Cardiology

BP lowering reduces MACE early; benefits do not progressively increase with time.

Individual-participant meta-analysis of 51 RCTs (358,642 participants; median follow-up 4.2 years) standardized to a 5-mmHg systolic reduction. A 5-mmHg lower systolic BP was associated with HR 0.88 for MACE in year 1, with modest attenuation in later years. Temporal patterns were similar across five antihypertensive drug classes. Authors conclude benefit emerges within months and does not steadily grow with longer treatment duration. 1

Protocol: large digital biobank and RCT of LLM-driven activity coaching.

Study protocol describes a prospective digital cohort with an embedded randomized crossover trial targeting N = 15,000 adults in the US and UK. Primary endpoint is change in daily step count comparing LLM-generated coaching prompts with generic prompts. Data sources include passive sensors, active fitness tests, ECGs, and EHR via FHIR. This is a design paper; clinical effectiveness and safety of LLM coaching remain to be demonstrated. 2

Cardio-oncology prevention trials show modest, inconsistent clinical benefit.

Review finds randomized trials of HF medications and exercise mainly show subclinical changes, not consistent reductions in overt heart failure or mortality. Oncology trials often exclude patients with prior cardiac disease and use heterogeneous cardiovascular definitions. Authors call for risk-enriched trial designs, standardized safety monitoring, and inclusion of patients with stable cardiovascular comorbidity. They note AI-enabled imaging and remote monitoring may help harmonize detection and endpoints. 3