied HN points • 02 Feb 24
🏥 Health & Wellness Cardiology
  1. The Watchman device for preventing stroke in atrial fibrillation might not be as effective as promised.
  2. Studies show a significant incidence of residual leaks after percutaneous left atrial appendage occlusion.
  3. Patients should be aware of the downsides and lack of proven benefits before opting for LAAO over other stroke prevention methods.

The Aktiia Bracelet is Almost Here

The Skeptical Cardiologist • 491 implied HN points • 06 Apr 23
🏥 Health & Wellness Cardiology
  1. The Aktiia Bracelet offers a cuffless way for 24/7 blood pressure monitoring with accuracy validated through studies.
  2. Validation studies have shown that the Aktiia Bracelet performs well and satisfies established criteria for accuracy.
  3. Continuous and unobtrusive monitoring provided by the Aktiia Bracelet can give a more accurate representation of blood pressure throughout the day and night, potentially improving cardiovascular outcomes.

My friend Shane decided to ignore my advice and listen to his doctor and got a COVID vaccine. He now has permanent heart damage.

Steve Kirsch's newsletter • 15 implied HN points • 12 Dec 25
🏥 Health & Wellness Cardiology
  1. A friend followed medical advice, got a COVID vaccine, and now has permanent heart damage.
  2. The author is frustrated that people ignore warnings and trust doctors, saying this led to severe injuries and even deaths among friends.
  3. The author believes COVID vaccines provide no benefit and only cause harm, and urges others to spread that message.

Four steps to reduce cardiovascular disease by up to 90%

More is Different • 12 implied HN points • 09 Jul 25
🏥 Health & Wellness Cardiology
  1. Statins could be safe and effective if made available over-the-counter. More people could benefit from them without needing a prescription.
  2. There's a lot of misinformation about statins causing muscle pain, but studies show most of the pain people feel isn’t actually caused by the drug.
  3. Screening for heart disease should start earlier, even in children, to help catch issues before they develop into serious problems.