July 2025
Blood Pressure Meds: Morning or Night?
It’s long been thought that taking blood pressure meds at night might work better. But a large new study from Canada found no difference in outcomes—like heart attacks, heart disease, or death—based on whether meds were taken in the morning or evening.
Cannabis Use Linked to Higher Heart and Brain Risk
A new analysis combining multiple studies found that cannabis users—mostly men with an average age of 38—had significantly higher risks of heart and brain issues:
29% higher risk of heart attack
42% higher risk of stroke
110% higher risk of heart disease
Another study this month showed that both cannabis smoke and THC edibles can harm heart cells, possibly explaining these findings.
For perspective: if your 10-year heart disease risk is 1% based on age alone, daily cannabis use could raise it to 2.1%. You can estimate your personal risk using the PREVENT calculator here.
Dr. Neuman says: “This is a correlation study, not a causation study. Are cannabis users more sedentary, eating poorly (munchies), or managing anxiety, pain, or boredom in less healthy ways? Folks use cannabis to treat pain, insomnia, and anxiety - what are the risks of untreated anxiety, pain, or insomnia? These factors may also contribute to heart risk."
Metformin Reverses Cellular Uterine Changes in PCOS (Polycystic Ovarian Syndrome)
In a groundbreaking study, researchers studied the uterine lining (endometrium) of women with PCOS and found major differences in cell types and gene activity compared to women without PCOS. Key hormone pathways—especially those related to estrogen, androgens, and insulin—were disrupted, which may help explain fertility problems and increased cancer risk in PCOS. They also found inflammation and abnormal blood vessel growth in the tissue. After 16 weeks of treatment with metformin, many of these changes improved, showing that some of the damage may be reversible. This study helps explain how PCOS affects the uterus at the cellular level and points to new treatment possibilities.
Dr. Neuman says: "Please consider the extended-release form of metformin, which carries a 12.5% risk of gastrointestinal distress (diarrhea and nausea, predominantly) vs the immediate-release, which carries a 50% chance."
Vaccine Update: What’s New in 2025
Yearly Vaccines:
COVID-19:
Healthy adults 18+: 1 dose annually if previously vaccinated; 2 doses (2 months apart) if never vaccinated.
Adults 65+: Now recommended to get 2 doses (2 months apart), regardless of prior vaccination.
High-risk groups (e.g. diabetes, heart/kidney/liver/lung disease, asthma, BMI >40, autoimmune conditions, or immunosuppressive meds): 2 doses recommended, 2 months apart.
Try to stay with the same brand you've had before (Pfizer, Moderna, or Novavax).
Flu:
Annual flu shot for everyone.
One-Time Vaccines:
RSV (Respiratory Syncytial Virus):
New! One dose for adults 60+ with chronic health conditions or any adult 75+.
Pneumonia:
New! Updated vaccines now protect against more strains.
All adults 50+ and high-risk adults 18–49 should get one of the newer versions:
Prevnar 15 (Vaxneuvance), Prevnar 20, or Capvaxive (PCV21).
Shingles:
Two doses, at least 4 weeks apart, for all adults 50+.
HPV (Human Papillomavirus):
3-dose series for adults up to age 26, or 27–45 if anticipating a new sexual partner.
Every 10 Years:
Tdap (Tetanus, Diphtheria, Pertussis):
One dose every 10 years for all adults.
Special Situations:
Hepatitis A:
2 doses for people who engage in anal sex.
Missed childhood vaccines?
Let Dr. Neuman know if you want to catch up.
Dr. Neuman says: "Lots of new recommendations this year. Working in healthcare, I’ll be treating myself to the new pneumonia vaccine alongside COVID and Flu vaccines."
Screen Time and Blurry Far Vision
An analysis of 45 studies (over 335,000 people) found that each additional hour of daily screen time increases the risk of nearsightedness by 21%.
Dr. Neuman says: “Ooph, I'm looking at a screen typing this. A good reminder to put my screens away when possible."
