Kennedy to Defend H.H.S. Overhaul as Democrats Denounce ‘War on Science'
Health Secretary Robert F. Kennedy Jr., whose drastic overhaul of the federal health apparatus has left scientists and patients reeling, will face a demand from the Republican chairman of the Senate health committee on Wednesday to explain to Americans how his reforms 'will make their lives easier, not harder.'
Mr. Kennedy will testify on Capitol Hill for the first time as health secretary, appearing back to back before the House and the Senate to promote President Trump's budget for the Department of Health and Human Services. But he will also be asked to defend the huge reductions he has already imposed on research grants and jobs, which key Democrats have condemned as part of what they call Mr. Trump's 'war on science.'
Mr. Trump has published only the broad outlines of his budget plan, which calls for deep cuts to the National Institutes of Health and the Centers for Disease Control and Prevention. Mr. Kennedy is expected to say that the cuts will save money 'without impacting critical services,' according to remarks he intends to deliver to the House Appropriations Committee.
The budget blueprint, Mr. Kennedy's remarks say, 'recognizes the fiscal challenges our country faces today, and the need to update and redirect our investments to meet the needs of a rapidly changing world.'
The remake of the health department, engineered in part by Elon Musk and his team at the Department of Government Efficiency, includes cutting 20,000 jobs — one quarter of the health work force. It also collapses entire agencies, including those devoted to mental health and addiction treatment, and emergency preparedness, into a new, ill-defined 'Administration for a Healthy America.'
Senator Bill Cassidy, the Louisiana Republican and health committee chairman, is expected to call on Mr. Kennedy to articulate 'a clearly defined plan or objective,' according to an excerpt from his prepared remarks. Mr. Cassidy voted to confirm Mr. Kennedy despite intense misgivings about his views on vaccines.
Mr. Cassidy asked Mr. Kennedy to testify about the job cuts at the health department last month, but the secretary did not appear.
'Much of the conversation around H.H.S.'s agenda has been set by anonymous sources in the media and individuals with a bias against the president,' Mr. Cassidy's remarks say. 'Americans need direct reassurance from the administration, from you Mr. Secretary, that its reforms will make their lives easier, not harder.'
That may be a tall order. A recent poll by KFF, a nonpartisan health policy research organization, found that a majority of the public opposed major cuts to staff and spending at the nation's health agencies. A majority of Americans said the Trump administration was 'recklessly making broad cuts to programs and staff, including some that are necessary for agencies to function.'
In anticipation of the hearing, Senator Bernie Sanders of Vermont, the ranking member on the health committee, released a report on Tuesday that accused Mr. Trump of waging an 'unprecedented, illegal and outrageous attack on science and scientists.' The report found, for instance, that Mr. Trump cut cancer research by 31 percent over the first three months of this year, compared to the same time frame last year.
'Trump's war on science is an attack against anyone who has ever loved someone with cancer,' Mr. Sanders said in a statement. 'The American people do not want us to slash cancer research in order to give more tax breaks for billionaires.'
Mr. Kennedy, one of the nation's most vocal vaccine skeptics, is also likely to face questions about his management of a measles outbreak that began in West Texas, which has killed two unvaccinated children and one adult, and has now sickened more than 1,000 people in 30 states, according to the C.D.C.
Mr. Kennedy has offered only a tepid endorsement of vaccination. He has acknowledged that vaccines are an effective way of preventing the spread of measles. But he has insisted that the choice to vaccinate should be voluntary.
He has instead promoted treating the disease after infection with alternative therapies, including cod liver oil, which contains vitamin A — a remedy that doctors said had sickened some children who took too much of it.
In the House, where Mr. Kennedy will appear before the Appropriations Committee, Democrats will argue that he and Mr. Trump and Mr. Musk are destroying 'the crown jewels of our health system,' according to a Democratic aide who spoke on condition of anonymity to preview lawmakers' remarks.
Representative Rosa DeLauro, the top Democrat on the Appropriations Committee, is likely to focus on cuts to scientific studies aimed at understanding and developing treatments for diseases such as cancer, Alzheimer's disease and diabetes. The aide said that cutting basic research funded by N.I.H. is 'destroying the pipeline of future medical treatments.'
Democrats will also press Mr. Kennedy on how the cuts are affecting clinical trials.
Senator Patty Murray, Democrat of Washington, who serves on the health committee but is also the top Democrat on the Appropriations Committee, hosted a round-table discussion last week at Seattle Children's Research Institute to put a spotlight, her office said, on 'what's at stake for patients and families as Trump takes a wrecking ball to this research.'
In an emailed statement on Tuesday, Ms. Murray complained that Mr. Kennedy was 'overdue to testify' after 'no-showing' when Mr. Cassidy invited him in April.
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Yahoo
8 minutes ago
- Yahoo
Trump tariffs live updates: Trump says he will set unilateral tariff rates within weeks
President Donald Trump told reporters on Wednesday that he would send letters to trading partners in the next week or two setting unilateral tariff rates. 'At a certain point, we're just going to send letters out. And I think you understand that, saying this is the deal, you can take it or leave it,' the president said at the Kennedy Center in Washington. Soon after introducing steep new tariffs that roiled markets, Trump instituted a pause on his most punishing duties that expires July 9. His latest comment, however, only muddies the waters about what could happen next as the deadline approaches. Earlier on Wednesday, Treasury Secretary Scott Bessent told Congress that it is "highly likely" that the tariff pause would be extended for countries that are negotiating with the administration "in good faith." "There are 18 important trading partners — we are working toward deals on those — and it is highly likely that those countries that are ... negotiating in good faith, we will roll the date forward," Bessent said during testimony before the House Ways and Means Committee. On Tuesday, the US and China agreed to a framework and implementation plan to ease tariff and trade tensions. Trump signaled his approval, saying the deal was "done" pending sign-off from him and Chinese President Xi Jinping. Trump and other US officials indicated the deal should resolve issues between the two countries on rare earths and magnets, though reports later indicated China would only loosen restrictions on rare earth mineral exports for a six-month period. Trump also said the US will allow Chinese students in US colleges, a sticking point that had emerged in the weeks following the countries' mid-May deal in Geneva. Trump said the US would impose a total of 55% tariffs on Chinese goods. Yahoo Finance's Ben Werschkul reports, citing a White House official, that Trump arrived at that figure by adding together an array of preexisting duties and not any new tariffs. Meanwhile, though Trump's most sweeping tariffs continue to face legal uncertainty, on Tuesday, the president received a favorable update. A federal appeals court held a decision saying his tariffs can temporarily stay in effect. The US Court of International Trade had blocked their implementation last month, deeming the method used to enact them "unlawful." Read more: What Trump's tariffs mean for the economy and your wallet Here are the latest updates as the policy reverberates around the world. Treasury Secretary Scott Bessent told House lawmakers on Wednesday that the Trump administration may extend the 90-day tariff pause on some countries in order to continue trade negotiations. When asked if Americans should prepare for another "Liberation Day" on July 9, when the tariff pause ends for most countries, Bessent said that the administration may choose to move the deadline on 18 of the most important trading partners, so long as they make an effort to come to the negotiating table. "We are working toward deals on those, and it is highly likely that [for] those countries — or trading blocs, in the case of the EU — who are negotiating in good faith, we will roll the day forward to continue good faith negotiations," Bessent said (see video below). "If someone is not negotiating, then we will not." A recent report on the drastic decline of US ocean imports serves as an example of how President Trump's increased tariffs on China affected supply chains and several industries as ttalks continue. Reuters reports: Read more here. The Treasury Department says that the US government is successfully using tariffs to decrease the budget deficit by more than $30 billion, largely due to increased customs receipts. Reuters reports: Read more here. China will ease curbs on exports of rare earth minerals for six months as part of a new trade understanding with the US, according to The Wall Street Journal. The move could add more uncertainty for American manufacturers, particularly the auto industry, which has been pushing for easier access. The Journal notes that the move gives China leverage down the line if tensions ratchet back up. From the report: In celebrating the agreement early Wednesday, President Trump noted "any necessary rare earths will be supplied, up front, by China." He did not mention any time limit on loosening those restrictions. Treasury Secretary Scott Bessent, in testimony before Congress on Wednesday, painted Wednesday's agreement as an incremental step on the longer road to a more comprehensive trade deal. "A trade deal today or last night was for a specific goal, and it will be a much longer process," he told a House committee. When asked if current US tariff levels on Chinese imports would not change again, Commerce Secretary Howard Lutnick told CNBC, "You can definitely say that." "We're in a great place with China," Lutnick said Wednesday. While the US-China truce framework is awaiting final word from US President Trump and Chinese President Xi Jinping, Lutnick added, "Both sides are really positive." The agreement is largely viewed as reestablishing the "handshake" that US and Chinese officials reached in Geneva last month, as details on a larger trade pact remain scant. Trump posted on social media this morning that the US has imposed 55% tariffs on China, a number that does not include any new tariffs but instead comprises some preexisting tariffs, Trump's fentanyl tariffs, and 10% "Liberation Day" tariffs. Lutnick touted that, as a result of the two-day talks, the US will gain access to rare earths and magnets, while the Chinese delegation sought to remove the US's export controls. He added that the trade deficit remains an ongoing issue, stating, "We're going to examine how China can do more business with us." May's Consumer Price Index (CPI) report showed inflation pressures eased on a monthly basis despite investor concerns that President Trump's tariffs would accelerate the pace of price increases. The Consumer Price Index (CPI) increased 0.1% on a monthly basis in May and 2.4% on an annual basis, a slight uptick from April's 2.3% gain. Yahoo Finance's Allie Canal reports: Read more here. I would keep an eye on consumer names off the news of a trade deal with China floated by President Trump this morning (see our prior post below). Seeing upticks premarket in heavily China-exposed retailers such as Nike (NKE), Walmart (WMT), Target (TGT), and Abercrombie & Fitch (ANF). The premarket gains here aren't mind-blowing in part because tariffs appear to still be in place. Trump posted on Truth Social: OUR DEAL WITH CHINA IS DONE, SUBJECT TO FINAL APPROVAL WITH PRESIDENT XI AND ME. FULL MAGNETS, AND ANY NECESSARY RARE EARTHS, WILL BE SUPPLIED, UP FRONT, BY CHINA. LIKEWISE, WE WILL PROVIDE TO CHINA WHAT WAS AGREED TO, INCLUDING CHINESE STUDENTS USING OUR COLLEGES AND UNIVERSITIES (WHICH HAS ALWAYS BEEN GOOD WITH ME!). WE ARE GETTING A TOTAL OF 55% TARIFFS, CHINA IS GETTING 10%. RELATIONSHIP IS EXCELLENT! THANK YOU FOR YOUR ATTENTION TO THIS MATTER!" A variety of market observers quickly weighed in hours after Tuesday evening's unveiling to suggest that the deal may not have a lot of meat on the bones — but at least relations are no longer moving in the wrong direction. The talks perhaps underscored how unlikely a comprehensive trade deal is anytime soon, noted AGF Investments Greg Valliere, "but at least relations may not worsen as talks continue throughout the summer." Both sides promised additional talks in the weeks or months ahead, but none have yet been scheduled. Veronique de Rugy, a professor at the Mercatus Center at George Mason University, suggested the talks continued to show China's leverage. "China is hurting, yes—but they still hold the upper hand on critical resources, and they know how to use them." Any lessening of tensions — and freer flow — of these mineral resources in China would be a significant boost to the global economy with China holding outsized leverage in both the reserves and processing capacity of these key building blocks for everything from computers to electric vehicle batteries to medical devices. Likewise, the US offering concessions on export controls would be a significant move after years where successive US administrations have wielded these controls — especially around the design and manufacture of semiconductors — by saying they need to be tight on China for national security reasons. Read more here. May's Consumer Price Index (CPI) report will be released on Wednesday and its expected to show that prices rose a bit faster than in April. Yahoo Finance's Allie Canal breaks down what to look out for and how President Trump's tariffs are impacting what consumers are now paying for goods and services. Read more here. Now that the US-China trade truce is back on track, both sides are keen to ensure it stays that way. China's Vice Premier He Lifeng said both sides need to now 'show the spirit of good faith in abiding by their commitments and jointly safeguard the hard-won results of the dialogue.' Bloomberg News reports: Read more here. Reuters reports: Read more here. Despite the US-China trade truce resuming the pain from President Trump's tariffs remains in China, especially among small exporters. Reuters reports: Read more here. Japan warned Wednesday that tariffs threaten its economic growth, the government said in a monthly report. Reuters reports: Read more here. Reuters reports: Read more here. Reuters reports: Read more here. A federal appeals could said on Tuesday that President Trump's sweeping tariffs can continue for now. This is a significant win for Trump, who introduced tariffs back in March and declared "Liberation Day," as he saw them as a way to free the US from what he called unfair trade practices. Bloomberg News reports: Read more here. Early summer sales for Inditex, the owner of fashion retailer Zara, came in weaker, as the company missed expectations for first quarter sales on Wednesday. President Trump's tariffs have impacted consumer demand in the US and other major markets. Reuters reports: Read more here. After weeks of back and forth, the US and China have agreed on a framework to implement the Geneva consensus that helped ease tariffs. The breakthrough came after two days of talks in London, including a marathon session on Tuesday. US Commerce Secretary Howard Lutnick said both sides had to "get the negativity out" before making progress. 'Now we can go forward to try to do positive trade, growing trade,' he said. As part of the deal, Beijing has promised to speed up shipments of rare earth metals, a crucial component for global auto and defense industries. Washington will ease export controls. This marks the first sign of movement on key issues. The proposal will now be presented to President Trump and China's Xi. Still, the discussions also did little to resolve a long-standing issue: China's trade surplus with the US. 'Markets will likely welcome the shift from confrontation to coordination,' said Charu Chanana, chief investment strategist at Saxo Markets. 'We're not out of the woods yet — it's up to Trump and Xi to approve and enforce the deal.' The meeting was set up after a phone call between the two leaders, following weeks of each side accusing the other of breaking the Geneva commitments. Both countries had used chips, rare earths, student visas and ethane as bargaining tools. Josef Gregory Mahoney, a professor at East China Normal University, said trust, not money, has been the biggest casualty of the trade war. 'We've heard a lot about frameworks,' he said. 'But the fundamental issue remains: Chips versus rare earths. Everything else is a peacock dance.' Bloomberg reports: Read more here. Treasury Secretary Scott Bessent told House lawmakers on Wednesday that the Trump administration may extend the 90-day tariff pause on some countries in order to continue trade negotiations. When asked if Americans should prepare for another "Liberation Day" on July 9, when the tariff pause ends for most countries, Bessent said that the administration may choose to move the deadline on 18 of the most important trading partners, so long as they make an effort to come to the negotiating table. "We are working toward deals on those, and it is highly likely that [for] those countries — or trading blocs, in the case of the EU — who are negotiating in good faith, we will roll the day forward to continue good faith negotiations," Bessent said (see video below). "If someone is not negotiating, then we will not." A recent report on the drastic decline of US ocean imports serves as an example of how President Trump's increased tariffs on China affected supply chains and several industries as ttalks continue. Reuters reports: Read more here. The Treasury Department says that the US government is successfully using tariffs to decrease the budget deficit by more than $30 billion, largely due to increased customs receipts. Reuters reports: Read more here. China will ease curbs on exports of rare earth minerals for six months as part of a new trade understanding with the US, according to The Wall Street Journal. The move could add more uncertainty for American manufacturers, particularly the auto industry, which has been pushing for easier access. The Journal notes that the move gives China leverage down the line if tensions ratchet back up. From the report: In celebrating the agreement early Wednesday, President Trump noted "any necessary rare earths will be supplied, up front, by China." He did not mention any time limit on loosening those restrictions. Treasury Secretary Scott Bessent, in testimony before Congress on Wednesday, painted Wednesday's agreement as an incremental step on the longer road to a more comprehensive trade deal. "A trade deal today or last night was for a specific goal, and it will be a much longer process," he told a House committee. When asked if current US tariff levels on Chinese imports would not change again, Commerce Secretary Howard Lutnick told CNBC, "You can definitely say that." "We're in a great place with China," Lutnick said Wednesday. While the US-China truce framework is awaiting final word from US President Trump and Chinese President Xi Jinping, Lutnick added, "Both sides are really positive." The agreement is largely viewed as reestablishing the "handshake" that US and Chinese officials reached in Geneva last month, as details on a larger trade pact remain scant. Trump posted on social media this morning that the US has imposed 55% tariffs on China, a number that does not include any new tariffs but instead comprises some preexisting tariffs, Trump's fentanyl tariffs, and 10% "Liberation Day" tariffs. Lutnick touted that, as a result of the two-day talks, the US will gain access to rare earths and magnets, while the Chinese delegation sought to remove the US's export controls. He added that the trade deficit remains an ongoing issue, stating, "We're going to examine how China can do more business with us." May's Consumer Price Index (CPI) report showed inflation pressures eased on a monthly basis despite investor concerns that President Trump's tariffs would accelerate the pace of price increases. The Consumer Price Index (CPI) increased 0.1% on a monthly basis in May and 2.4% on an annual basis, a slight uptick from April's 2.3% gain. Yahoo Finance's Allie Canal reports: Read more here. I would keep an eye on consumer names off the news of a trade deal with China floated by President Trump this morning (see our prior post below). Seeing upticks premarket in heavily China-exposed retailers such as Nike (NKE), Walmart (WMT), Target (TGT), and Abercrombie & Fitch (ANF). The premarket gains here aren't mind-blowing in part because tariffs appear to still be in place. Trump posted on Truth Social: OUR DEAL WITH CHINA IS DONE, SUBJECT TO FINAL APPROVAL WITH PRESIDENT XI AND ME. FULL MAGNETS, AND ANY NECESSARY RARE EARTHS, WILL BE SUPPLIED, UP FRONT, BY CHINA. LIKEWISE, WE WILL PROVIDE TO CHINA WHAT WAS AGREED TO, INCLUDING CHINESE STUDENTS USING OUR COLLEGES AND UNIVERSITIES (WHICH HAS ALWAYS BEEN GOOD WITH ME!). WE ARE GETTING A TOTAL OF 55% TARIFFS, CHINA IS GETTING 10%. RELATIONSHIP IS EXCELLENT! THANK YOU FOR YOUR ATTENTION TO THIS MATTER!" A variety of market observers quickly weighed in hours after Tuesday evening's unveiling to suggest that the deal may not have a lot of meat on the bones — but at least relations are no longer moving in the wrong direction. The talks perhaps underscored how unlikely a comprehensive trade deal is anytime soon, noted AGF Investments Greg Valliere, "but at least relations may not worsen as talks continue throughout the summer." Both sides promised additional talks in the weeks or months ahead, but none have yet been scheduled. Veronique de Rugy, a professor at the Mercatus Center at George Mason University, suggested the talks continued to show China's leverage. "China is hurting, yes—but they still hold the upper hand on critical resources, and they know how to use them." Any lessening of tensions — and freer flow — of these mineral resources in China would be a significant boost to the global economy with China holding outsized leverage in both the reserves and processing capacity of these key building blocks for everything from computers to electric vehicle batteries to medical devices. Likewise, the US offering concessions on export controls would be a significant move after years where successive US administrations have wielded these controls — especially around the design and manufacture of semiconductors — by saying they need to be tight on China for national security reasons. Read more here. May's Consumer Price Index (CPI) report will be released on Wednesday and its expected to show that prices rose a bit faster than in April. Yahoo Finance's Allie Canal breaks down what to look out for and how President Trump's tariffs are impacting what consumers are now paying for goods and services. Read more here. Now that the US-China trade truce is back on track, both sides are keen to ensure it stays that way. China's Vice Premier He Lifeng said both sides need to now 'show the spirit of good faith in abiding by their commitments and jointly safeguard the hard-won results of the dialogue.' Bloomberg News reports: Read more here. Reuters reports: Read more here. Despite the US-China trade truce resuming the pain from President Trump's tariffs remains in China, especially among small exporters. Reuters reports: Read more here. Japan warned Wednesday that tariffs threaten its economic growth, the government said in a monthly report. Reuters reports: Read more here. Reuters reports: Read more here. Reuters reports: Read more here. A federal appeals could said on Tuesday that President Trump's sweeping tariffs can continue for now. This is a significant win for Trump, who introduced tariffs back in March and declared "Liberation Day," as he saw them as a way to free the US from what he called unfair trade practices. Bloomberg News reports: Read more here. Early summer sales for Inditex, the owner of fashion retailer Zara, came in weaker, as the company missed expectations for first quarter sales on Wednesday. President Trump's tariffs have impacted consumer demand in the US and other major markets. Reuters reports: Read more here. After weeks of back and forth, the US and China have agreed on a framework to implement the Geneva consensus that helped ease tariffs. The breakthrough came after two days of talks in London, including a marathon session on Tuesday. US Commerce Secretary Howard Lutnick said both sides had to "get the negativity out" before making progress. 'Now we can go forward to try to do positive trade, growing trade,' he said. As part of the deal, Beijing has promised to speed up shipments of rare earth metals, a crucial component for global auto and defense industries. Washington will ease export controls. This marks the first sign of movement on key issues. The proposal will now be presented to President Trump and China's Xi. Still, the discussions also did little to resolve a long-standing issue: China's trade surplus with the US. 'Markets will likely welcome the shift from confrontation to coordination,' said Charu Chanana, chief investment strategist at Saxo Markets. 'We're not out of the woods yet — it's up to Trump and Xi to approve and enforce the deal.' The meeting was set up after a phone call between the two leaders, following weeks of each side accusing the other of breaking the Geneva commitments. Both countries had used chips, rare earths, student visas and ethane as bargaining tools. Josef Gregory Mahoney, a professor at East China Normal University, said trust, not money, has been the biggest casualty of the trade war. 'We've heard a lot about frameworks,' he said. 'But the fundamental issue remains: Chips versus rare earths. Everything else is a peacock dance.' Bloomberg reports: Read more here. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Medscape
8 minutes ago
- Medscape
The Most Vicious Cycle of All: Cardiac PTSD
Just surviving a major cardiac event is an achievement, but of course getting through whatever initial resuscitation and procedures necessary are merely the first steps. As a patient embarks on their rehabilitation journey, one incredibly dangerous setback cardiologists must be on the lookout for is cardiac posttraumatic stress disorder (PTSD). This remarkably common complication — according to a 2004 study published in Critical Care Medicine , as many as 27% of those who survive cardiac events may develop PTSD — can not only cause noncompliance with medication and other ongoing treatment modalities but also put the patient at an increased risk for a second cardiac event. 'In the aftermath of cardiac arrest or a heart attack, one of the most overlooked aspects of recovery is the emotional toll it takes, said Srihari S. Naidu, MD, a professor of medicine at New York Medical College and director of the Cardiac Cath Labs at the Westchester Medical Center Health Network, both in Valhalla, New York. 'The experience can be deeply traumatic, not just for the patient, but for their loved ones as well. Despite this, mental health remains one of the least systematically addressed components of cardiac care.' One problem, Naidu said, is that we 'still, we lack standardized approaches to routinely screen, diagnose, and treat PTSD in this vulnerable population.' Indeed, the American Heart Association identified this as a problem in its 2020 scientific statement, Sudden Cardiac Arrest Survivorship. In this publication, the association said the coordination of multidisciplinary care, to include emotional care, must start as early as within the ICU, but that it needs to continue throughout the recovery period. Srihari S. Naidu, MD 'Without a coordinated plan during hospitalization to assess both short- and long-term recovery needs, we risk missing the broader picture,' said Naidu, who is also the president of the Society for Cardiovascular Angiography and Interventions. 'In my experience, the outpatient clinic visit is often the first, and sometimes the only, opportunity to uncover these issues, which may manifest as anxiety or persistent thoughts about the event, or a variety of unrelated symptoms.' James Jackson, MD, director of Behavioral Health and professor of medicine and psychiatry at Vanderbilt University in Nashville, Tennessee, said the symptoms are all united by one thing: The fact that the patient has the source of their trauma with them at all times. 'If you're carrying your heart around with you and the heart is the source of the trauma, you're constantly reminded, right? And if your cardiac event developed out of the blue, the concern is it could develop out of the blue again, right? So you're carrying this trauma around with you. It's a constant reminder,' he said. 'The trauma is not parked somewhere in the rear view. The trauma is sort of in the present and even in the future.' Symptom-wise, this trauma manifests itself in a variety of ways and can often go overlooked due to the focus on the physical recovery, Naidu said. 'During follow-up, subtle cues begin to emerge; patients who seem emotionally distant, who have trouble sleeping, or who avoid talking about what happened (can be red flags),' he said. 'PTSD doesn't always present dramatically.' Sometimes, Naidu said, it's the patient who suddenly bursts into tears when recalling the event. Other times, it's the one who avoids follow-ups, skips cardiac rehab, or steers clear of anything that reminds them of the hospital. Early symptoms may include hypervigilance, nightmares, intrusive memories, emotional numbness, and avoidance. The Cycle Folds Onto Itself When you break it down and look at triggering factors, it's not hard to understand how PTSD becomes a self-fulfilling prophecy. 'Often with patients in a cardiac context, they get quite anxious. Their heart starts beating fast, and then they really worry. And so their response to that is, I'm going to withdraw. I'm going to disengage,' Jackson said. While physical activity or exercise often helps reduce stress, patients are often short of breath and are reminded how it felt when they were having the attack. James Jackson, MD 'And so if they start to exercise, it's all well and good,' Jackson said. 'But as soon as they get slightly short of breath, even if they're fine physiologically, as soon as they get short of breath, they're going to shut that down. And this is just one example, but it becomes a very isolating sort of process.' Patients left in this sustained crisis state experience a significantly diminished overall quality of life, and a study led by Antonia Seligowski and published in the March 2024 issue of Brain, Behavior, and Immunity found that PTSD after cardiac arrest significantly increases the risks for both major adverse cardiovascular events and all-cause mortality within just 1 year of discharge. This is supported by the findings of Donald Edmondson, MD, associate professor of behavioral medicine in medicine and psychiatry at Columbia University Irving Medical Center, New York City, both in his 2013 study published in the American Heart Journal and in research he has done since. 'Over the years now, we've studied cardiac patients, both acute coronary syndrome, so myocardial infarction, as well as cardiac arrest and stroke,' Edmondson said. 'What we see is that between 15 and 30% of patients will screen positive for PTSD due to that cardiac event 1 month later. Those who screen positive for PTSD are at least at doubled risk, if not greater, for having another cardiac event or dying within the year after that first cardiac event.' These outcomes highlight how critical it is to address PTSD early and effectively, Naidu said. 'As cardiologists, we often focus on optimizing medications, procedures, and physical rehabilitation, but without integrating behavioral support, we're missing a major part of the healing process,' he said. PTSD and cardiovascular disease have a well-documented relationship: PTSD can worsen cardiovascular risk, and in turn, living with heart disease can amplify psychological stress. Jackson said that there are behavioral health approaches at work in other areas that may be useful for cardiac events that are not sudden onset. 'There's a general sort of a movement afoot called prehab,' Jackson said. 'The general idea about prehab would be, 'Hey, you're going to have this surgery. We think that it's going to knock your brain down. So we're going to try to do some brain training with you before the surgery, and we think that in doing that, we're going to build your reserve up.' Is There a Type? Although a 2022 study led by Sophia Armand and published in the Journal of Cardiovascular Nursing showed that younger age, female sex, and high levels of acute stress at the time of the event to be significant risk factors for developing PTSD after cardiac arrest. There's no one overarching 'profile' in terms of who's likely to develop PTSD after any cardiac event. Naidu has his hunches, though. Donald Edmondson, MD 'I would say that I suspect cardiac arrest is more frequently associated with PTSD than other types of cardiac events. Compared to conditions like myocardial infarction or unstable angina, the psychological impact of cardiac arrest, particularly when complicated by anoxic brain injury, tends to be more profound,' Naidu said, cautioning that individual risk factors should be weighed in every case. 'Anoxic injury significantly increases the risk of depression, anxiety, and PTSD, often for an uncertain duration.' At Columbia, Edmondson said there are two indicators that together predict a high risk for a cardiac patient developing PTSD. 'They tend to pay close attention to their cardiac sensations and catastrophize them,' Edmondson said of the patients who go on to develop PTSD. 'Initially, in the ER [emergency room], they're extremely distressed. Then, post event, they'll say over the past 4 weeks, when I feel my heart beating fast, I worry that I'm having another heart attack. Or if I feel short of breath, I worry that I'm going to die.' 'Having those two predictors together, so initial high distress in the emergency department and this sort of high, what we call interoceptive bias, those two things together place people at high risk for developing PTSD at that 1-month period (after their cardiac event).' Regardless, more research must be done on this extremely risky and highly debilitating mental health issue that's so deeply entwined with its cardiac trigger. 'More focused studies are needed to better understand the timing, risk factors, and mechanisms behind these symptoms, and to develop standardized strategies for early screening, intervention, and long-term psychological support,' said Naidu. 'An urgent need exists to screen for and treat PTSD, not just for mental health but to help prevent repeat hospitalizations and improve long-term cardiovascular outcomes.'
Yahoo
11 minutes ago
- Yahoo
Rubio congratulates Russians on Russia Day: US supports "aspirations for a brighter future"
US Secretary of State Marco Rubio has congratulated Russians on Russia Day and stated that the US is seeking "constructive engagement with the Russian Federation to bring about a durable peace between Russia and Ukraine". Source: Rubio's statement on the website of the US Department of State Quote: "On behalf of the American people, I want to congratulate the Russian people on Russia Day. The United States remains committed to supporting the Russian people as they continue to build on their aspirations for a brighter future. We also take this opportunity to reaffirm the United States' desire for constructive engagement with the Russian Federation to bring about a durable peace between Russia and Ukraine. It is our hope that peace will foster more mutually beneficial relations between our countries." Background: The General Staff of the Armed Forces of Ukraine reported that Russian losses in the war had exceeded one million soldiers killed and wounded since the beginning of the full-scale invasion. Support Ukrainska Pravda on Patreon!
