These seasonal vaccines are safe and effective, based on many well-designed scientific trials. The Advisory Committee on Immunization Practices of the CDC has comprehensive, reliable and balanced information about all available vaccines.

Whether you’re in the middle of menopause or well past it, your heart health matters more than ever. Hormonal changes during and after menopause can raise your risk for cardiovascular disease – but the good news is, you can take action to protect yourself. Watch this webinar to learn: - How menopause impacts your heart, both now and later - The raising risk of heart disease after menopause - Practical steps you can take to strengthen your heart at any stage

Living with Postural Orthostatic Tachycardia Syndrome (POTS) can be incredibly taxing and overwhelming, often depleting resources we didn't even know we had. Amidst the constant management of symptoms, or mental health and overall well-being can sometimes take a back seat. However, nurturing our mental and emotional health is just as crucial as caring for our physical health. Join three chronic health psychologists for an engaging and supportive discussion where we will explore practical strategies to cope with the daily challenges of POTS. Learn how to manage your symptoms while prioritizing your mental well-being effectively. Follow along with the worksheet: https://drive.google.com/file/d/1DMhCvjhUcXQ08zG2OYu2Uo5r_ahG1bst/view?usp=sharing Evolvinn Contact information: Website: https://evolvinn.com/ Facebook: https://www.facebook.com/Evolvinn Linked in: https://www.linkedin.com/company/evolvinn Instagram: https://www.instagram.com/evolvinntherapy/ Pinterest: https://www.pinterest.com/evolvinntherapy/ Office phone: (703) 520-7878 Email: info@evolvinn.com

Join us as we welcome Skylar Griggs, MS, RD, LDN of Newbury Street Nutrition. We will be discussing 5 simple diet changes you can make to optimize your heart health and how your food choices directly affect your blood pressure, cholesterol levels and gut health.

Dive into the heart health breakthrough of the moment with our expert-led webinar on GLP-1 medications. We'll dissect how these drugs work, their impact on your heart health, common concerns, and what the future holds. This session is tailored for patients who seek a deeper understanding of their treatment options in a rapidly evolving medical landscape.

Please join us as we continue our discussion on the benefits of exercise in cardiovascular health. This webinar will be devoted to understanding the role of exercise in patients with cardiac diseases including coronary artery disease, atrial fibrillation, and heart failure. Study on Coronary Artery Disease: https://www.jacc.org/doi/10.1016/j.jacep.2022.12.002 Study on Atrial Fibrillation: https://www.jacc.org/doi/10.1016/j.jacep.2022.12.002 Study on Heart Failure with Preserved EF: https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.117.030617 Study on Heart Failure with Reduced EF: https://jamanetwork.com/journals/jama/fullarticle/183708  Overview study of all cardiac diseases: https://www.jacc.org/doi/10.1016/j.jacc.2022.07.004

Please join us as we welcome Dr. Amit Anand for his talk on Pranayama-Breath Work. The talk will focus on the role of Pranayama-breath-work practices for the cultivation of health and well-being. Breath-work has its roots in the wisdom tradition of Yoga. The accumulated science on breath-work and its effects on pulmonary and cardiovascular physiology, emotional wellbeing and sleep will be highlighted. The participants will also learn simple breathing exercises that they can incorporate into their lives on a daily basis. Dr. Anand's Website: https://www.pranayamarx.com/

Join us as we welcome Dr. Marie Gerhard-Herman to discuss “Raynaud’s and Beyond: why are my fingers and toes cold and discolored?” Dr. Gerhard-Herman is an internationally renowned Cardiologist and Vascular Specialist at Brigham and Women’s Hospital, where her clinical expertise includes peripheral arterial disease, venous disease, Raynaud’s phenomenon, and the impact of aging on the blood vessels. She has extensive experience as a lecturer, mentor, and teacher, and is beloved by her many patients and trainees. Resources: Follow Up Info Sheet Stress Response Sheet

Getting a good night's sleep every night is vital to cardiovascular health. Please join us for an in-depth discussion on optimal sleep. We welcome Dr. Karen Lee, a sleep-medicine-trained neurologist, with a busy practice at Mass Eye and Ear and appointment at Harvard Medical School. Dr. Lee will review sleep recommendations, tactics to optimize sleep, treatments for insomnia, and when to see a sleep-medicine physician.  Follow up questions answered by Dr. Karen Lee Q: Is there a specific brand of melatonin that you recommend? A: Per my talk, a prescription would be optimal to control what is in the melatonin. But if you would still like to purchase over the counter, some recommended over the counter brands are: Natrol, Nature's Made, and Puritan's Pride. If you try a different brand ensure it is USP or NSF certified on the label. Q:Is it normal to wake up about twice a night to go to the bathroom? A: There is not a straight forward answer to this, as there could be several reasons why this occurs, that could range from normal to abnormal, based on what is leading to the night time urination. It is known that sleep apnea leads to sympathetic surges at night, that lead to the need to urinate. So often, I have patients that urinate once, twice, or more per night, and when their sleep apnea is treated, this completely resolves or improves, regardless of patient age. If you would like to better understand of your fluid intake could be contributing, you can do a trial of cutting off fluids a few hours before bedtime several nights and see if that has an impact. Q: What can be done if the need for frequent urination interrupts sleep? Other then holding fluids after a certain time of night. A: See above, as it is always important to ensure sleep apnea is not contributing. This is a frequent referral to sleep specialists from Urologists, as if there is a Urology work up and they cannot find a reason for night time urination (there are several such as over active bladder, or insufficient emptying, or prostate issues etc.,), then they refer to sleep medicine to ensure sleep apnea is not leading to this. You should also evaluate if there is an issue with just as frequent urination during the day, this can help be clue if this is just related to sleep, or a consistent issue during the day. Q: What do you think about Trazodone? A: I prefer FDA approved sleep aids, as these medication are formulated directly to help with sleep, and trazodone is not. It is an antidepressant that has a side effect of drowsiness. But it has some positive and negatives. Some negative besides using this medication for its side effects, is that it impacts serotonin, and they may be good or bad, depending on the patient and other medications they take and how they feel. It also tends to have a very long half life, so it very commonly leads to morning and/or daytime sedation or cognitive complaints. Another negative is that it can lead to an EKG abnormal finding of QT prolongation, so this needs to be initially checked and potentially monitored moving forward based on the patient. Pros are that it is less habit forming than some other sleep aids like Ambien. Another pro is that often it can help individuals fall asleep or stay asleep. Q:Can you discuss how to improve sleep during menopause, with frequent hot flashes during the night? For women who cannot take hormones. A: This is still an active field of research. Off label medication used for this from a sleep medicine perspective is Gabapentin at night. On the other hand, Ob-gyn often uses serotonin acting medications to help with hot flashes in general. The CBTI that I spoke about in my talk is usually felt to be the most helpful. Below is a nice article that summarizes some aspect of this topic: https://womensmentalhealth.org/posts/managing-sleep-problems-in-menopausal-women-what-options-do-we-have/

What is the Mediterranean Diet and is it really so great for me? Why should I care about potassium? Am I getting enough protein? We are delighted to welcome back Erin DeMille, formerly Erin Murray, to answer all these questions and more! Join us for our next webinar as Erin shares strategies for optimizing our diet to maximize heart health. Erin's website: https://erindemillewellness.com/ Email: erin@erinmurraywellness.com LinkedIn: https://www.linkedin.com/in/erin-murray 

Source: GoodRx, American Diabetes Association A New Era for Diabetes and Weight Loss Drugs For patients seeking new solutions to managing type 2 diabetes and obesity, the introduction of a class of drugs called GLP-1 receptor agonists (RA) has simultaneously inspired hope and excitement along with misuse and confusion. We developed the following Q&A to go beyond the headlines and explore how Ozempic and similar drugs work, who may benefit most from them, and why they may ultimately represent a true breakthrough in the way these chronic conditions are classified, considered and treated. What defines type 2 diabetes? More than 37 million Americans have type 2 diabetes, a chronic disease that affects the ability of the body to regulate glucose (blood sugar) levels. This leads to an increase of glucose over time which significantly increases the risk for complications to vital organs such as the heart, kidneys, eyes and nerves. Diagnosis is made when testing shows: fasting glucose of 126 mg/dl or higher; or non-fasting glucose of 200 mg/dl or higher; or A1C (average of glucose over the past 3 months) of 6.5% or higher. How was type 2 diabetes previously treated? Approved by the FDA in 1994, Metformin is well established as the first line therapy for management of type 2 diabetes if lifestyle changes (low-carbohydrate diet, weight loss and exercise activity) are not enough to bring blood sugar levels down near the normal range. Metformin works by decreasing the amount of blood sugar produced by the liver in a fasting state, decreasing the absorption of food through the intestines, and restoring the body’s response to insulin. What is different about the GLP-1 RA drugs? Among the major benefits this class of drugs brings to patients with type 2 diabetes is lowering their risk for heart disease and stroke, and providing a significant boost to weight loss, in addition to helping reduce glucose levels to a near-normal range. As a result of the positive outcome reported in trials, the American Diabetes Association changed its longstanding guidelines for first-line treatment of type 2 diabetes to include recommendations for GLP-1 RA drugs in patients at high risk for cardiovascular disease or with risk factors such as high blood pressure, high cholesterol, or chronic kidney disease. How do GLP-1 RA drugs work? Known as incretin mimetics, this class of drugs mimics the effect of a hormone, glucagon-like peptide-1, or GLP-1, which is normally produced naturally to stimulate the release of insulin secretion after eating a meal. Receptors to GLP-1 are found in the pancreas, the brain and elsewhere in the body. The drug enhances these receptors, which help the pancreas release more insulin and help reduce blood sugar levels without raising the risk for hypoglycemia (too- low blood sugar levels). By limiting the amount of sugar the liver releases into the bloodstream in a fasting state, and slowing down how long food stays in the stomach, the drug promotes a feeling of satiety, leading people to be satisfied with eating smaller portions. In addition, some patients have reported a marked decrease in cravings for carbohydrate-rich and fatty foods. What are GLP-1 RA drugs intended to treat – diabetes, obesity, or both? Under certain names, GLP-1 RA drugs are FDA-approved only for treatment of type 2 diabetes while offering added benefits of weight loss and cardiovascular protection; under other names, the drugs are indicated only for weight loss, but not for treatment of diabetes. While the ingredients can be identical, the difference is in dosage amounts and whether the trials focused on the drug’s impact on blood sugar or weight changes. For example, semaglutide, a GLP-1 drug, is approved to treat diabetes under the name Ozempic; a higher-dose version of semaglutide, Wegovy, is only FDA approved for weight loss. The same is true for liragutide, approved for type 2 diabetes as Victoza, and for weight loss as Saxenda. Are there side effects? Most side effects for these types on drugs are gastrointestinal, including nausea, diarrhea or constipation, abdominal pain. How effective are GLP-1 RA drugs like Saxenda and Wegovy for weight loss? Trials to date have shown excellent results, with patients able to lose between 5 to 20% of their total body weight. However, these drugs are not meant for people wanting to lose 10 or 15 pounds. They are indicated for those who are obese, as measured by a body mass index (BMI) of 30 or higher; or for people with a BMI of 27 or greater with at least one weight-related coexisting condition such as high blood pressure, elevated cholesterol levels. It’s important to note that obesity is a chronic disease, and these drugs may be needed as a long-term treatment to help lose pounds and maintain weight loss, along with lifestyle changes that include a healthy diet and 150 minutes a week of moderate-intensity aerobic and muscle-strengthening activities. How do SGLT2 inhibitors fit into the mix of drugs for diabetes? This is a newer class of drugs that lowers blood sugar levels by preventing the kidneys from reabsorbing glucose back into the bloodstream but instead releasing it through urine. Originally intended only for lowering blood sugar, later research data showed the drugs offered significant benefits for type 2 diabetes patients with coexisting conditions. Now some SGLT2 drugs- Invokana (canaglifozin), Farxiga (dapaglifozin), and Jardiance (empagliflozin) - have also been approved for use by non-diabetic patients with a history of chronic kidney disease or congestive heart failure. Are other drugs in the wings? Mounjaro, a GLP-1 RA drug that also promotes a second gut hormone (glucose-dependent insulinotropic polypeptide, or GIP) is currently approved for treatment of type 2 diabetes, and on a fast track approval by the FDA to be used as a weight loss medication. How will I know which drug is right for me? This is a decision best made on an individual basis with your physician, who will consider factors such as your overall health status, drug intolerances, risk factors for developing diabetes-related complications, benefits versus possible harm from side effects, and preferred formulation (oral or injection). Drugs with Benefits: A Guide to GLP-1 RA Therapies NOTE: Non-GLP-1 RA drugs used for weight loss are not listed here… Please consult with your healthcare provider regarding your best option.