It is not uncommon for doctors to misidentify a health condition or misdiagnose due to lack of information or conflicting symptoms. However, many times these mistakes can lead the patient to get the wrong treatment, and cause problems like prolonged treatment, more health problems as well as patients feeling unheard.

A new report suggests that doctors are often missing a common, hormone-related reason for high blood pressure. This overlooked condition, called primary aldosteronism, could be affecting a significant number of people with high blood pressure without them even knowing. According to a study published in the Journal of Clinical Endocrinology & Metabolism, most doctors fail to identify this condition, even though it is the most common cause of high blood pressure.

More Common Than Thought

Research shows that as many as 30% of high blood pressure patients seen by heart specialists, and 14% of those seen by general doctors, actually have primary aldosteronism. This condition occurs when the adrenal glands (small glands located on top of your kidneys) produce too much of a hormone called aldosterone.

Despite how common it might be, many people with high blood pressure are never given a simple blood test to check for primary aldosteronism. In other cases, they might finally be tested years after their high blood pressure diagnosis. By this time, the condition can already lead to serious health problems.

Misdiagnoses in other health problems are also very common. According to a 2023 study published in the JAMA journal, every year, a staggering number of people—around 795,000—either die or are left with permanent disabilities because of mistakes in their diagnosis or related issues in healthcare. Even with a more conservative estimate, the number is still very high, at about 549,000 people harmed.

Why Is It Important to Diagnose?

People with primary aldosteronism face a higher risk of heart and blood vessel problems compared to those with regular high blood pressure.

Aldosterone helps control the balance of sodium (salt) and potassium in your blood. When aldosterone levels are too high, your body can lose too much potassium and hold onto too much sodium, which directly leads to higher blood pressure. Studies have shown that individuals with primary aldosterosteronism are:

• Nearly 2.6 times more likely to have a stroke.
• Twice as likely to experience heart failure.
• 3.5 times more likely to develop an irregular heartbeat.
• 77% more likely to end up with heart disease.

A simple and inexpensive blood test could help identify more people with primary aldosteronism, ensuring they get the right treatment.

New Guidelines and Treatment Options

The new report suggests that everyone diagnosed with high blood pressure should have their aldosterone levels checked. If primary aldosteronism is found, specific treatments for that condition should be given.

There are prescription medications available to treat primary aldosteronism. These include drugs like spironolactone and eplerenone, which help lower blood pressure and increase potassium levels in the body.

Doctors might also recommend surgery to remove one of the two adrenal glands if only one gland is making too much aldosterone. Patients are also usually advised to follow a balanced low-sodium diet and try to lose weight to help manage the condition.

Dementia is a condition that can effectively dismantle a person’s life and everything they have worked for. Your memories, the way you think and behave, and all of these factors will slowly change as dementia progresses. While we have known about the disease for quite some time now, there are many aspects of it that we are still exploring, like what are some of its risk factors and causes, as these will help us find a cure for the disease.

New research suggests that developing conditions like heart disease and diabetes before age 55 could significantly raise your chances of developing dementia later in life. The study also indicates that experiencing strokes or mental health issues such as anxiety and depression between ages 55 and 70 might double that risk.

Key Conditions and Critical Time Windows

The study, published in Brain Communications, revealed that heart conditions, including heart disease and an irregular heartbeat called atrial fibrillation, along with diabetes, were most strongly linked to an increased risk of dementia when they appeared before age 55. However, for those between 55 and 70, mental health disorders like anxiety and depression, as well as strokes, were found to double the dementia risk. This suggests different conditions pose a higher risk at different stages of life.

Link Between Chronic Conditions and Dementia

Researchers at the University of Oxford found that a large majority, about 80%, of people with dementia also have two or more chronic health problems. However, there hasn't been a clear understanding of how specific diseases, and when they occur, are connected to dementia. This study aimed to identify important periods in life where certain illnesses pose the biggest threat. They analysed health information from over 282,000 individuals in the UK Biobank, looking at patterns across 46 long-term health conditions.

Other Risk Factors for Dementia

According to Stanford Health Care, many things can raise a person's chance of getting dementia, though some factors we can change and others we can't. Growing older significantly increases the risk for common types like Alzheimer's and vascular dementia. Your genes and family history also play a role, as certain genes can increase the risk for Alzheimer's and other rarer forms like Creutzfeldt-Jakob disease.

However, having a family member with Alzheimer's doesn't guarantee you'll get it, and many without a family history still develop it. People with Down's syndrome often show signs of Alzheimer's in middle age.

Lifestyle choices matter too. For example, smoking heavily increases dementia risk, possibly due to its link with hardened arteries. While heavy alcohol use seems to increase risk, moderate drinking might actually lower it compared to drinking a lot or not at all. Health conditions are also key factors. Atherosclerosis, where arteries harden, is a big risk for vascular dementia and might be linked to Alzheimer's.

High "bad" cholesterol (LDL), high levels of an amino acid called homocysteine, and diabetes all raise the risk for both Alzheimer's and vascular dementia. Finally, if someone has mild cognitive impairment, they are at a much higher risk of developing dementia, with about 40% of those over 65 progressing to dementia within three years in one study.

Insights for Future Prevention

This research highlighted that individuals who had conditions like heart disease and diabetes in middle age and then later developed strokes and mental health disorders faced the highest chance of getting dementia. Experts em that considering all existing health issues is important when assessing someone's dementia risk, which could help in creating strategies to lower that risk at particular life stages. Future studies will explore if managing or preventing these health problems during these critical periods could reduce dementia rates.

Emergency rooms are handing out significantly fewer opioid prescriptions to people experiencing lower back pain. Researchers reported in the Annals of Emergency Medicine on July 12 that the rate of opioid prescriptions for back pain in ERs dropped by more than half between 2016 and 2022.

Dramatic Decline in Opioid Prescribing

Just a few years ago, in 2016, almost one out of every three visits to the ER for back pain ended with a prescription for opioid painkillers. But by 2022, that number had fallen dramatically to just over one in ten visits. This big drop means that doctors are learning from the available information and changing the way they practice medicine, especially as more people become aware of the widespread problems caused by opioid addiction. It's a positive sign that medical professionals are actively working to curb the opioid crisis.

Understanding the Study and Patient Experience

To figure this out, researchers looked at records from nearly 53 million ER visits for low back pain that happened between 2016 and 2022. These records were gathered by a national health statistics centre. The study found that when people went to the ER for back pain, they were usually in a lot of discomfort, rating their pain at more than 7 out of 10. On average, they had to wait about 37 minutes before a doctor saw them and spent around four hours in the emergency room getting treatment.

Why Opioid Usage Is Risky For Patients

A 2023 study even found that opioids may not be as effective for back pain. Published in the JAMA network, a 2023 study conducted a trial on those who were experiencing back pain. The trial involved 347 adults who had been experiencing pain for up to 12 weeks. Everyone in the study received standard care, which included reassurance, advice to avoid bed rest, and encouragement to stay active. Half of the participants also received a combination of oxycodone and naloxone (an opioid), while the other half received a placebo (a dummy pill).

The study also revealed that while side effects were similar for both groups, there was a significant difference in the risk of opioid misuse. One year later, 20% of the participants who took opioids were at risk of misusing them, compared to only 10% of those who received the placebo. This suggests that even for short-term pain relief, opioids carry a greater risk of future misuse.

NSAIDs Emerge as Preferred Treatment

Now, when you go to the ER with low back pain, nonsteroidal anti-inflammatory drugs, often called NSAIDs (like ibuprofen), are the most common painkillers prescribed. They're given to almost 29% of patients. It's not just about prescriptions either; fewer patients are actually given opioids while they are being treated in the ER. That number went down from 35% of cases in 2016 to less than 25% by 2020, showing a clear shift away from immediate opioid use during emergency care for back pain.

Next Issues People Must Tackle

Even though there's good progress with reducing opioids, ER doctors still have some areas where they could improve how they treat back pain. For example, many patients with back pain are still getting X-rays that they don't really need. In 2022, about 37% of patients had an X-ray, which is pretty much the same as in 2015. In fact, in 2021, almost 44% of cases involved an X-ray, which was the highest rate. It's tough to get this number down because deciding whether to order an X-ray can be complicated and depends on what both the doctor and the patient think is best.

In a major step forward for heart transplants, doctors at two leading U.S. hospitals — Duke University and Vanderbilt University — have developed simpler and potentially life-saving methods to recover hearts from donors whose hearts have already stopped beating. Their research, published Wednesday in the New England Journal of Medicine, could expand the pool of viable donor hearts, especially for babies and young children who often face the longest waits and highest risks.

Rethinking Heart Donation After Cardiac Death

Most donor hearts used for transplants come from people who are declared brain-dead but whose hearts are still beating. In these cases, organs are kept alive on a ventilator until they’re retrieved. However, another type of donor, someone whose heart has stopped after life support is withdrawn, often goes unused. These are known as DCD (donation after circulatory death) donors.

While DCD organs are commonly used for kidneys and livers, using their hearts is more complicated. Once the heart stops, oxygen is cut off, and even a short delay before retrieval can make the heart unusable. That’s why new methods are needed to safely assess and preserve these hearts for transplant.

Controversial and Costly Options

One current method to save DCD hearts is called normothermic regional perfusion (NRP). It involves restarting blood flow to the heart and other organs, but only after clamping off the arteries leading to the brain. While effective, this technique is ethically controversial because it reintroduces circulation after death, which some hospitals do not allow.

Another alternative is to use high-tech machines to “reanimate” the heart outside the body, pumping it with blood and nutrients to keep it functioning until it reaches the transplant hospital. These machines, however, are expensive and complex, and not suitable for infants, whose small hearts can’t be supported by the equipment.

Simpler, Safer Methods Emerging

In response to these challenges, the Duke team developed a new, less invasive technique. Instead of reanimating the heart or using costly machinery, they simply removed the heart and briefly tested it by pumping blood and oxygen through it on a sterile table. This short test, done without restoring full-body circulation, was enough to confirm the heart was still viable.

The method was first tested on piglets and then used in a real case: a 1-month-old infant at another hospital became a donor, and Duke surgeons transported the heart to save a 3-month-old baby. The retrieval took just minutes and the heart showed clear signs of life , “it’s pink, it’s beating,” said Dr. Joseph Turek of Duke.

Meanwhile, Vanderbilt’s team took an even more streamlined approach. They simply flushed the heart with a cold, nutrient-rich solution, similar to what’s done for brain-dead donors, before transporting it. “You don’t necessarily need to reanimate the heart,” said Dr. Aaron Williams, the lead author of the Vanderbilt study. The hospital has already completed about 25 such heart transplants using this method.

A New Chance for Patients Waiting in Line

The need for more donor hearts is urgent. Each year, around 700 children in the U.S. are added to the transplant waiting list, and nearly 20% of them die before receiving a new heart. Infants are especially vulnerable due to their small size and limited donor pool.

Last year, 43% of organ donors were DCD, yet only 793 out of 4,572 heart transplants came from this group. That’s a huge gap many experts hope to close.

Brendan Parent, a transplant ethics expert at NYU Langone Health, called the research “promising and essential.” He added, “Innovation to find ways to recover organs successfully after circulatory death is key to reducing the organ shortage.”

As these new techniques continue to be tested and refined, they may offer fresh hope to thousands of patients, especially the youngest ones, waiting for a second chance at life.