Christine Kao/STATIn 2010, the American Heart Association set a decade-long goal to reduce the number of deaths from cardiovascular disease and stroke by 20%. It didn’t happen. Cardiovascular disease is still the number one cause of death in the U.S., and the AHA called it a “disappointment” that the goal wasn’t met.So what went wrong? It’s a big question that STAT’s Liz Cooney has posed to almost a dozen experts in cardiology, primary care, endocrinology, and vascular disease over the last few months. There’s no easy answer, but nearly everyone she spoke to pointed to one main factor: a crisis in primary care.“We’re losing ground,” said FDA Commissioner and cardiologist Robert Califf. “I think the biggest single remediable issue for us is that we don’t have a primary care system in the U.S. that’s functional.”Read more in a story by Liz about the role of the primary care system. Then, hop to the second story in this special report, on the host of additional factors that affect cardiovascular help. (And if you’re feeling stressed — experts in that story also discuss some trends that give them hope.)

Aggregating Asians in health data masks big differences in heart health

Last year, STAT’s Usha Lee McFarling wrote movingly about the danger of grouping nearly 25 million Asian Americans — from Hmong to Laotians, and Koreans to Indonesians — together as one entity in medical and public health research. Native Hawaiians and Pacific Islanders are often lumped into the Asian category, she wrote, even though federal standards clearly state they should be separate. A study out yesterday in the Annals of Internal Medicine shows how aggregating Asians into one group can mask significant health differences, in this case cardiovascular disease.

Death rates from cardiovascular disease were 1.5 times higher for Native Hawaiian and Pacific Islander adults over age 35 than for other Asian adults, ranking them third in the U.S. after Black and white adults, an analysis from 2018 through 2022 revealed. Heart disease was the cause most often noted on death certificates for NHPI adults, at 73%, while cerebrovascular disease accounted for 19% of deaths. More than a third of cardiovascular deaths occurred before age 65, something the authors call potentially premature and therefore concerning.

“Collectively, these results signal a need for focused interventions to promote cardiovascular health and prevent CVD among the NHPI population,” they wrote. — Liz Cooney

New study identifies potential brain cell targets for Alzheimer’s treatments

For decades, the Alzheimer’s field has largely focused on the idea that clumps of a protein fragment known as beta-amyloid drive the deadly neurodegenerative disease. While this hypothesis has led to two approved therapies, scientists are eager for targets that could lead to more effective treatments. A new study suggests the key to this search could be focusing on cell types lost early in disease.

A scientific team led by researchers at the Allen Institute analyzed 3.4 million cells from the brains of 84 deceased Alzheimer’s patients. They found a whole set of cellular changes that happen before symptoms first appear, including a dramatic loss in a population of cells known as somatostatin-expressing inhibitory neurons. These cells are lost well before beta-amyloid or tau, another disease-related protein, build up in the brain, the authors report in Nature Neuroscience.

It’s unclear for now exactly what is triggering the loss of these neurons. But the researchers say the findings suggest that protecting the cells could prevent a whole cascade of events that lead to cognitive symptoms, though it will take more detailed follow-up studies to show whether that’s true. — Jonathan Wosen

from AXIOS:

Questions hang over 23andMe customers’ data

Photo: Justin Sullivan/Getty Images

23andMe’s financial travails are casting uncertainty over the genetic information of millions of people who’ve used its mail-in DNA tests, according to reports.Why it matters: The health-privacy law HIPAA doesn’t apply to genetic testing companies. And 23andMe says customers’ personal information can be accessed, sold or transferred as part of a sale, merger or bankruptcy.The latest: 23andMe’s trove of genetic data might be its most valuable asset as the company teeters on the brink of collapse, The Atlantic reports.While users can request data deletion, it’s unclear what might happen if the company is sold or goes under, USA Today reports.Drugmakers could scan the data for information about individuals’ risk factors and target advertisements for treatments to those people.Insurers might get a glimpse of genetic predispositions that make one more susceptible to certain diseases, and more expensive to cover, per The Atlantic.About 80% of 23andMe’s customers consented to have their genetic data analyzed for medical research when they signed up, a spokesperson told NPR. The information is anonymized, so there’s no way third parties can connect the sample to a real person, the spokesperson said.Going forward, “any scenario which impacts our customers’ data would need to be carefully considered,” a spokesperson told The Atlantic.Between the lines: States like California and Florida have genetic information laws that give consumers extra protections.”If customers are really worried, they could ask for their samples to be withdrawn from these databases under those laws,” University of Iowa law professor Anya Prince told NPR.The bottom line: Vera Eidelman, a staff attorney with the American Civil Liberties Union, told NPR the patchwork of laws governing DNA data makes the information of millions potentially vulnerable to being sold off, or even mined by law enforcement.