Medical Bulletin 29/ March/ 2025 - Video

Many teenagers enter adulthood with significant risk factors for cardiovascular disease, and the transition from adolescence to adulthood is a key time to address these risk factors and reduce the risk of developing future cardiovascular disease, according to a new American Heart Association scientific statement published in the Journal of the American Heart Association.

According to the scientific statement, “Cardiovascular Health in the Transition from Adolescence to Emerging Adulthood,” emerging adulthood is the period between age 18 and the mid- to late-twenties, when the brain and decision-making ability are still maturing to adult levels. Greater independence and many changes in life circumstances are occurring simultaneously during this time.

The scientific statement reviews many of the individual and social challenges to protecting heart health in emerging adults, and it identifies types of interventions that may help. In childhood and adolescence, there are typically standard occasions to see health care professionals, such as scheduled vaccinations and school or sports check-ups. These visits provide an opportunity to measure weight and blood pressure and check cholesterol and blood sugar levels. They can also open the door to a discussion about maintaining heart health and addressing any concerns before a risk factor is apparent.

American Heart Association’s key measures for improving and maintaining cardiovascular health, include several health behaviors (such as eating a healthy diet and getting enough physical activity) that may worsen in emerging adulthood. This period of life usually brings greater responsibilities along with a loss of structures that were in place during adolescence. Becoming more sedentary is common, as is gaining weight.

The authors concluded by outlining strategies for optimizing cardiovascular health promotion and disease prevention, underscoring the importance of primordial prevention, early intervention, and tailored approaches to address the unique needs of emerging adults. Addressing these multifaceted factors is crucial for mitigating the burden of cardiovascular disease risk factors among emerging adults and promoting long‐term cardiovascular well‐being.

Ref: Scott J, Agarwala A et al. Cardiovascular Health in the Transition From Adolescence to Emerging Adulthood: A Scientific Statement From the American Heart Association. Journal of American Heart Association. https://doi.org/10.1161/JAHA.124.039239

Compared to sugar, consuming sucralose—a widely used sugar substitute—increases activity in the hypothalamus, a brain region that regulates appetite and body weight, according to a new USC study. Sucralose also changes how the hypothalamus communicates with other brain regions, including those involved in motivation. The study was published in the journal Nature Metabolism.

The study included 75 participants, about evenly split between male and female and weight status (healthy weight, overweight or obese). On three separate visits, each participant was tested with sucralose, sugar or water, allowing the researchers to look for differences both within and between individuals.

The researchers tested how 75 participants responded after consuming water, a drink sweetened with sucralose or a drink sweetened with regular sugar. They collected functional magnetic resonance imaging (fMRI) brain scans, blood samples and hunger ratings before and after participants consumed the drink. Sucralose increased hunger and activity in the hypothalamus, especially in people with obesity. It also changed the way the hypothalamus communicated with other brain regions. Unlike sugar, sucralose did not increase blood levels of certain hormones that create a feeling of fullness.

The findings show how sucralose confuses the brain by providing a sweet taste without the expected caloric energy

Ref: Chakravartti, S.P., Jann, K., Veit, R. et al. Non-caloric sweetener effects on brain appetite regulation in individuals across varying body weights. Nat Metab 7, 574–585 (2025). https://doi.org/10.1038/s42255-025-01227-8

When someone has a stroke, it can accelerate the loss of cognitive ability over the coming years. Stroke survivors who have attended some level of higher education may face even steeper mental declines, according to a study led by Michigan Medicine.

In an analysis of cognitive outcomes for more than 2,000 patients seen for stroke between 1971 and 2019, college graduates performed better on initial post-stroke examinations of global cognition, a measure of overall cognitive ability that includes mental functions like memory, attention and processing speed.

However, stroke survivors who attended any level of higher education had faster declines in executive functioning — skills used to manage everyday tasks, such as working memory and problem solving — compared to patients with less than a high school degree.

For years, researchers have considered education level as a predictor of cognitive reserve, the ability to preserve higher levels of functioning despite brain injury that occurs over the course of life. This led the researchers to hypothesize that highly educated people would have slower cognitive decline after a stroke.

However, the results, published in JAMA Network Open, reflect the opposite. Having a higher number of the ApoE4 allele, a genetic risk factor for Alzheimer's disease, did not affect the association between education level and cognitive decline after stroke. The number of strokes a person suffered also did not affect the relationship.

This means that the critical point of brain injury at which cognitive compensation fails in the highly educated does not depend on underlying genetic risk and can be reached after a single stroke.

Hence, they concluded that identifying which stroke patients are at the highest risk for cognitive decline will help target future interventions to slow cognitive decline.

Ref: Education Levels and Poststroke Cognitive Trajectories,” JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.2002