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early vascular risk factors for later dementia

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  a recent article assessed long-term vascular risk factors associated with future incident dementia, quantifying the early presence of hypertension, diabetes, and smoking to the subsequent development of dementia both before and after age 80, taking into account apolipoprotein ε4, and calculating the population attributable fractions (PAFs) for these risk factors individually and in combination: see   dementia early risk for later dementia JamaNeuro2025  in dropbox or doi:10.1001/jamaneurol.2025.1495 Details : -- 7731 participants in the Atherosclerosis Risk and Communities (ARIC) study with 33 years of follow-up from 1987 to 2020, in the current ARIC-NCS study (ARIC-Neurocognitive Study)     -- this study included participants from Jackson, Mississippi; Forsyth County, North Carolina; Minneapolis suburbs, Minnesota; and Washington County, Maryland     -- these sites reflected significant diversity in terms of socioeconomic factors, including rac...

Hyperaldosteronism 2025 guidelines

  Hyperaldosteronism 2025 guidelines  Modest, Geoffrey (HMFP - Medicine) ​ Modest, Geoffrey (HMFP - Medicine) ​   a recent clinical practice guideline for primary aldosteronism was just published by the Endocrine Society: see  aldosteronism practice guideline JClinEndoMetab2025  in dropbox, or doi.org/10.1210/clinem/dgaf284). this is a 43 page document, so i will present their major recommendations applicable to the primary care outpatient setting, with my commentary (thanks to Ian Huntington for bringing this to my attention) Recommendations -- All patients with hypertension should be screened for primary aldosteronism (PA) by measuring aldosterone and renin levels, and determining the aldosterone-to-renin ratio     -- very little direct data supporting this (only one large retrospective VA study), finding that very few people were screened for PA (1.6%)         -- international studies in Canada, Australia and several E...