Internal Medicine

GLP-1 RA weight loss is broadly consistent, with greater benefit observed in women

This systematic review and meta-analysis of 64 RCTs examined GLP-1 RA weight-loss heterogeneity by age, sex, race, BMI, and HbA1c. Across six trials including 19,906 patients, women experienced greater percentage weight loss than men (10.9% vs 6.8%). No significant heterogeneity was seen by age, race, ethnicity, baseline BMI, or baseline HbA1c. Clinically, GLP-1 RAs can be used across demographic and metabolic subgroups, while counseling women about somewhat greater expected weight loss. 1

2025 AHA/ACC BP guideline expands treatment and intensification, especially in younger and obese adults

Using 2015-2020 NHANES data, investigators modeled medication eligibility under 2017 versus 2025 AHA/ACC BP guidelines. Among untreated adults, 18.7% were medication-eligible under 2017 guidance versus 18.4% plus another 10.8% conditionally under 2025 guidance. Eligibility increases were most pronounced among adults aged 30-60 years and those with obesity. Among treated adults, nearly 60% were above <130/80, and 17.6% became newly eligible for intensification toward <120/80. Primary care should anticipate more treatment discussions and intensification pressures, particularly in younger and obese patients. 2

High anticholinergic burden in older adults remains common and strongly predicts mortality

This NHANES-based cohort included 16,188 older adults followed for a median of 81 months. Prevalence of strong anticholinergic use and high anticholinergic burden (score ≥3) declined from 1988-94 to 2017-2020 across scales. High anticholinergic burden was independently associated with higher all-cause mortality, with adjusted hazard ratios around 1.5-1.6 on major scales. It also predicted substantially increased cardiovascular and cancer mortality. Findings support routine anticholinergic burden assessment and deprescribing as a core element of geriatric primary care. 3

Higher engagement in hypertension RPM improves BP control without clear demographic disparities

This retrospective cohort studied 835 adults in a primary care hypertension remote patient monitoring program. High engagement—BP measurements on more than half of days in at least two of three early months—occurred in about 62% of participants. Older age slightly increased odds of high engagement, while gender, race/ethnicity, and preferred language showed no association. Overall, 62.7% achieved BP <140/90 mmHg at six months. High engagement was associated with 83% higher odds of BP control versus low engagement after adjustment. 4