Category: 8. Health

Few people with high blood pressure were using salt substitutes, even though they are a simple and effective way to lower sodium intake and manage blood pressure, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2025. The meeting is in Baltimore, September 4-7, 2025, and is the premier scientific exchange focused on recent advances in basic and clinical research on high blood pressure and its relationship to cardiac and kidney disease, stroke, obesity and genetics.

High blood pressure occurs when the force of blood flowing through the blood vessels is consistently too high. High blood pressure can lead to other serious events such as heart attack and stroke. Using data from 2017 to 2020, 122.4 million (46.7%) adults in the U.S. had high blood pressure and it contributed to more than 130,000 deaths. Too much sodium and too little potassium in the diet are risk factors for high blood pressure.

Overall, less than 6% of all U.S. adults use salt substitutes, even though they are inexpensive and can be an effective strategy to help people control blood pressure, especially people with difficult-to-treat high blood pressure. Health care professionals can raise awareness about the safe use of salt substitutes by having conversations with their patients who have persistent or hard-to-manage high blood pressure.”

Yinying Wei, M.C.N., R.D.N., L.D., lead study author and Ph.D. candidate in the departments of applied clinical research and hypertension section, cardiology division, at UT Southwestern Medical Center, Dallas

Salt substitutes are products that replace some or all of the sodium with potassium. Potassium salt tastes similar to regular salt, except when heated it can have a bitter aftertaste. Many foods contain some sodium in their natural state, however, the largest amount of sodium comes from processed and packaged foods and meals prepared at restaurants. The American Heart Association recommends consuming no more than 2,300 mg of sodium a day, with an ideal limit of less than 1,500 mg per day for most adults, especially for those with high blood pressure. For most people, cutting back by 1,000 mg a day can improve blood pressure and heart health.

This study is the first to examine long-term trends in salt substitute use among a nationally representative sample of U.S. adults. Using data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2020, researchers analyzed the use of products that replace salt with potassium-enriched or other alternative salts.

The investigation focused on people with high blood pressure, and an additional analysis was conducted among adults eligible to use salt substitutes, including people with normal kidney function and those not taking medications or supplements that affect blood potassium levels. Some salt substitutes contain potassium, and they can raise blood potassium to dangerous levels in people with kidney disease or those taking certain medications or potassium supplements. Excessive potassium can lead to irregular heart rhythms. People with high blood pressure who are thinking about switching from regular salt to a salt substitute should first consult with a health care professional.

The analysis found:

• Overall, salt substitute use among all U.S. adults remained low, peaking at 5.4% in 2013–2014 before falling to 2.5% by 2017–March 2020. Data collection for 2020 stopped before March because of the pandemic.
• Among adults eligible to use salt substitutes, only 2.3% to 5.1% did so.
• Usage was highest in people with high blood pressure whose BP was controlled with medications (3.6%–10.5%), followed by those with high blood pressure whose BP was not controlled despite medications (3.7%–7.4%).
• Salt substitute use remained consistently less than 5.6% among people with untreated high blood pressure and for people with normal blood pressure.
• Adults who ate at restaurants three or more times a week appeared less likely to use salt substitutes compared to those who ate out less often, but this difference was no longer statistically significant after accounting for age, race/ethnicity, education level and insurance status.

“Salt substitute use remained uncommon over the last two decades including among people with high blood pressure,” Wei said. “Even among individuals with treated and poorly managed or untreated high blood pressure, most continued to use regular salt.”

“This study highlights an important and easy missed opportunity to improve blood pressure in the U.S.-the use of salt substitutes,” said Amit Khera, M.D., M.Sc., FAHA, an American Heart Association volunteer expert. “The fact that use of salt substitutes remains so low and has not improved in two decades is eye-opening and reminds patients and health care professionals to discuss the use of these substitutes, particularly in visits focused on high blood pressure.” Khera, who was not involved in this study, is a professor of medicine, clinical chief of cardiology and director of preventive cardiology at UT Southwestern Medical Center in Dallas.

The study has several limitations. First, information about salt substitute use was self-reported, so there may have been underreporting or misclassification. In addition, all types of salt substitutes were included in the analysis, therefore, the analysis could not specifically separate potassium-enriched salt from other types of salt substitutes. Finally, the survey data did not capture how much salt substitute the participants used.

“Future research should explore why salt substitute-use remains low by investigating potential barriers, such as taste acceptance, cost and limited awareness among both patients and clinicians,” said Wei. “These insights may help guide more targeted interventions.”

Study details, background and design:  

• The analysis included 37,080 adults, ages 18 and older (37.9% were aged 18–39, 36.9% were aged 40–59 years, and 25.2% were aged 60 and older). 50.6% of participants were women, 10.7% of participants self-reported their race as non-Hispanic Black, and 89.3% self-reported they were from other racial and ethnic groups.
• Participants were categorized into four subgroups based on presence or absence of high blood pressure (≥130/80 mm Hg) and whether they were using blood pressure lowering medication: 1) high blood pressure that was treated and controlled; 2) high blood pressure that was treated and not controlled; 3) untreated high blood pressure; and 4) those with normal blood pressure.
• Salt types were classified as ordinary salt (iodized salt, sea salt, kosher salt), salt substitute (potassium-enriched or other salt substitute) and no salt use.
• An additional analysis was conducted on a subgroup of individuals eligible to use salt substitutes-those with healthy kidney function (estimated glomerular filtration rate ≥ 60) and not taking medications or supplements that affect blood potassium levels. 
• The frequency of eating at restaurants to assess its influence on salt substitute use was also evaluated.
• All analyses incorporated NHANES sampling weights and complex survey design.

Health experts say next week’s Africa Climate Summit offers a high-stakes opportunity to prioritise a sector that is on the frontline of the human impacts of global warming.

In Southern Africa, countries such as Botswana, eSwatini, Namibia, and Zimbabwe have experienced a dramatic surge in malaria cases in 2025 after a drought followed by above-average rainfall led to optimum conditions for mosquito breeding. 

These climate change impacts cause life-threatening harm to communities across Africa – particularly for women and children – while further burdening already stressed health systems.  

Mosquitos at large as weather changes

Aggrey Aluso, executive director at Resilience Action Network Africa (RANA), an advocacy organisation, said the continent is among the most vulnerable to climate impacts, including heatwaves, prolonged droughts, and heavy rainfall that create ideal conditions for disease outbreaks.

“Evidence shows a 63% increase in zoonotic outbreaks over the past decade, highlighting how environmental shifts are driving a silent but deadly health emergency,” he told African Business.

Africa is also witnessing the expansion of vectors such as Aedes mosquitoes, which cause yellow fever, due to warmer temperatures. 

Tafadzwa Mabhaudhi, a professor of climate change, food systems and health in the Department of Population Health at the London School of Hygiene & Tropical Medicine, said temperature and rainfall changes affect mosquito breeding, biting frequency, and the development of parasites within vectors, leading to shifting and often extended transmission seasons. 

“The science tells us that climate change is significantly impacting malaria and other vector-borne diseases in Africa by altering the geographical distribution, seasonality, and intensity of these diseases,” he said.

“Typically, during droughts, people dig a lot of wells and create water storage close to homes as a coping strategy. If, in the subsequent season, we receive heavy rains, all these spots will then create breeding sites for mosquitoes that are close to homes, which may lead to an increase in malaria cases.” 

Though Africa is the world’s most populous continent after Asia, it is responsible for only about 4% of global emissions. But as temperatures rise and extreme weather events occur with greater frequency and intensity, the cost of climate change is growing on the African continent. Most poor African countries are the least able to pay for the damage. Africa warmed faster than the rest of the world, according to a report released by the World Meteorological Organisation (WMO) in 2024. The World Health Organisation (WHO) considers climate change a fundamental threat to human health. 

A study on vector‑borne infectious diseases in pregnancy in the era of climate change reveals that the situation is likely to worsen with time. The geographic range of malaria is expected to expand into higher elevations and temperate regions by mid-century, with transmission suitability increasing in East Africa and parts of South Asia.

The expansion is already happening in many high-burden malaria countries across Africa. Sungano Mharakurwa, a professor and director of Africa University’s Malaria Institute, said he has been observing disease epidemiological shifts that are associated with changing climate patterns.

“These include the encroachment of malaria in areas that were previously always non-malarial areas, such as so-called ‘highland malaria’, and concomitant expansion in vector habitat, as well as novel vectors actively transmitting the disease in such non-traditional malaria zones,” he told African Business.

Vector-borne diseases associated with rising temperatures and shifts in rainfall patterns, such as malaria, dengue or Zika and other viral or bacterial infections transmitted by mosquitoes, ticks, midges, and flies disproportionately affect pregnant women and children. Infections from these vectors can trigger miscarriage, or cause stillbirths, preterm births, low birth weights and congenital anomalies. 

“Children under five years are a vulnerable group and have the highest burden of malaria deaths,” says Mabhaudhi. “Besides accounting for most malaria deaths, it can also cause anaemia and stunted growth in children, affecting their overall growth and development, with lasting impacts into their adult life,” he said.

In 2023, Africa accounted for 94% of the 263 million malaria cases recorded globally, according to the WHO. The continent also accounted for 95% of the 597,000 malaria deaths in 83 countries. Children under five accounted for about 76% of deaths in the region. 

Summit offers opportunity

As African leaders, policymakers, private sector, climate and adaptation finance partners gather in Addis Ababa from 8 to 10 September for the second Africa Climate Summit, there is an opportunity to mobilise resources to fund effective mitigation and adaptation initiatives that can avoid unbreakable health risks brought by climate change across the continent. 

In 2001, African Union governments adopted the Abuja Declaration, in which they set a target of allocating at least 15% of their national budgets to improve health care. But decades later, the majority of the African countries are spending far less of the targeted percentage. 

Aluso said the summit is a critical opportunity for African leaders to mobilise and demand resources the health impacts of climate change.

“Strengthening climate-resilient health systems and centering health in climate action are therefore urgent priorities,” he says. “Integrating health into climate policies and adaptation financing frameworks is no longer optional – it is urgent.”

He said he wants to see dedicated adaptation financing for climate-resilient health systems – which is grant-based, predictable, and accessible – aligned with the Africa Centre for Disease Control’s Climate and Health Strategy, as well as the integration of health into countries’ nationally determined contributions (NDCs) and national adaptation plans (NAPs).

Mabhaudhi hopes that Africa Climate Week’s discussions around health and climate change could trigger long overdue political action.

“What is critical will be to turn this growing interest and political will into climate action on the ground, tangible adaptation financial commitments through increased budget allocations to climate and health, and greater coordination across science, policy, and practitioners to avoid fragmentation of efforts,” he said. 

Parkinson’s disease often begins subtly. A slight tremor in the hand. A bit of stiffness. But over time, brain cells begin to die, and the symptoms worsen. The cause has long remained a mystery – but scientists may now be a step closer to an explanation.

At the center of attention is the protein α-synuclein, which plays a role in cell-to-cell communication in the healthy brain. In Parkinson’s, however, it starts to behave abnormally and clumps into toxic structures.

Until now, most research has focused on the large aggregates known as fibrils, which are visible in brain tissue from patients with Parkinson’s. But a new study focuses on smaller, less understood, and more toxic structures: α-synuclein oligomers. According to the researchers, these are the ones that drill microscopic holes in the membranes of nerve cells.

The study was recently published in the prestigious journal ACS Nano, published by the American Chemical Society.

Tiny revolving doors in the cells

“We are the first to directly observe how these oligomers form pores – and how the pores behave,” says Mette Galsgaard Malle, postdoctoral researcher at both Aarhus University and Harvard University.

The process unfolds in three steps. First, the oligomers attach to the membrane, especially at curved regions. Then they partially insert themselves into the membrane. Finally, they form a pore that allows molecules to pass through and potentially disrupt the cell’s internal balance.

But these are not static holes. The pores constantly open and close like tiny revolving doors.

“This dynamic behavior may help explain why the cells don’t die immediately,” says Bo Volf Brøchner, PhD student and first author of the study. “If the pores remained open, the cells would likely collapse very quickly. But because they open and close, the cell’s own pumps might be able to temporarily compensate.”

Molecular movie in slow motion

This is the first time such pore dynamics have been observed in real time. It was made possible by a newly developed single-vesicle analysis platform that allows researchers to follow interactions between individual proteins and individual vesicles.

Vesicles are small artificial bubbles that mimic cell membranes and serve as simplified models of real cells.

“It’s like watching a molecular movie in slow motion,” explains Mette Galsgaard Malle. “Not only can we see what happens – we can also test how different molecules affect the process. That makes the platform a valuable tool for drug screening.”

Long road to treatment

In fact, the team has already tested nanobodies – small antibody fragments – developed to specifically bind these oligomers. They show promise as highly selective diagnostic tools. However, as a treatment, there is still some way to go.

“The nanobodies did not block the pore formation,” says Bo Volf Brøchner. “But they may still help detect oligomers at very early stages of the disease. That’s crucial, since Parkinson’s is typically diagnosed only after significant neuronal damage has occurred.”

The study also shows that the pores are not formed randomly. They tend to emerge in specific membrane types – especially those resembling the membranes of mitochondria, the cell’s energy factories. This could indicate that the damage begins there.

One step at a time

However, the researchers emphasise that the study was conducted in model systems – not in living cells. The next step will be to replicate the findings in biological tissue, where more complex factors come into play.

“We created a clean experimental setup where we can measure one thing at a time. That’s the strength of this platform,” says Mette Galsgaard Malle. “But now we need to take the next step and investigate what happens in more complex biological systems.”

Digitoxin, an as-yet-unapproved cardiac glycoside, has proven its superiority to placebo in the phase 4 DIGIT-HF trial in patients with chronic heart failure with reduced ejection fraction (HFrEF) who had been treated with current medical and cardiac device therapies.¹

Presented at the European Society of Cardiology Congress 2025 in Madrid, DIGIT-HF highlighted a significantly lower risk of all-cause mortality and hospitalization for HF in patients assigned to digitoxin versus placebo.¹

Unlike its counterpart digoxin, which exhibits a shorter half-life and lower protein binding, digitoxin is a highly lipophilic drug which extensively binds to plasma proteins and is mainly eliminated in the metabolized state. Digitoxin also does not accumulate in kidney dysfunction, resulting in an apparently lower incidence of toxic side effects compared to digoxin.²

“However, the lack of double-blind, randomized, clinical trials that use digitoxin underscores the need for further investigation,” Udo Bavendiek, MD, department of cardiology and angiology, Hannover Medical School, and colleagues wrote. “The DIGIT-HF (Digitoxin to Improve Outcomes in Patients with Advanced Chronic Heart Failure) trial was conducted to evaluate the efficacy and safety of digitoxin at low concentrations in patients with chronic heart failure and reduced ejection fraction that had been treated with current medical and cardiac device therapies.”¹

The double-blind, randomized, placebo-controlled trial was conducted at 65 sites in Austria, Germany, and Serbia. It included patients who were ≥18 years old, had symptomatic chronic HF (specified as a left ventricular ejection fraction of ≤40% and an NYHA functional class of III or IV, or a left ventricular ejection fraction of ≤30% and an NYHA functional class of II), and had received evidence-based therapy for HF for ≥6 months.¹

The team randomly assigned patients in a 1:1 ratio to either digitoxin at a starting dose of 0.07 mg daily or matching placebo. Adjustments were made based on an algorithm: digitoxin serum concentration was measured 6 weeks post-randomization, and if the level was outside the predefined target range of 8 to 18 ng/mL, the dosage was adjusted accordingly, up to 0.1 mg or down to 0.05 mg daily.¹

The trial’s primary outcome was a composite of all-cause mortality and hospital admission for worsening HF, whichever occurred first. Secondary outcomes included all-cause mortality, which was tested for noninferiority to exclude a detriment from digitoxin as compared with placebo, and a composite of all-cause mortality and any hospitalization due to HF. Investigators also highlighted the safety outcomes of serum digitoxin concentrations and adverse and serious adverse events.¹

An initial total of 1240 patients were included in the study; 25 were removed after never taking a dose of digitoxin or placebo post-randomization. Additionally, 3 were excluded from 1 trial site due to the closure of the site, leaving a final total of 1212. 613 were assigned to digitoxin and 590 received placebo.¹

At baseline, characteristics of the patients and therapies appeared well-balanced. However, by the end of the trial, the primary-outcome event had occurred in 242 patients (39.5%; 12.8 events per 100 patient-years) in the digitoxin group and 264 (44.1%; 15.7 events per 100 patient-years) in the placebo group (hazard ratio [HR] 0.82; 95% CI, 0.69-0.98; P = .03). All-cause mortality occurred in 167 patients (27.2%; 7.8 deaths per 100 patient-years) in the digitoxin group and 177 (29.5%; 8.9 deaths per 100 patient-years) in the placebo group.¹

Regarding safety, mean (+/- Standard Deviation [SD]) serum digitoxin concentration at the dose-adjustment visit was 17 +/- 5.9 ng/mL in 550 patients in the digitoxin group. At 12 months, this was down to 13.5 +/- 5.1 ng/mL in 398 patients. At least 1 serious adverse event occurred in 29 patients in the digitoxin group and 17 in the placebo group.¹

Ultimately, investigators noted a significantly lower incidence of primary-outcome events among the digitoxin group compared to placebo.

“Our findings can be readily implemented into clinical practice, as shown by the simple digitoxin dosage protocol and by the fact that patient selection in our trial was based primarily on the burden of heart failure symptoms and the left ventricular ejection fraction rather than threshold levels of the brain natriuretic peptide biomarker,” Bavendiek and colleagues wrote.¹

References

1. 1: Bavendiek U, Großhennig A, Schwab J, et al. Digitoxin in patients with heart failure and reduced ejection fraction. New England Journal of Medicine. Published online August 29, 2025. doi:10.1056/nejmoa2415471

2. 2: Belz GG, Breithaupt-Grögler K, Osowski U. Treatment of congestive heart failure–current status of use of digitoxin. Eur J Clin Invest. 2001;31 Suppl 2:10-17. doi:10.1046/j.1365-2362.2001.0310s2010.x

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Long-term relationships built on a foundation of trust between communities, researchers and the natural world can transform science, education and climate adaptation. That is the central message of a study published in Emotion, Space and Society by Scott Laursen, a climate adaptation extension specialist with the University of Hawaiʻi at Mānoa Pacific Islands Climate Adaptation Science Center (PI-CASC).

The article, co-led by long-term Kealakekua residents, cultural practitioners and lineal descendants, showcases a decade of community-driven work on Hawaiʻi Island and its connection to multiple UH Hilo projects.

‘Speed of trust’

“When science is co-led by communities rooted in place and guided by respect for human and more-than-human relationships, communities and science innovate rapidly; they drive effective actions, and create lasting solutions,” said Laursen. “Moving at the ‘speed of trust’ has been fundamental to the human condition since the dawn of time. Locating and empowering long-term, place-based networks offers a powerful way forward in a rapidly changing world.”

The research focuses on how “relational worldviews”—where people, places and ecosystems are seen as deeply interconnected—are shaping new and effective approaches to climate adaptation. From coral restoration in Kapukapu to rethinking shoreline management on Hawaiʻi Island, the article demonstrates how sustained collaboration addresses urgent local challenges while training the next generation of scientists and resource stewards.

The publication emphasizes:

• Immersing the scientific method within place-based pathways to drive real-world impact through applied science.
• Highlighting the value of building and maintaining long-term relationships between community and research networks.
• Stressing the importance of storytelling and narratives for general audiences in academic literature.
• Presenting hoe waʻa (traditional outrigger canoe paddling) as a metaphor for uniting diverse forms of knowledge (e.g., emotion, instinct, cultural norms, rational intellect).

Paddling together

The article uses the metaphor of hoe waʻa to illustrate how collaboration functions. Just as a canoe crew must trust each other and stay attuned to changing ocean conditions to navigate successfully, research partnerships require skill, humility, flexibility and an awareness of their surroundings.

Co-author Akoni Palacat-Nelsen, executive director of Hoʻāla Kealakekua Nui and Kapukapu ʻOhana co-founder, connected this approach to on-the-ground action.

“Climate adaptation is a global initiative. Hoʻāla Kealakekua Nui redirected its resources to address climate adaptation by implementing traditional ecological knowledge,” said Palacat-Nelsen. “It is critical to first re-establish the broken relationship between humans and the impacted resource(s), such that we transcend notions of ‘resources’ and instead engage such arenas as the ‘source’ of life. Place-based traditional knowledge employs methods like kilokilo (community-driven data collection), as seen in our Kanu Koʻa project, which focuses on rebuilding resilient coral communities and restoring the habitat for ʻopae ʻula (shrimp) in our anchialine pools at Kealakekua Bay. The practice of kilokilo reinforces trust in the long-term relationship between humans and the more-than-human experiences.”

Other co-authors include artists, NOAA and National Park Service employees, a policy professional, UH Hilo geography and environmental science professor Ryan Perroy, recent UH Hilo graduate students Aloha Kapono and Rose Hart, and PI-CASC’s Executive Director Darren Lerner.

Mothers-to-be with the condition have higher risks as pregnancy hormones can make it harder for them to regulate their blood glucose levels.

They will now be offered a “game-changing” specialised tool to help them manage their blood glucose levels effectively.

About 400,000 people in the UK have type 1 diabetes, a lifelong condition which causes the immune system to attack insulin-producing cells in the pancreas.

Insulin helps the body use sugar for energy, and without this hormone, blood sugar levels can become dangerously high.

Type 1 diabetes needs constant management to keep blood sugar within range, with patients required to take insulin through injections or pumps.

If diabetes is poorly controlled during pregnancy it can lead to stillbirth, miscarriage, larger babies, birth injuries and increased need for neonatal care.

The new tool, also known as a hybrid closed loop system, will be offered to the 2,000 women with type 1 diabetes who fall pregnant each year.

It will be also offered to women who have type 1 diabetes and are planning a pregnancy, NHS England said.

The technology, which is linked to a mobile phone app, delivers the precise insulin dosages a woman requires before and during pregnancy.

Unlike other artificial pancreases, this allows pregnant women to set a glucose target to the lower level required to achieve better outcomes in pregnancy, NHS England said.

It also allows remote monitoring by health workers which means fewer check-ups for mothers-to-be.

Specialist Diabetes Midwife Nina Willer, who lives with type 1 diabetes, has shared her experience about using new technology during her pregnancy at a national conference. https://t.co/j8DfVdHnKZ pic.twitter.com/CDCC6n6dV3

— Norfolk and Norwich University Hospitals (@NNUH) November 19, 2024

The tool has already been given to a number of women, including mother-of-two Nina Willer.

The 40-year-old, from Norwich, works as a diabetes specialist midwife at Norfolk and Norwich University Hospital.

During her first pregnancy, Ms Willer monitored her condition using finger prick glucose tests and an insulin pump every hour during the day and every 30 minutes overnight.

When her baby girl was born she needed neonatal intensive care for a week and received treatment for jaundice, weight issues and other health complications.

During her second pregnancy, Ms Willer used the specialist artificial pancreas and did not need to perform the same constant monitoring.

Her second daughter was born healthy at 36 weeks.

“This new generation ‘artificial pancreas’ is a game-changer for women with type 1 diabetes who are pregnant or planning a pregnancy, so it is fantastic that its available on NHS to protect the health of mums-to-be and babies,” Ms Willer said.

“As someone who has used this tech when I was pregnant with my own daughter, and as an NHS diabetes specialist midwife to help my patients, I’ve both experienced and seen how this technology can quickly and simply help women with type 1 diabetes achieving much better glucose levels, and ease the physical and mental burden of this condition.

“I am so proud of what the NHS is doing with the help of this technology, and am acutely aware of the onward effect that this will have, not only for patients but their family, their livelihood and of course their long-term health, once a pregnancy is complete.”

Kate Brintworth, chief midwifery officer for England, said: “This life-changing technology is great news for women with type 1 diabetes because their chronic condition can make it difficult for them to effectively regulate their blood glucose levels to have a safe pregnancy.

“Effective management of blood glucose levels before and during pregnancy for women living with type 1 diabetes has been shown to reduce the risk of poor maternity outcomes, such as miscarriage, stillbirth birth and birth injuries, and minimise risk to a baby’s development.

“The NHS is offering this cutting-edge ‘artificial pancreas’ because we want to transform the experiences of women with type 1 diabetes – helping to make this special time in their life safer, less stressful, and more enjoyable.”

Partha Kar, type 1 diabetes technology lead at NHS England, added: “This ingenious yet simple technology is helping pregnant women living with type 1 diabetes – and those planning a pregnancy – live better lives, improving maternal outcomes for them, reducing serious health complications, and making care simpler.”

Anthony Walker, senior policy officer at Diabetes UK, said: “Offering the hybrid closed loop systems that are proven to be most effective during pregnancy – and the additional devices like mobile phones needed to use them – is essential in ensuring that everyone has access to the right technology for them.”

August 2025 brought several significant updates in pulmonology, spanning advances in early detection, disease-modifying therapies, and clinical guidance. For World Lung Cancer Day, experts highlighted progress in lung cancer screening, where low-dose CT, emerging liquid biopsy biomarkers, and evolving treatment options offer new hope for earlier diagnosis and improved outcomes, though access and implementation challenges persist. In bronchiectasis, the FDA approved brensocatib for patients aged 12 and older, marking the first therapy to target neutrophil-driven inflammation and reduce exacerbation rates, while and HCPLive RX Review discussion explored the landscape’s shift toward disease-modifying care.

The FDA approval of zopapogene imadenovec-drba (Papzimeos), the first immunotherapy for adults with recurrent respiratory papillomatosis, underscored innovation in another rare and chronic respiratory disease. Updates in sinusitis management reinforced cautious antibiotic use, watchful waiting, and shared decision making, alongside guidance for biologic therapies in chronic rhinosinusitis with nasal polyps. In pediatric asthma, new predictive models integrating oral microbiome profiles, serum inflammatory mediators, and past attack history achieved superior accuracy for identifying children at risk of future severe attacks, offering clinicians data-driven tools to inform preventive strategies.

Check out this August 2025 pulmonology month in review for a recap of HCPLive’s coverage of the top news and research from the past few weeks:

1. World Lung Cancer Day: Experts Offer New Hope for Screening and Emerging Treatments

Lung cancer outcomes continue to improve through expanded low-dose CT screening, innovative blood-based biomarkers, and evolving therapies, though implementation and access remain major barriers. Albert Rizzo, MD, Mary Pasquinelli, DNP, Lindsey Cotton, DOMed, DHSc, MS, and Jacob Sands, MD, discuss the latest updates in this perspective.

2. FDA Approves First Bronchiectasis Therapy, Brensocatib, for Ages 12 and Up

The FDA approved brensocatib as the first disease-modifying therapy for non-cystic fibrosis bronchiectasis in patients aged 12 and older, based on phase 3 ASPEN trial data showing a 21% reduction in annualized pulmonary exacerbation rates versus placebo. Brensocatib, targeting neutrophil-driven inflammation, also demonstrated modest preservation of FEV1 and a manageable safety profile, representing a potential new standard of care.

3. Zopapogene Imadenovec First Immunotherapy Approved for Recurrent Respiratory Papillomatosis

The FDA approved zopapogene imadenovec-drba (Papzimeos) as the first immunotherapy for recurrent respiratory papillomatosis in adults, offering a non-replicating adenoviral vector–based approach to reduce disease burden. In a pivotal Phase 1/2 trial, 51% of patients achieved complete response and over 85% experienced reduced surgical interventions, with a favorable safety profile dominated by mild-to-moderate injection site reactions and systemic symptoms.

4. Cautious Antibiotic Use and Shared Decision Making Emphasized in 2025 Sinusitis Guidelines

The AAO-HNSF 2025 adult sinusitis guideline update emphasizes cautious antibiotic use and shared decision making, recommending watchful waiting as the preferred initial approach for uncomplicated acute bacterial rhinosinusitis. First-line therapy remains amoxicillin with or without clavulanate, while topical intranasal therapies and patient education are highlighted for symptom relief. The update also provides guidance on biologics for chronic rhinosinusitis with nasal polyps, discourages routine imaging or empiric antibiotics for CRS, and reinforces evidence-based diagnostic timelines.

5. Oral Microbiome, Serum Markers Improve Childhood Asthma Risk Prediction

New research shows that integrating oral microbiome profiles, serum inflammatory mediators, and past asthma attack history improves prediction of future severe asthma attacks in children. Models combining these biomarkers achieved high predictive accuracy (AUROCC ~0.87 in discovery and 0.84 in replication), outperforming conventional measures like FENO and blood eosinophil counts.

6. Shifting Bronchiectasis Treatment Toward Disease Modification

In an HCPLive RX Review Special Report, pulmonologists Albert Rizzo, MD, and James Chalmers, MBChB, PhD, explore the evolving landscape of bronchiectasis care, emphasizing the disease’s chronic morbidity, delayed diagnosis, and heterogeneity. They discuss the longstanding absence of disease-modifying therapies until the recent United States Food and Dug Administration approval of brensocatib in August 2025 under the name Brinsupri.

7. Breaking the Surgery Cycle in RRP With First Immunotherapy, with Simon Best, MD

HCPLive spoke with Simon Best, MD, about the FDA’s August 14 approval of zopapogene imadenovec-drba (Papzimeos), the first immunotherapy for adults with recurrent respiratory papillomatosis (RRP). The therapy, a non-replicating adenoviral vector–based immunotherapy, addresses a lifelong, HPV 6/11–driven disease previously managed only with repeated surgeries.

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‘It’s had a huge effect on my life’

Side effects

High blood pressure, also known as hypertension, is fairly common, and almost half of all adults in the U.S. have the condition. High blood pressure is defined as having a systolic blood pressure (the top number in a blood pressure reading) greater than 130 mm Hg or a diastolic blood pressure (the lower number in a blood pressure reading) greater than 80 mm Hg. 

But just because hypertension is common doesn’t mean it’s benign. Having high blood pressure, especially when it’s not controlled, places you at a higher risk of heart disease and stroke, both leading causes of death in the U.S. and globally.

With hypertension being so common, researchers have been looking for practical ways to help people lower their blood pressure for years now, and that includes dietary methods. Some of that research has led to beets, which contain nitrates that may help lower blood pressure. While there is mounting evidence of beets’ connection to healthier blood pressure, researchers are always digging deeper into the how and why of it. 

Case in point: Researchers from the University of Exeter in the UK wanted to know if beet juice altered the oral microbiome, and if so, whether those changes have anything to do with changes in blood pressure. They published their findings in the journal Free Radical Biology and Medicine. Let’s break down what they found. 

How Was This Study Conducted?

Researchers recruited two groups of participants. An older group, consisting of 36 older adults, ages 65 to 80, and a younger group of 42 young adults, ages 18 to 30. All participants were considered healthy at baseline with normal blood pressure levels, though the older group’s blood pressures averaged higher than the younger group’s.

There were three two-week interventions for this study. Before and after each intervention, participants went to the lab to have their mouths swabbed so researchers could look at their oral microbiomes—the good and bad bacteria that live in our mouths. They also had bloodwork and blood pressure measurements taken. Between each intervention was a two-week “washout” period to allow the oral microbiome to return to each participant’s “normal.”

For the first intervention, participants were instructed to drink two concentrated beet juice “shots” a day, one in the morning, one in the evening, for two weeks. Each shot was 70 ml of beet juice, which is about equal to just under ⅓ cup. For the second intervention, they did the same thing, but with a placebo beet juice that had been stripped of its natural nitrates—though participants were not aware of this. The third intervention involved participants swishing with an antiseptic mouthwash twice a day. 

What Did This Study Find?

Researchers found that the beet juice with nitrates changed the oral microbiomes in both groups for the better, reducing harmful bacteria and increasing beneficial bacteria. But the changes in specific bacteria differed between groups. 

The older group experienced a reduction in potentially harmful bacteria called Prevotella after drinking the nitrate-rich juice, and an increase in the growth of bacteria known to benefit health; these changes were more pronounced in the older compared to the younger group, and did not occur with the placebo juice. 

The older adults in this study had an average blood pressure of 126/80 at baseline, which was higher than the younger group’s average baseline blood pressure, but the older group’s baseline nitrite blood concentrations did not differ from the younger group’s. Yet, while the younger group saw no significant changes in blood pressure or in blood nitrite concentration throughout the study, the older group saw an average reduction in systolic blood pressure of 7 mm Hg, plus an increase in blood nitrite concentration. This amount of reduction in systolic blood pressure is clinically significant, which means that the benefits may extend to reducing other risks, including heart disease and stroke. 

As with any study, there is a risk of researcher error and participant bias with reporting adherence, though these participants reported 100% adherence to the study protocol. This study was also funded by the Biotechnology and Biological Sciences Research Council (BBSRC) Industrial Partnership Awards, which supports collaboration between academic research groups and industries. In this case, the collaboration might have been between the researchers and the company providing the beet juice. While this has the potential for introducing bias into the study and its results, this study does support previous research on beets and blood pressure. 

How Does This Apply to Real Life?

If you’re one of the 120 million U.S. adults with high blood pressure—or if you want to prevent the condition—there are several things you can do. Including beets and beet juice in your day might help. And of course, we have lots of amazing beet recipes, including our Beet Salad, Ginger-Beet Juice and Balsamic-Rosemary Melting Beets. 

If you’re not a fan of beets, other foods high in nitrates include spinach, kale, fennel and celery. And we’ve got lots of tasty recipes that include these plants, too—like our Wild Rice, Shrimp and Fennel Soup or our Spring Green Soup with Chicken, which has both celery and spinach. 

Here’s the thing: We don’t typically eat foods in isolation, and your whole eating pattern matters more than singling out one food. That’s why these study authors mention the Mediterranean diet, because it’s loaded with foods that naturally contain nitrates and a wealth of other essential nutrients. To get you started, we have several Mediterranean diet plans to choose from, including ones that support healthy blood pressure. Start with our 7-Day High-Protein Mediterranean Diet Meal Plan for High Blood Pressure, or if you want more, go for our 30-Day Mediterranean Diet Meal Plan for High Blood Pressure.

Other lifestyle habits also influence blood pressure. This includes physical activity, sleep and stress. Too much sodium has been connected with high blood pressure, and so has drinking too much alcohol. Even being dehydrated may raise your blood pressure, so try to drink enough water each day. 

Our Expert Take

This study suggests that beet juice may help lower blood pressure, and that there may be a connection between beet juice, blood pressure and your mouth’s microbiome—including reducing potentially harmful inflammatory bacteria. Nitrates are found in many plants, including beets, spinach, kale, fennel and celery. 

Taking a whole-health view of blood pressure means considering your diet, physical activity, stress and sleep. Choose an area you’re likely to have success with and start working on it today. While changes don’t happen overnight, small changes and healthy habits can add up to helpful benefits for your heart health.