Welcome to Med Op-Ed, where we highlight recently published editorials. In this installment: New research challenges guidelines that call for 3 days a week of exercise; obstacles hinder a push to monitor blood pressure at home; and “social comparison theory” could be key to cardiovascular disease prevention.
Can Fewer Days of Exercise Suffice?
Physical activity concentrated into one or two weekly sessions may provide similar cardiovascular and mortality benefits as more frequent exercise for people with type 2 diabetes, challenging current guidelines that recommend spreading activity across at least 3 days per week, Ronald J. Sigal, MD, MPH, and Normand G. Boulé, PhD, write in Annals of Internal Medicine.
The ContextExisting guidelines recommend at least 3 weekly sessions, based on the rationale that acute glucose metabolism benefits only last 24-48 hours after a single exercise session.A recent study of 51,650 US adults with diabetes found “weekend warriors” who exercised 150+ minutes in 1-2 sessions had significantly lower all-cause mortality (hazard ratio [HR], 0.79) and cardiovascular mortality (HR, 0.67) compared to inactive participants.Although observational studies suggest mortality benefits from weekend warrior patterns, randomized trials like Look AHEAD have shown less dramatic effects, highlighting the need for caution in interpreting causation, the editorialists write.In Their Own Words
“Not everyone is able to find 3 or more blocks of time per week to exercise, so it is important to determine the extent to which being physically active once or twice per week could have health benefits.”
Read it: Physical Activity in Type 2 Diabetes: Could One or Two Weekly Sessions Be Enough?
Time to Get Serious About Home BP Monitoring?
Home blood pressure monitoring (HBPM) represents the preferred approach for longitudinal management of hypertension and should replace ambulatory monitoring for medication titration. But successful implementation requires systematic infrastructure changes such as validated devices, team-based care, and proper data integration, according to Jordana B. Cohen, MD, MSCE, and colleagues, writing in the Journal of the American College of Cardiology.
The ContextThe 2025 American Heart Association (AHA)/American College of Cardiology guidelines now strongly recommend HBPM over ambulatory monitoring for long-term blood pressure management, representing a significant shift from previous recommendations that did not specify preference between methods.Current implementation barriers include lack of insurance coverage for validated devices, limited clinician reimbursement for patient education, and poor integration of home blood pressure data into electronic health records.Only approximately half of adults with hypertension perform HBPM monthly, while some clinicians express skepticism about accuracy and utility despite substantial evidence supporting this approach, the authors write.In Their Own Words
“Until these issues are resolved and the implementation of HBPM is prioritized, utilization of HBPM will remain piecemeal and fundamentally inadequate.”
Read it: Home BP Monitoring: Getting It Right This Time
Social Comparison Theory May Drive Cardiovascular Disease Prevention
Cardiovascular risk communication may be improved by leveraging social comparison psychology, write Mohammad Al Mouslmani, MD, MPH, and colleagues in JAMA Cardiology. Providing patients with personally meaningful “biological age” estimates may transform how they understand their cardiovascular health by showing them how many years older their heart may be compared to their chronological age.
The ContextThe PREVENT risk age metric — derived from AHA equations — frequently exceeds chronological age, and some historically marginalized and socioeconomically disadvantaged groups may have discordances exceeding 5-10 years.Risk age messaging taps into our intuitive understanding of time and aging, which makes it more emotionally salient than probabilistic estimates, the authors write.Although having a higher biological age may motivate some individuals to improve their health, it could demoralize others, so sensitive framing of this information is required.In Their Own Words
“When individuals see that their heart is aging faster than their peers’, it can transform abstract probabilities into urgent motivation.”
Read it: Older Than You Think—The Psychology of Comparison
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.