Watches Commonly Monitor Heart Rate Variability

Wearable clothing  can measure several aspects of health, including heart rate variability. So, what does it mean if your heart rate variability is high or low? Cardiologist Dr. Elijah Behr with Mayo Clinic Health in London, said oftentimes your watch or wearable device is measuring the balance of nerve activity in the body and the way it relates to your heart rate and blood pressure.  

The nerve system that heart rate variability relates to is called the autonomic nervous system. It can be thought of as the balance between the effects of adrenaline in the body and the other part of the nervous system. “From beat to beat, or over periods of time, heart rate variability can be measured in different ways to try to assess this balance within the autonomic nervous system,” said Dr. Behr. “In general, people who have higher heart rate variability are more likely to have better cardiovascular fitness. Athletes tend to have a very high heart rate variability, for instance.”

Older adults with lower heart rate variability may be more likely to lack cardiovascular fitness or to have underlying heart disease. “Heart rate variability by itself isn’t likely to give you a good view of your likelihood of suffering a heart attack or heart rhythm problems. Ignore it as a stand-alone measure. Do use it as a way of pushing you toward being a bit healthier in your lifestyle,” said Dr. Behr. “Watch blood pressure, cholesterol, weight, and exercise. If you’re worried about your heart rate variability, you should be worried about these. They are more tangible risks that can be acted upon and that we know will have an impact on your longevity.”

Ozempic and its Chemical Cousins Ushering in a New Era in Battling Obesity.

GLP-1 agonists, a class of medications such as Ozempic and Wegovy, can help manage diabetes and obesity, and are ushering in a new era for combating obesity and heart disease. Keerthana Kesavarapu, a professor from the Rutgers Robert Wood Johnson Medical School, helps lead the Rutgers Center of Metabolic Health and Weight Management and said we have been losing the fight against obesity for the past 50 years. 

“I think we're finally gaining ground. With the advent of GLP-1 agonists like Ozempic, we're seeing weight loss results almost comparable to bariatric surgery, but with fewer risks and side effects. This is a game-changer,” said Kasavarapu. He noted that bariatric surgery still has its place, but these medications are  going to be playing an increasingly prominent role in obesity treatment. 

New use of Ozempic was associated with a lower risk for medical care related to smoking in adults with type 2 diabetes compared with 7 other anti-diabetes medications. Those who used Ozempic were less likely to have a medical encounter that included a diagnosis of smoking that was so pronounced they would be prescribed a smoking cessation medication or smoking cessation counseling. These findings have been published in Annals of Internal Medicine. 

Previous reports of reduced desire to smoke in adults taking Ozempic had raised interest about its potential to help adults who want to kick the habit. Researchers from the National Institute on Drug Abuse, National Institutes of Health and Case Western Reserve University School of Medicine compared the effectiveness of Ozempic versus the use of 7 other anti-diabetes medications. The researchers found that it was associated with a lower risk for smoking-related healthcare utilization when compared to the other anti-diabetes medications.

Preventing Pancreatitis with New Medications

GLP-1 receptor agonists may lower the risk of acute pancreatitis recurrence in people with obesity and those with type 2 diabetes, according to a new study. Acute pancreatitis is a sudden inflammation of the pancreas and can be very painful. Doctors have been cautious about prescribing these medications in patients with a history of pancreatitis due to the potential risk of worsening the condition.

 Dr. Mahmoud Nassar, with the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo in Buffalo, New York, said there is even a warning that is included in prescribing information. “Our research highlights the safety and the potential for GLP-1 receptor agonists to reduce the risk of acute pancreatitis recurrence in individuals with obesity and type 2 diabetes, challenging previous concerns and offering new hope for effective disease management,”  said Dr. Nassar.

The researchers used data from a large database called TriNetX, which contains information from about 127 million patients across 15 countries. They identified 638,501 individuals with a history of acute pancreatitis.

The researchers wanted to see if certain medications for diabetes and obesity (specifically, GLP-1 receptor agonists, SGLT2 inhibitors and DPP4 inhibitors) affected their risk of getting pancreatitis again. Their analysis covered a wide range of medications within each category to understand how these types of treatments might affect pancreatitis risk. They also looked closely at different patient characteristics, such as age, gender, body mass index (BMI) and blood test results, to better understand overall risks.

The researchers tracked how many patients developed pancreatitis within 5 years of starting their medications. When the GLP-1 group was compared with patients taking SGLT2 inhibitors, the GLP-1 group showed a lower risk of acute pancreatitis recurrence (15.2%) compared with 24% in the SGLT2 inhibitors group. 

When GLP-1 patients were compared with those taking DPP4i drugs, the GLP-1 group's recurrence risk was 14.4%, compared with 23.3% in the DPP4i group. When GLP-1 patients were compared with those not taking any of these medications, the GLP-1 group's recurrence risk was 14.5%, compared with 51.6% in the comparison group.

“This study provides critical insights that could change the treatment landscape for patients with obesity and type 2 diabetes, particularly those with a history of acute pancreatitis,” said Dr. Nassar. “The possibility of using GLP-1 receptor agonists more broadly offers hope for better managing these conditions, improving patient outcomes and enhancing quality of life.”

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.  He can be reached at medicalminutes@gmail.com