My goodness, this month there was so much going on that it would have been a lot easier for me to write on what’s not hot in clots!

Extended-duration anticoagulation after provoked VTE in patients with enduring risk factors

Many people thought and practiced as if provoked VTE meant that patients needed only short-term anticoagulation. The reality of clinical practice, however, has been more nuanced as acknowledged by some guidelines.

We sometimes face patients with VTE that had a major provoking factor but also one or several enduring risk factors (such as inflammatory diseases, cardiopulmonary disease, etc).

The HI-PRO addressed the tradeoffs of extended-duration anticoagulation in those patients. Briefly, low-intensity apixaban was superior to placebo for extended-duration treatment, with marked relative risk reduction for recurrent VTE and no increase in major bleeding.  Read more.

Would aspirin have added benefit in stable patients who receive anticoagulation?

We discussed previously (here and here) that in a pooled analysis of clinical trials from East Asia, among stable patients with CAD and AF, aspirin as an add-on to anticoagulation did not confer ischemic benefit and was associated with excess bleeding. Similar results are now shown in the AQUATIC trial from France. Read more.

Clots and the court: Venous thromboembolism-related litigation after orthopedic surgery

A research article provides a systematic assessment of some of these malpractice cases involving patients with. VTE. Briefly, key themes included delays in diagnosis and treatment, and improper use of VTE prophylaxis.

In the Editorial, we discussed how appropriate care should be considered without moving toward “defensive medicine.” Read more here and here.

H-pylori screening not beneficial to all-comers with acute MI

What? Are you now “what’s hot in general internal medicine”? Ummm, I love medicine, but have and will keep my fidelity to WHIC! The thought here was that H-pylori may be related to an excess risk of GI ulcers and GI bleeding therefore, screening could improve outcomes.

Well, the study didn’t quite prove that, although there are signals for higher-risk individuals (with anemia) that may be explored further in future. Read more.

Is it okay to stop anticoagulation after successful catheter ablation for AF?

The guidelines have largely encouraged continuation of anticoagulation (if there is an indication) irrespective of success with AF ablation. Now, a randomized trial is challenging that conventional wisdom, showing fewer strokes during follow-up and more bleeds with anticoagulation…

Not so fast, though. I am still cautious. This was a relatively small trial, the follow-up was for a maximum of 2 years (not all patients achieving that), and those who had recurrence of AF in the control arm were allowed to receive anticoagulation.

So, to me, it’s interesting data—especially for those who insist on stopping anticoagulation, but not entirely game-changing…yet. Read more here and here.

Twice-daily clopidogrel vs ticagrelor in STEMI

The traditional dosing of clopidogrel (unlike ticagrelor) is once daily. The thinking is that clopidogrel is an irreversible P2Y12 inhibitor. However, the investigators thought that twice-daily dosing might provide more consistent platelet inhibition and did a single center double-blind randomized trial in patients with STEMI.

The study was underpowered and inconclusive. Still, the findings are interesting and will generate further discussion, especially in low-resource settings. Read more here and here.

Vasculearn Network | Join the Community

Vasculearn Network (VLN) —where patients, clinicians, and experts connect to share knowledge, attend events, and access exclusive resources in vascular health. Engage, learn, and collaborate with a network dedicated to improving patient outcomes.

Behnood Bikdeli, MD, MS Cardiologist, Section of Vascular Medicine, Division of Cardiovascular Medicine, Brigham and Women’s Hospital  Investigator, Thrombosis Research Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital  Assistant Professor of Medicine, Harvard Medical School  Investigator, Yale/ YNHH Center for Outcomes Research and Evaluation, Yale School of Medicine  Investigator, Cardiovascular Research Foundation

Table of Contents

• Heart and Vascular Care: Who Treats What?

• Real Talk in the Barbershop: A New Video Series on …

• In Case You Missed It: Could Artificial Sweeteners …

• Upcoming Patient Events

Heart and Vascular Care: Who Treats What?

Knowing who to see for a heart or vascular condition isn’t always straightforward. Today’s healthcare system has a wide range of providers, most of whom focus on specific areas of care. According to a national study published in 2023, about 63% of physicians work in medical or surgical specialties, while only about 37% practice in primary care. With so many specialists, it can be hard to know where to start.

Types of Clinicians You Might See

If you have a heart or vascular condition, your care team may include more than one of these specialists, depending on your symptoms or diagnosis. Many heart and vascular teams also include nurse practitioners (NPs) or physician assistants (PAs) who support day-to-day care, answer questions, and help coordinate follow-up.

Primary Care Provider (PCP)

Your PCP is usually the first person you see for any new health concern. PCPs check symptoms, help manage risk factors like high blood pressure or cholesterol, and coordinate care. They may refer you to a cardiologist or other specialist if your condition is complex or if you need tests or treatments they don’t provide.

Cardiologist

A cardiologist treats problems with the heart and major blood vessels, including high cholesterol, high blood pressure, coronary artery disease, irregular heart rhythms, valve disorders, and recovery after a heart attack. They manage more complex cases, order and interpret specialized tests, and adjust treatment plans when symptoms are hard to control. Cardiologists often collaborate with PCPs and other specialists to plan for long-term or more advanced heart care.

Vascular Medicine Specialist or Vascular Surgeon

Vascular medicine specialists focus on treating blood vessel problems outside the heart and brain. Many are cardiologists or internists with extra training in vascular medicine. They work to find the cause of a condition, manage risk factors, and provide nonsurgical treatment. While they don’t perform surgery themselves, they may help coordinate it if needed.

People with conditions like peripheral artery disease (PAD) or blood clots such as deep vein thrombosis (DVT) or pulmonary embolism (PE) may see a vascular medicine specialist for diagnosis, treatment, and ongoing care.

People with conditions like peripheral artery disease (PAD) or blood clots such as deep vein thrombosis (DVT) or pulmonary embolism (PE) may see a vascular medicine specialist for diagnosis, treatment, and ongoing care.

Vascular surgeons do procedures like stents, bypass surgery, or repairs inside blood vessels to help with blood flow. They handle both medical and surgical care, especially when symptoms are severe

Both vascular medicine specialists and vascular surgeons also help patients manage risk factors through lifestyle guidance, medication management, and follow-up care.

Electrophysiologist 

Cardiologists who specialize in heart rhythm problems, or arrhythmias, are called electrophysiologists (EPs). Arrhythmias include a heartbeat that’s too fast, too slow, or irregular, like atrial fibrillation. EPs may use medications, procedures like catheter ablation, or implantable devices such as pacemakers or defibrillators to help manage your heartbeat and keep it steady. You may see an EP if you have fainting, dizziness, or heart palpitations that are hard to explain or manage. EPs often work with other heart doctors for more complex cases.

Interventional Cardiologist

An interventional cardiologist treats blocked arteries, valve problems, and sometimes PAD using minimally invasive procedures. They use a thin tube (catheter) inserted through a blood vessel in the wrist or groin to treat narrowed arteries, so open-heart surgery isn’t needed. You might see this type of specialist for a heart attack, chest pain, valve problems, or PAD that isn’t improving with medicine.

Common procedures include inserting stents and transcatheter valve replacement—a way to replace a heart valve using a catheter instead of open surgery. Unlike vascular surgeons, who can do both open and minimally invasive surgery, interventional cardiologists focus on catheter-based treatments, mainly for the heart.

Heart Failure Specialist 

A heart failure specialist is a cardiologist with extra training in treating complex or advanced heart failure.

They help find the cause, adjust medications to help your heart pump more effectively, and decide if you need more advanced care, like a heart pump or a transplant. People often see a heart failure specialist if symptoms worsen despite treatment, if hospital visits occur more often, or if tests or treatments are needed beyond what a general cardiologist provides.

Pulmonologist 

A pulmonologist specializes in treating lung and breathing problems. They also help manage conditions that affect the blood vessels in the lungs, like pulmonary hypertension or chronic thromboembolic pulmonary hypertension (CTEPH)—a type of high blood pressure in the lungs caused by blood clots that don’t fully dissolve. These conditions can make it harder to breathe and put strain on your heart. Pulmonologists often work together with cardiologists to help manage these problems.

How to Choose the Right Specialist for You

1. Start with your PCP. They know your medical history and can help refer you to specialists based on your symptoms or diagnosis.

2. Check your insurance coverage. Use your health plan’s directory or website to find in-network specialists. This can help you avoid surprise bills.

3. Check credentials. Make sure the clinician is board certified in their specialty. Certification shows they’ve met national standards.

4. Ask about experience. If you’ve been told you may need a procedure or have a complex diagnosis, it’s okay to ask the specialist how often they’ve treated cases like yours.

5. Consider communication style. Choose someone who listens, explains things clearly, and answers your questions. Check the provider's bio, online reviews, or call the office—friendly staff can be a good sign for a positive environment. Recommendations from friends or support groups can also help.

6. Consider access. Check how soon you can get an appointment, how far you’ll need to travel, and if the clinician offers offer virtual visits.

7. Get a second opinion if needed. Not sure about a diagnosis or treatment plan? Getting a second opinion is a smart step, especially for major health decisions.

Real Talk in the Barbershop: A New Video Series on Men’s Health

When real conversations about men’s health happen where trust already lives

Barbershop Talks is our new video series that brings honest, peer-to peer conversations about health straight to the barber chair. Research has shown that bringing health discussions into trusted community spaces, like barbershops, can help improve health outcomes.

Led by LaVon Woodard—a master barber, business owner, and patient advisor on our Medical Advisory Board who lives with vascular disease—each episode features real conversations about cardiovascular disease and what really stands in the way of staying healthy. LaVon and his clients cover everything from high blood pressure and cholesterol to blood clots, diabetes, and nutrition. They also discuss how to navigate a healthcare system that doesn’t always feel trustworthy, and the steps men can take to protect their health. For many men, especially those in underserved communities, the barbershop has always been more than just a place for a haircut. It’s a respected space to talk, share, and support each other.

LaVon at VonDre Barbershop

Barbershop Talks builds on that tradition to:

Raise awareness with clear, culturally relevant education on vascular health and prevention.

• Raise awareness with clear, culturally relevant education on vascular health and prevention.

• Build trust through open, judgment-free conversations and peer connection.

• Encourage action by helping men take charge of their health through screenings, lifestyle changes, and better communication with their medical team.

• Foster community to remind men they’re not alone in this journey. LaVon’s chair is opening soon—and so is the conversation.

LaVon and client Anthony

Join us, listen in, and share. Together, we can help more men feel informed, supported, and ready to take the next step toward better health. Stay tuned for our first episode launching August 20th, exclusively from VLN.

In Case You Missed It: Could Artificial Sweeteners Raise Clot Risk?

There’s been a lot of buzz about artificial sweeteners and blood clots lately—and VLN has been right in the middle of it. We dug into one sweetener that shows up in many keto-friendly and sugar-free foods. Some research suggests that high levels of this sweetener in the blood could raise clot risk, especially for people with other cardiovascular or clotting risk factors.

But are all sweeteners the same? Are there any safe options out there?

Not all sugar substitutes work the same way in the body, and the science isn’t settled yet. If you missed this article, now’s a great time to catch up. Find out what the evidence says, what experts recommend, and how to make safer choices for your health.

Read the full article on our website.

Upcoming Patient Events

Blood Clot Support Group

Hosted by Joelle Hochman, RRT, Chair of Patient Engagement & Education

After experiencing a blood clot, it’s normal to have a lot of questions. Many people are left feeling confused about why this happened to them and are anxious about it happening again. We’re pleased to offer a support group experience where patients can share their stories, connect with others who’ve had blood clots, and receive emotional support.

• August 21, 2025

• September 18, 2025

• October 16, 2025

Long-PE and CTEPH Support Group (Quarterly)

Have you or someone you care for experienced a pulmonary embolism (PE)? VLN offers a dedicated support group for patients with post-PE syndrome and CTEPH (Chronic Thromboembolic Pulmonary Hypertension).

This group provides a safe space to connect with others, receive support, and learn more about managing life after PE. Each session includes introductions and a Q&A with a clinician.

• September 11, 2025

• November 13, 2025

Women's Support Group (Quarterly)

We at VLN understand the unique heart health challenges that women face throughout their lives. Women have distinct risk factors from men and may experience unique issues related to heart and blood vessel conditions— including heavy periods, spotting between cycles, bleeding complications when taking blood thinners, pregnancy-related vascular changes, and hormone-related concerns.

VLN's quarterly support group is a welcoming space for women of all ages to connect, share experiences, and find strength together as they navigate their heart health journey.

• September 25, 2025

Ask the Expert

Our Ask the Expert series, formerly called Blood Clot Education Group, is a space to connect with others and learn about all things related to blood clots and overall vascular health.

Get accurate information on the latest research and treatments, and share your experiences.

• September 30, 2025

• October 21, 2025

Do you like what you see in The Beat and find this information helpful? Please consider making a small donation to VLN to further support blood clot education.

References

Bass TA, Abbott JD, Mahmud E, et al. 2023 ACC/AHA/SCAI advanced training statement on interventional cardiology (coronary, peripheral vascular, and structural heart interventions): a report of the ACC Competency Management Committee. J Am Coll Cardiol. 2023;81(14):1385-1431. doi:10.1161/HCV.0000000000000088

Calligaro KD, Amankwah KS, D’Ayala M, Sarac TP, Shutze WP, Webb TH. Guidelines for hospital privileges in vascular surgery and endovascular interventions: Recommendations of the Society for Vascular Surgery. J Vasc Surg. 2018;67(5):1337-1344.

Cannata A, Mizani MA, Bromage DI, et al. Heart failure specialist care and long-term outcomes for patients admitted with acute heart failure. JACC Heart Fail. 2025;13(3):402-413. doi:10.1016/j.jchf.2024.06.013

Choosing a primary care provider. MedlinePlus. https://medlineplus.gov/ency/article/001939.htm. Updated January 30, 2024. Accessed July 28, 2025.

Damani DN, Beckman JA, Gray B, Hamburg NM, Levy MS, Gornik HL. Vascular Medicine Patient Information Page: What is a vascular medicine specialist? Vascular Medicine. 2025;0(0). doi:10.1177/1358863X251343051

Fernandes CJ, Steigner ML, Piazza G, Goldhaber SZ. Collaborative cardiology and pulmonary management of pulmonary hypertension. Chest. 2019;156(2):200‑202. doi:10.1016/j.chest.2019.04.099

Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2019;74(7):e51-e156.

Rotenstein LS, Apathy N, Edgman-Levitan S, Landon B. Comparison of work patterns between physicians and advanced practice practitioners in primary care and specialty practice settings. JAMA Netw Open. 2023;6(6):e2318061. doi:10.1001/jamanetworkopen.2023.18061

What is a cardiologist? CardioSmart. https://www.cardiosmart.org/topics/manage-your-care/your-care-team/what-is-a-cardiologist. Accessed July 28, 2025.

Victor RG, Lynch K, Li N, et al. A cluster-randomized trial of blood-pressure reduction in Black barbershops. N Engl J Med. 2018;378(14):1291-1301. doi:10.1056/NEJMoa1717250

By Behnood Bikdeli, MD, MS
Vascular Medicine Advisor, VLN Medical Advisory Board

To thin or not to thin the blood after intracranial bleed and AF? That’s the question.

It’s such a challenging situation for patients and clinicians alike to find a path forward after an intracranial bleed in patients with atrial fibrillation (AF). Do we stop anticoagulants for good? Do we restart them after a while? There have been a few randomized controlled trials—but none were definitive in isolation, which makes this ewly published systematic review and meta-analysis very timely.

Briefly, there was a reduction in ischemic stroke and net adverse clinical events, although this finding was accompanied by an increase in recurrent intracranial bleeding.

PFO and stroke: Here’s what you need to know

Nearly one in every four individuals have a patent foramen ovale (PFO), which translates to nearly one in every two of these patients having an embolic stroke of unclear source (cryptogenic stroke) above the age of 60. This JAMA review article summarizes the approach for risk stratification and management.

Patient perspectives on antithrombotic therapy in the setting of advanced cancer

Although I don’t often cover qualitative studies, this one is pretty interesting. And if my endorsement isn’t enough, see what the authors placed as the first part of their title–true story: “Who am I to say that I'm not going to take it…”. There are important lessons to learn here for clinicians, investigators, and patients.

Edoxaban vs warfarin for the early period after bioprosthetic mitral or aortic valve replacement

This randomized trial tested edoxaban vs the historical reference (warfarin) for the early period after replacement with a tissue valve. The bigger question in my mind is whether most of these patients in current practice need anticoagulation at all...

Vasculearn Network | Join the Community

Vasculearn Network (VLN) —where patients, clinicians, and experts connect to share knowledge, attend events, and access exclusive resources in vascular health. Engage, learn, and collaborate with a network dedicated to improving patient outcomes.

vln.thrombosis.org/feed

Behnood Bikdeli, MD, MS  Cardiologist, Section of Vascular Medicine, Division of Cardiovascular Medicine, Brigham and Women’s Hospital  Investigator, Thrombosis Research Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital  Assistant Professor of Medicine, Harvard Medical School  Investigator, Yale/ YNHH Center for Outcomes Research and Evaluation, Yale School of Medicine  Investigator, Cardiovascular Research Foundation

Table of Contents

• A Story of Survival and Gratitude: Meet Chad and M …

• A Heart-Healthy Holiday Recipe

• Upcoming Patient Events

A Story of Survival and Gratitude: Meet Chad and Mary

Mary and Chad at their first event post-recovery.

What began as a typical day—biking, playing pickleball, and dinner with friends—became an unexpected battle for health and advocacy. On August 5, 2023, Mary woke in the middle of the night to find her husband, Chad, missing from bed. "I thought he was up working on his laptop like he sometimes did," Mary recalls.

Back at the hospital, Chad's blood pressure was dangerously low, his pupils were unresponsive, and he was experiencing seizures. The doctors needed to relieve the pressure in his brain, but there was one problem. Chad had been put on blood thinners after his PE and couldn't have any procedures or surgeries until an agent was administered to reverse his blood thinners. Without an antidote to his blood thinners before a procedure, he would have been at risk for severe or fatal bleeding.

All they could do now was wait. "We had to wait for the antidote, and it seemed like forever. We're standing there watching the monitors, hearing the alarms, and asking the medical staff if they can do anything. But all they could do was give him fluids." After the reversal agent was finally administered, the doctors performed the procedure to relieve the pressure in Chad's brain — but the bleeding continued. The neurosurgeon re-coiled the aneurysm, but brain scans the next day showed that blood was still leaking. To stop it, the surgeon needed to do a craniotomy (where part of the skull is removed to access the brain), but several multidrug-resistant infections, including pneumonia, made surgery risky. With no other choice, the neurosurgeon went ahead and successfully repaired the aneurysm.

A Time for Thanks

Chad’s first time outside the hospital with Mary and their sons.

A week after his infection cleared, Chad underwent surgery, and by Thanksgiving, he was a completely different person. "We walked in, and he knew he was in Boston and who we were. We were rejoicing," Mary recalls.  After recovering, Chad returned to inpatient rehab, weaker but improving. "He could participate and knew who he was and what he was doing," says Mary. Even after catching COVID, Chad kept up with his therapies. After months in the hospital, Chad came home in a wheelchair and on a feeding tube. Mary, now managing his recovery herself, watched him grow stronger every day. "Nothing has been easy, but he relearned to swallow, eat, tie his shoes, and write.

Now, he walks, drives, and even played golf yesterday. He still struggles with balance and strength, but other than that, he's back," she says proudly. Both his short-term and long-term memory are intact. In addition, four months after his return home, a retina surgeon performed surgery on his left eye to restore the vision he had lost after his brain bleed.

Be the Advocate

Through nonstop challenges, Mary stood by Chad as a strong advocate, carefully tracking his medications, procedures, and vital signs. She regularly questioned doctors, seeking clear explanations and pushing for answers when things seemed off. "You have to be their voice," she says. "I had to push for things. He couldn't speak for himself."

Mary didn't just take notes; she actively collaborated with the medical team and addressed communication gaps. "I knew I couldn't just sit back," she recalls. Her dedication and vigilance kept Chad's care on track, ensuring he received optimal treatment through every setback.

Chad playing golf with his daughter.

Message of Hope

Reflecting on their experience, Mary and Chad have a message for others facing similar journeys: "Don't give up too early. Some doctors were ready to give up on me, but I'm here. Keep fighting." Chad's recovery was made more difficult by vascular complications, including PE and the challenge of having to urgently reverse his anticoagulation (blood thinners). Chad believes that Mary's role as his advocate made all the difference. "If you have a loved one in a critical situation, be their voice. Write everything down, ask every question, and don't be afraid to speak up," Mary advises.

A Heart-Healthy Holiday Recipe

The holidays are a busy and joyous time—but not a time to ignore your health! Overeating food with unhealthy fats, sugar, and processed ingredients can lead to atherosclerosis, the buildup of cholesterol and other substances in the arteries. This process causes plaque to form, which can eventually rupture and trigger blood clots. These clots can block blood flow, increasing the risk of heart attacks or strokes. Choosing heart-healthy foods like fruits, vegetables, and healthy fats can help lower this risk. Making mindful food choices during the holidays can help support your heart and reduce the risk of harmful clots.

Here’s a recipe that’s both delicious and heart-friendly! Courtesy of the American Heart Association.

Rosemary Balsamic Roasted Vegetables

INGREDIENTS Servings 8
• Cooking spray
• 1/2 pound Brussels sprouts, brown ends trimmed off and cut in half
• 1/2 medium cauliflower cut into florets
• 4 medium carrots sliced
• 1/2 pound turnips peeled, cut into 1/2-inch cubes
• 1/2 pound beets peeled, cut into 1/2-inch cubes
• 1/3 pound sweet potatoes peeled, cut into 3/4-inch cubes, optional
• 3 tablespoons balsamic vinegar
• 3 teaspoons extra-virgin olive oil
• 2 teaspoons no-calorie sweetener granulated
• 2-3 tablespoons fresh, chopped rosemary OR 2-3 teaspoons dried rosemary
• 2 medium garlic cloves minced
• 1 teaspoon onion powder
• 1/2 teaspoon pepper
• 1/4 teaspoon salt

DIRECTIONS
1. Preheat the oven to 375˚F.
2. Lightly spray 13 x 9 x 2-inch baking dish with cooking spray.
3. Place all the vegetables in a large bowl.
4. In a small bowl, whisk together the vinegar, oil, no-calorie sweetener, rosemary, garlic, onion powder, pepper, and salt. Pour over the vegetable mixture, tossing to coat.
5. Pour the vegetable mixture into the baking dish. Bake for 30 to 35 minutes, stirring once, or until all the vegetables are tender when easily pierced with a fork.

Upcoming Patient Events

Blood Clot Support Group

Hosted by Joelle Hochman, RRT, Chair of Patient Engagement & Education After experiencing a blood clot, it’s normal to have a lot of questions. Many people are left feeling confused about why this happened to them and are anxious about it happening again. We’re pleased to offer a support group experience where patients can share their stories, connect with others who’ve had blood clots, and receive emotional support.

• December 19, 2024

• January 16, 2025

• February 20, 2025

• March 20, 2025

Blood Clot Education Group

Join our Blood Clot Education Group to connect with others and learn about all things related to blood clots. Get accurate information, hear from experts on the latest research and treatments, and share your experiences. Each session includes participant introductions and a Q&A with a clinician, where you can submit questions in advance.

• January 8, 2025

• February 13, 2025

• March 11, 2025

Long-PE and CTEPH Support Group (Quarterly)

Have you or someone you care for experienced a pulmonary embolism (PE)? VLN offers a dedicated support group for patients with post-PE syndrome and CTEPH (Chronic Thromboembolic Pulmonary Hypertension). This group provides a safe space to connect with others, receive support, and learn more about managing life after PE. Each session includes introductions and a Q&A with a clinician, where you can submit questions in advance.

• January 23, 2025

Cancer-Associated Thrombosis Support Group (Quarterly)

Our cancer-associated thrombosis (CAT) support group is for individuals who are receiving cancer treatment and have been diagnosed with a blood clot. We recognize the physical, emotional, and psychological toll that managing both conditions can take.

Join us on World Cancer Day to share stories, connect with others who have a dual diagnosis of cancer and blood clots, and receive emotional support.

• February 4, 2025

Women’s Blood Clot Support Group

Did you know that women have a higher risk for blood clots over their lifetime than men? Being pregnant, taking birth control pills or hormone therapy, or even receiving infertility treatment are risk factors unique to women. Women who take blood thinners may also have side effects that don’t affect men, including heavy periods, spotting between cycles, or bleeding after sex.

February is Women’s Heart Month, dedicated to raising awareness about women’s unique heart health challenges, including the risk of blood clots. Join other women of all ages in a quarterly support group to connect, ask questions, and receive support.

• February 25, 2025

All meetings start at 7:00 PM EST

In all online groups, a clinician will be available to answer general questions about blood clots. Please note that they cannot provide personalized medical advice to any patients.

To register for these programs, please visit Patient Events on our website at https://vln.thrombosis.org

beehiiv — The newsletter platform built for growth

Access the best tools available in email, helping your newsletter scale and monetize like never before.

beehiiv.com

Do you like what you see in The Beat and find this information helpful? Please consider making a small donation to VLN to further support blood clot education.

References
Brain Aneurysm Repair–MedlinePlus

Endovascular Coiling–Mayo Clinic

Hydrocephalus–National Institute of Neurological Disorders and Stroke

In Brief: What Happens During a Lumbar Puncture (Spinal Tap)?–InformedHealth.org

Nutrition, Thrombosis, and Cardiovascular Disease – Circulation Research

Table of Contents

• A Dismissed Diagnosis: LaVon’s Story

• Men—Your Vascular Health Called. Time for a Checku …

• Upcoming Patient Events

Building Momentum Together: Highlights from the VLN Board Retreat

There’s something powerful about being in the same room. This year’s VLN Board Retreat brought together dedicated leaders, passionate staff, and longtime supporters for a few energizing days of connection and collaboration in Sea Island, Georgia.

Top row left to right: Nathan Connell, John Fanikos, JoMarie Monzon, Brandon Linn, Christian Ruff, Tara Lech
Middle row left to right: Alfonso Tafur, Adam Judeh, Kathryn Mikkelsen, Margo Minissian, Joelle Hochman, Aviva Schwartz, Scott Woller.
Bottom row left to right: LaVon Woodard, Courtney Anderson, Jelena Spyropoulos, Courtney Battaglia, Heather Johnson

Throughout our time together, we reflected on what’s working, what’s needed, and what’s possible. The energy in the room made one thing clear: when we come together, we can make meaningful change.

Thanks to the ideas and momentum sparked at the retreat, we’re already moving forward. Our team is focused on making it easier to connect with others, access trustworthy information, and feel supported every step of the way.

To our community: we’re so glad you’re here. We’re building this with—and for—you. Here’s to what’s next.

A Dismissed Diagnosis: LaVon’s Story

In 2017, LaVon was at the gym when he felt sudden pain in his right leg. At first, he didn’t think much of it and went home. But the pain worsened, and his leg began to swell. He went to the emergency room and shared his family history of blood clots. “You look healthy, so I don’t think it’s a blood clot,” the doctor told him, recommending leg elevation and rest. A few days later, his primary care doctor said the same thing.

For five years, LaVon lived with pain, swelling, and visible changes to the skin on his leg. It wasn’t until 2022 that he finally got the answers he needed. LaVon shares his experience, what he wishes he had known, and what he wants others to learn from his journey.

When did you first notice something was wrong?

At the gym, my leg suddenly started hurting. I thought maybe I’d pulled a muscle or something, so I went home to see if it’d go away. As the evening went on, my leg started swelling and the pain worsened. Even though this happened a while ago, I can still remember that pain. It felt like a bad bruise, almost like someone had kicked me in the leg. It was so painful that I could barely walk. I remember crawling to the restroom because putting weight on my leg hurt too much. That’s when I knew something was seriously wrong.

What else did you notice?

The swelling went from my ankle to my calf. My friends said my right leg looked different from my left. Over time, the hair on my leg fell out, and the skin got shiny and reddish.

How did you finally get diagnosed?

In 2022, I was getting ready to take a trip to Africa. I wanted to get my leg checked out before my trip and decided to switch doctors. I mentioned my leg pain and my family history of blood clots to my new doctor. She ordered an ultrasound and blood work. That's when I found out I had deep vein thrombosis (DVT) in my leg.

How did you feel when you got the diagnosis?

At first, I was terrified but also relieved to have an answer. I didn't know enough about blood clots before to know that I was going to be okay once I started treatment. I knew what could happen if a blood clot was left untreated and I was lucky that mine didn't turn into something more serious. I worried about moving too much because I thought the clot might travel. Once I talked to my doctor, I understood that staying active was important.

What was your treatment plan?

My doctor prescribed Eliquis® (apixaban), a blood thinner. At first, my doctor wasn't sure if I needed to go to the hospital, but then she decided I could start treatment at home. I'm still on blood thinners because of my family history of blood clots. My doctor also mentioned I may have Factor V Leiden (a genetic mutation that can increase the risk of clotting), but I haven't been tested for it yet.

What changes have you made to your daily routine? I stay hydrated and make sure to move throughout the day. I work as a barber, so I stand a lot. I take a few steps every 45 minutes to keep my circulation moving. I still work out. I also wear compression stockings, which help with swelling. I have to be extra careful at work because I use sharp tools like razors and shears. Since I'm on blood thinners, even a small cut can bleed more than usual.

Do you still have the clot?

Yes, it's still there. I get ultrasounds twice a year. It hasn't gotten bigger, but it hasn't gone away either. The clot is just there. My hematologist reassured me that some clots take longer to dissolve, and as long as I keep taking medication, I’ll be fine. The pain’s gotten better. In fact, it was recently that I noticed the pain was starting to decrease.

What’s your advice to others with a new diagnosis?

Don't panic. Treatment works. Ask your doctor questions about what you can and cannot do. I wanted to know if I could still exercise and work long hours on my feet. Getting those answers made me feel more in control.

And for those who feel dismissed? Speak up. If a doctor dismisses your concerns, ask them to check again. You don’t have to be disrespectful but be firm. If you feel that you're not being heard, find a provider that will really listen. You must advocate for yourself.Speak up. If a doctor dismisses your concerns, ask them to check again. You don’t have to be disrespectful but be firm. If you feel that you're not being heard, find a provider that will really listen. You must advocate for yourself.

Any final thoughts?

Know the signs of a blood clot. Pain, swelling, and redness are big warning signs. If I had known that earlier, I would’ve pushed harder. Don’t be afraid to speak up; it could save your life. 

Men—Your Vascular Health Called. Time for a Checkup

Many men aren’t thinking about their vascular health—but problems can build long before symptoms appear. In honor of Men’s Health Month, we’re taking a closer look at vascular health: what it is, why men face earlier risks, and what you can do to protect yourself.

How Vascular Health Is the Common Link

The vascular system is made up of capillaries, arteries, and veins that work together to deliver oxygen and nutrients throughout your body. Vascular health refers to how well your blood vessels function—how flexible they are, how easily blood flows through them, and whether they’re free of blockages. Blood flows freely when your vessels are open and healthy, which reduces your risk of serious health problems. But when blood vessels become stiff, narrowed, or blocked, complications can occur.

Heart attacks

The arteries that deliver blood to your heart can become blocked by plaque—fatty deposits that build up inside the vessels. If the plaque ruptures, a clot can form and stop blood flow. When that happens, part of the heart muscle can become permanently damaged, leading to a heart attack.

Stroke

A stroke occurs when blood flow to the brain is disrupted, cutting off the oxygen that brain cells need. Strokes can be caused by a blocked vessel (ischemic stroke) or a rupture that leads to bleeding in the brain (hemorrhagic stroke).

Atrial fibrillation (AFib) AFib is an irregular heartbeat that affects how well the heart pumps blood. It often starts when there are changes in the upper chambers of the heart (the atria)— like scarring from a past heart attack, enlargement of the atria, or weakening of the muscle. These changes can disrupt the heart’s electrical signals, causing the atria to beat out of rhythm. When that happens, blood may pool and form clots. If a clot travels to the brain, it can cause a stroke.

Why Men Are at Higher Risk

Men face heart-related conditions earlier in life than women. Men often have their first heart attack 6 to 10 years sooner than women, face strokes at younger ages, and are more likely to develop AFib.

Here’s the big question: why does it affect men more—and sooner?

Hypertension and high cholesterol occur earlier

High blood pressure often starts in men between the ages of 40 and 60. They also tend to have lower levels of nitric oxide, a compound that helps blood vessels relax and stay flexible. Without routine checks, high blood pressure may go unnoticed and silently damage the vascular system for years.

Men are also more likely to have high LDL (the “bad” cholesterol) at younger ages, which contributes to artery clogging plaque that can start as early as the teenage years. Estrogen helps regulate cholesterol levels, which may explain why women often have lower LDL levels until menopause.

Hormones and lifestyle habits play a role

Before menopause, estrogen helps protect women’s blood vessels by reducing inflammation, improving flexibility, and lowering plaque buildup. Men have higher testosterone levels, which may lead to more inflammation and unstable plaque that's more likely to rupture.

In some large studies, men were more likely to smoke, be less active, and skip checkups. Delayed screenings mean that warning signs can go unnoticed until something more serious occurs. These behaviors increase the risk of earlier disease.

How Men Can Lower Their Risk

Men can take simple steps to lower the risk of heart attacks, strokes, and afib. These changes matter—even if you start later in life.

1. Get regular checkups. Ask your doctor to check your blood pressure, cholesterol, and blood sugar at least every few years—more often if you're over 40 or have other risk factors.

2. Be active most days. Try to get 150 minutes of moderate activity (like brisk walking, biking, or swimming) each week. Short on time? Just 30 minutes a day, 5 days a week, can make a big difference.

3. Eat for your heart. Focus on fruits, vegetables, whole grains, fish, nuts, and lean proteins. Cut back on red meat, processed food, sugary drinks, and foods high in salt or trans fats.

4. Watch your weight. Extra weight, especially in the belly area, raises your risk for high blood pressure and AFib. Losing just 5 to 10 percent of your body weight can help improve how your heart and blood vessels function.

5. Quit smoking. Every tobacco-free day helps lower your risk of blood clots and other serious health problems. If you're ready to take the next step, smokefree.gov offers support and tools to help you get started.

6. Drink less alcohol (or none at all). Too much can raise your risk for AFib and stroke. It’s also linked to other serious health issues, including some cancers, especially in older adults.

7. Manage stress. Long-term stress raises blood pressure and increases inflammation. Daily walks, deep breathing, and getting enough sleep can help.

8. Take sleep problems seriously. Loud snoring, gasping during sleep, or always feeling tired could be signs of sleep apnea, which is linked to high blood pressure and AFib. It’s treatable—so bring it up at your next checkup.

You don’t have to change everything at once. Pick one or two areas to start with and build from there. Many men start making changes in midlife (around ages 40 to 65) or beyond and still see major benefits.

Meet our newest team member, Courtney

Hi! I’m Courtney, the new Patient Education & Community Content Manager at VLN—and the writer behind The Beat, our newsletter. I live in the scenic Texas Hill Country and bring 16 years of experience as a registered nurse. Throughout my career, I’ve worked in a wide range of specialties, from cardiovascular care to autoimmune disorders and oncology. One thing that’s always stayed the same? My love of patient education. Hi! I’m Courtney, the new Patient Education & Community Content Manager at VLN—and the writer behind The Beat, our newsletter.

I live in the scenic Texas Hill Country and bring 16 years of experience as a registered nurse. Throughout my career, I’ve worked in a wide range of specialties, from cardiovascular care to autoimmune disorders and oncology. One thing that’s always stayed the same? My love of patient education. I also love writing, which led me into health communication. I’m passionate about making medical information easier to understand and grounded in science. I believe education can be empowering, and am honored to support this community by helping share stories, resources, and tools for healing.

Outside of work, I’m a self-taught (and still learning!) home cook. I bake a lot— Carmelita bars are my go-to—and I’m usually balancing cooking and writing with a full family life. If there’s a topic you’d like to see covered or something on your mind, I’d love to hear from you. Reach out in the community anytime!

Upcoming Patient Events

Blood Clot Support Group

Hosted by Joelle Hochman, RRT, Chair of Patient Engagement & Education After experiencing a blood clot, it’s normal to have a lot of questions. Many people are left feeling confused about why this happened to them and are anxious about it happening again.

We’re pleased to offer a support group experience where patients can share their stories, connect with others who’ve had blood clots, and receive emotional support.

• June 17, 2025

• July 17, 2025

• August 21, 2025

• September 18, 2025

Spanish-speaking Support Group

We’re excited to offer a virtual support group series for Spanish speakers. Led by expert physicians, these sessions provide practical guidance on heart health in a supportive, interactive space.

Participants can join live Q&As and discussions tailored to their needs.

• June 18, 2025

Ask the Experts

Our Ask the Expert series, formerly called Blood Clot Education Group, is a space to connect with others and learn about all things related to blood clots and overall vascular health.

Get accurate information on the latest research and treatments, and share your experiences.

• July 15, 2025

• August 12, 2025

In all online groups, a clinician will be available to answer general questions. Please note that they cannot provide personalized medical advice to any patients.

Do you like what you see in The Beat and find this information helpful? Please consider making a small donation to VLN to further support blood clot education.

References:

Acute myocardial infarction - The New England Journal of Medicine

Association of Younger vs Older Ages With Changes in Incidence of Stroke and Other Vascular Events, 2002-2018 - JAMA Network

Diverging Trends in Age at First Myocardial Infarction: Evidence from Two German Population-Based Studies - Scientific Reports

Sex differences in endothelial function important to vascular health and overall cardiovascular disease risk across the lifespan - American Journal of Physiology-Heart and Circulatory Physiology

Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants - The BMJ

Vascular Diseases - MedlinePlus

What is Atrial Fibrillation - American Heart Association

2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia: A Report of the American College of Cardiology Solution Set Oversight Committee - Journal of the American College of Cardiology

Table of Contents

• Goodbyes and Hellos: Meet the 2025 Medical Adv …

• Introducing our Newest Medical Advisory Board Memb …

• Heart Failure’s Quiet Companion: The Risk of Blood …

• Upcoming Patient Events

Goodbyes and Hellos: Meet the 2025 Medical Advisory Board

The Medical Advisory Board (MAB) was founded in 2020 to support the North American Thrombosis Forum (NATF – now Vasculearn Network, VLN) in delivering timely, relevant educational resources to both clinicians and patients. Over the past four years, the MAB has not only guided us through a global pandemic but also played a pivotal role in shaping our mission, vision, and strategic goals.

We wouldn’t be the organization we are today without the dedication, expertise, and passion of this incredible group of advisors. To our emeriti members: thank you for your invaluable contributions. We deeply appreciate your time, knowledge, and commitment.

Though these departures are bittersweet, we’re thrilled to welcome new perspectives and leadership in 2025. Members of the VLN Medical Advisory Board (MAB) will serve as both advisors to—and advocates for—the organization and will focus on:

• Offering insights, scientific guidance, and expertise to advance VLN’s mission

• Enhancing our visibility

• Supporting our strategic growth and development

The 2025 VLN Medical Advisory Board

Behnood Bikdeli, MD, MS
Vascular Medicine Advisor
Heather Johnson, MD, MS
Preventive Cardiology Advisor
JoMarie Monzon, FNP-BC, MSN
Vascular Surgery / Advanced Practice Provider (APP) Advisor
LaVon Woodard
Patient Advisor
Margo Minissian, PhD, ACNP
Technology & Innovation Advisor
Scott Woller, MD
Thrombosis Medicine Advisor
Taylor Anzidei, DNP-EL, RN, CCRN
Clinical Nursing Advisor

Introducing our Newest Medical Advisory Board Members

Heather Johnson, MD, MS Preventative Cardiology Advisor

Dr. Heather M. Johnson is the Director of Preventive Cardiology for Women’s Services at Florida Atlantic University. She earned her medical and population health degrees from the University of Wisconsin-Madison and a Master of Medical Management from USC. Her NIH-funded research focuses on cardiovascular risk management, and she is a Fellow of multiple cardiology organizations.

JoMarie, Lead Nurse Practitioner for the Division of Vascular Surgery at Cedars-Sinai Medical Center, oversees advanced practice initiatives and protocol development. A Nurse Practitioner since 2009 with board certification, she has led projects like an APP-led aortic clinic and expanding vascular surgery services. JoMarie was named Cedars-Sinai APP of the Year (2023) and is developing a sclerotherapy clinic for venous disease.

Jomarie Monzon, FNP-BC, MSN Vascular Surgery APP Advisor

LaVon Woodard Patient Advisor

LaVon Woodard, a licensed barber and barbershop owner in Brunswick, Georgia, experienced symptoms of a leg blood clot in 2017 but was sent home without treatment. In 2022, he was diagnosed with deep vein thrombosis (DVT). He is grateful to be a part of the VLN Medical Advisory Board, where he can share his story and learn from Vasculearn Network.

LCDR Taylor Anzidei is a critical care nurse and leader in the U.S. Navy Nurse Corps. She specializes in trauma and cardiovascular care, advanced cardiac devices, and military medical readiness. Taylor is a decorated officer, educator, and speaker, committed to advancing military healthcare and mentoring the next generation of nurses.

Lieutenant Commander Taylor Anzidei Clinical Nursing advisor

Scott Woller, MD Thrombosis Medicine Advisor

Dr. Woller, a specialist in thrombosis medicine and anticoagulation, focuses on venous thromboembolic disease prevention. A Professor of Medicine at the University of Utah and Chair of Medicine at Intermountain Medical Center, he has led NIH-funded studies and co-chaired ACCP antithrombotic therapy guidelines. Board certified in Internal Medicine, Dr. Woller is a Fellow of major medical societies and a renowned educator.

Heart Failure’s Quiet Companion: The Risk of Blood Clots

Heart failure (HF) is a serious condition that affects millions of people worldwide and is becoming more common as the population ages. Most people know that it causes fatigue, swelling, and shortness of breath. Few realize that the condition also increases the risk of blood clots.

Raising awareness about this connection is one step forward in improving outcomes for those living with heart failure.

What Is Heart Failure?

HF occurs when the heart has trouble pumping properly. The walls of the heart might be stiff or damaged, or the heart muscle might not pump as strongly as it should. These problems can raise pressure in the heart or reduce its ability to circulate enough blood to support the body, whether at rest or during activity. HF can affect different parts of the heart, resulting in:

Left-Sided HF: The left side of the heart pumps oxygen- rich blood to the body. When it doesn’t work properly, fluid may build up in the lungs, and make breathing difficult. This can be described as systolic HF (trouble pumping blood out) or diastolic HF (the pumping chamber becomes stiff, doesn't relax between beats, making it harder to fill with blood).

Right-Sided HF: The right side of the heart sends blood to the lungs to pick up oxygen. When this side fails, blood backs up in the veins, causing swelling in the legs, ankles, or belly.

Understanding Blood Clots

As part of the body's natural healing process, blood clots form when a blood vessel has become damaged. Platelets and proteins in the blood work together to create a clot that stops bleeding and protects the injured area. Sometimes, clots can form inside blood vessels even when there's no clear injury, or they may not break down as they should, leading to serious health risks.

Why Does Heart Failure Increase Blood Clot Risk?

HF raises the risk of blood clots in several ways, including slowing blood flow and damaging blood vessels. These changes create conditions where dangerous clots, like deep vein thrombosis (DVT) or pulmonary embolism (PE), are more likely to form.

Damage to blood vessel walls 

Heart failure can damage the walls of blood vessels, leading to endothelial dysfunction, a condition where the vessel lining loses its ability to work properly. Increased pressure in the vessels, abnormal blood flow, and oxidative stress—an imbalance of harmful molecules that damages the vessel lining—are key contributors. Over time, this damage weakens the vessels' ability to relax and regulate blood flow.

Changes in the blood 

Inflammation in HF raises levels of clot-promoting molecules like fibrinogen. It also activates platelets, making them stickier and more likely to form clots. Oxidative stress disrupts the blood's natural balance between clotting and anti-clotting factors. Medications used to reduce fluid buildup in HF can increase blood concentration and further promote clot formation.

Altered blood flow

When HF reduces the heart’s pumping ability, it can lead to low cardiac output, where less blood is pumped out than normal. Over time, the heart’s chambers may stretch and enlarge, further weakening its function. This slower blood flow increases the risk of blood clots. Atrial fibrillation (Afib), a common condition in people with HF, can further disrupt blood flow.

In Afib, the heart's irregular rhythm causes blood to pool in the atria, the two chambers of the heart that receive blood and pump it into the ventricles. This pooling creates an environment where clots are more likely to form. These clots can travel to the brain, leading to a stroke.

Living Well with Heart Failure and Blood Clot Risks

Take your medications as prescribed and follow your clinician's advice for managing other conditions that can make HF worse. Follow these tips to help manage HF and reduce your risk of blood clots:

1. Stay physically active: Regular movement improves heart health and prevents blood from pooling.

2. Stop smoking: Smoking increases your heart rate and blood pressure and reduces your ability to stay physically active.

3. Get enough rest: Take breaks to reduce strain on your heart. Simple things like napping, putting your feet up, or sitting during tasks can prevent overexertion. For better sleep, avoid caffeine, alcohol, and heavy meals before bed.

4. Manage stress: Use healthy coping methods like deep breathing, yoga, or joining a support group.

5. Eat heart-healthy foods: Focus on fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit processed foods, sugar, salt, and red meat.

Upcoming Patient Events

Blood Clot Education Group

Hosted by Joelle Hochman, RRT, Chair of Patient Engagement & Education. After experiencing a blood clot, it’s normal to have a lot of questions.

Many people are left feeling confused about why this happened to them and are anxious about it happening again.

References
Atrial Fibrillation and Heart Failure – Journal of Clinical Medicine
Blood Clots – American Society of Hematology
Blood Clots – MedlinePlus
Blood Coagulation Disorders in Heart Failure: From Basic Science to Clinical Perspectives – Journal of Cardiac Failure
Impact of Atrial Fibrillation in Patients with Heart Failure and Reduced, Mid-Range or Preserved Ejection Fraction - Heart
Lifestyle Changes for Heart Failure – American Heart Association
Oxidative Stress and Inflammation in the Evolution of Heart Failure: From Pathophysiology to Therapeutic Strategies – European Journal of Preventive Cardiology
Stroke – Mayo Clinic
Types of Heart Failure - American Heart Association

Table of Contents

• Introducing the New Vasculearn Network

• VLN Launch Party

• Skip the Floss, Risk the Clot? The Surprising Link …

• Upcoming Patient Events

Introducing the New Vasculearn Network

We’re excited to unveil the new and improved Vasculearn Network (VLN) website—built to better serve our growing community with easier access to trusted resources, engaging discussions, and exclusive events.

You’ll notice there’s something different, aside from the new look and feel:

• You’re now able to access all of our resources with the ability to save content, share with friends, comment, and ask questions on everything.
  

• Our events will be streamed within our new platform, allowing conversations to happen in the discussion thread during the event AND after.
  

• Since this is a community, we've incorporated features like:

  • Platforms for sharing ideas to make our network stronger.

  • A member space to build new relationships.

  • Simple ways to share your story.

  • Exclusive member benefits including event registration, resource bookmarks, and community engagement.

This transition marks a major step in our mission to not just provide information but build a network of support and shared knowledge.

The next chapter of our mission:

Circulating knowledge. Saving lives.

We’d love to hear your feedback as we continue to grow. Comment on a post, share with your friends/family, and RSVP to an event.

See you in the network!

Meet our new Chief Technology Officer

Adam Judeh, the driving force behind the VLN online community, is dedicated to making vascular health education more accessible, collaborative, and impactful.

Adam came to us from a long career in operations leadership with Chipotle Mexican Grill and building his own operations and automation agency.

Instead of just building a website for our new brand, Adam came in with excitement and desire to help us truly evolve our nonprofit. We now have a true network that extends beyond just the digital space.

Fun Facts About Adam: He has a large, furry family (and yes, they make appearances at our meetings). He lives with his partner, 4 dogs, and a cat in sunny Minnesota. If he’s not working, you’ll find him with his family, golfing with his parents, and working on home renovation projects.

Thank you, Adam, for helping us build something special, and we’re excited to continue building the future of VLN with you!

VLN Launch Party

In March, we had the incredible opportunity to celebrate the official launch of VLN with so many of you—our dedicated clinicians, patients, supporters, and partners.

This event marked a major milestone in our journey, as we continue expanding VLN from a thrombosis-focused organization to a thriving community-driven network that bridges the connections between vascular health, education, and innovation.

Seeing so many passionate individuals come together in one space—sharing ideas, reconnecting, and looking toward the future—was truly inspiring.

We want to express our deepest gratitude to President Emeritus Dr. Samuel Z. Goldhaber, current President Dr. Christian T. Ruff, our VLN board members, and every single person who attended and contributed to making this night special.

Your support fuels our mission to create a space where education, collaboration, and impact thrive.

See the post ↓

A Heartfelt Thank You to Our Community! | Vasculearn Network

Last week, we had the incredible opportunity to celebrate the official launch of Vasculearn Network (VLN) at the Boston Harbor Hotel with so many of you—our dedicated clinicians, patients, supporters, and partners. This event marked a major milestone...

vln.thrombosis.org/c/what-s-new-at-vln/a-heartfelt-thank-you-to-our-community

Skip the Floss, Risk the Clot? The Surprising Link Between

May is National Stroke Awareness Month, making it a great time to highlight an often overlooked risk factor: oral health. Poor oral hygiene can lead to inflammation, which may contribute to conditions like stroke and heart disease.

As awareness grows, so does our understanding of why caring for your teeth and gums matters—not just for a healthy smile but for overall well-being. 

We spoke with Dr. Souvik Sen, Professor and Chair of the Department of Neurology at the University of South Carolina School of Medicine, to explore the connection between oral health and cardiovascular risk, including how something as simple as flossing might play a role.

His recent study suggests a potential link between regular flossing and lower stroke risk, though the findings are still preliminary and haven't been published in a peer reviewed journal.

Further research is needed to confirm whether improving oral hygiene can truly help prevent strokes. "Flossing is a simple habit, but it appears to have a significant impact on reducing inflammation and the risk of clot-related strokes," Dr. Sen explained.

Your mouth is home to a mix of helpful and harmful bacteria. Normally, these bacteria maintain balance, aid digestion, and support oral health. However, poor oral hygiene allows harmful bacteria to grow, leading to gum disease and inflammation. Over time, bacteria from the mouth can enter the bloodstream, triggering an immune response.

Gum Disease and Inflammation

When bacteria build up on the teeth and gums, they form dental plaque. If left untreated, plaque can lead to periodontitis, a chronic condition that damages gum tissue. Inflamed gums become an easy entry point for bacteria into the bloodstream. Everyday activities like brushing or chewing food can dislodge bacteria, allowing them to enter your body.

Once in the bloodstream, bacteria trigger inflammation, affecting blood vessels in ways that increase cardiovascular risk:

• Artery narrowing: Inflammation damages blood vessel walls, making them stiffer and more prone to blockages.

• Plaque buildup: Some bacteria release toxins that contribute to fatty deposits in the arteries, making clots more likely.

• Increased clot formation: Inflammation can promote platelet aggregation, increasing the risk of clots that block blood flow to the heart or brain.

Researchers have even found oral bacteria inside artery plaques, meaning they can travel through the blood. These bacteria can worsen plaque buildup by triggering inflammation and immune responses, making plaques weaker and more likely to rupture. If a plaque ruptures, it can cause a blood clot, which may lead to a heart attack or stroke.

Flossing and Stroke Prevention

Dr. Sen’s research suggests that flossing at least once a week is associated with a 22% lower risk of all types of strokes. Even after considering other habits like brushing and regular dental visits, flossing had an independent protective effect.

He also noted that flossing regularly may help reduce the risk of atrial fibrillation (Afib), a common irregular heartbeat that increases the risk of stroke.

Flossing and Stroke Risk: A Closer Look

Stroke can be divided into two main types:

• Ischemic stroke (87% of strokes): Caused by a blood clot blocking a vessel.

• Hemorrhagic stroke (13% of strokes): Caused by bleeding in the brain.

A cardioembolic stroke is a type of ischemic stroke caused by a clot that forms in the heart and travels to the brain. AFib increases the risk of these clots forming. If a clot breaks loose, it can travel to the brain and cause a stroke.

When looking at specific types of stroke, cardioembolic stroke showed the most significant reduction, with a 44% lower risk. While more research is needed, these findings suggest that a simple habit like flossing could have a meaningful impact on stroke prevention.

The Need for Further Research

Dr. Sen said his next step is to review the data carefully, making it easier to compare to a clinical trial.

A large trial would be hard to do, but ongoing studies could help give clearer answers. "It’s hard to do a clinical trial where half of the participants floss, and the other half don’t for 25 years. But the next step is to refine our data and see how we can match groups to get clearer results," he explained.

Flossing Early and Often: A Simple Way to Support Heart Health

While flossing alone isn’t a guarantee against cardiovascular disease, maintaining good oral hygiene, including brushing, flossing, and seeing a dentist regularly may help.

“Flossing is very affordable. It's also easily done at home. Somebody doesn’t need access to a dentist to be flossing regularly,” said Dr. Sen.

He also emphasizes the importance of starting early. "Flossing should be part of early education, just like other good hygiene habits," he explained. Teaching good oral health practices at a young age could help more people adopt lifelong habits that may reduce health risks later.”

*The American Dental Association (ADA) recommends brushing your teeth twice a day, and flossing once a day.

Learn More About Oral Hygiene

Looking for more guidance on maintaining good oral hygiene? Trusted resources from the American Dental Association (ADA) and the National Institute of Dental and Craniofacial Research (NIDCR) offer evidence-based recommendations on brushing, flossing, and preventing gum disease.

Scan the QR code to access important website links.

Upcoming Patient Events

Ask the Expert

Our Ask the Expert series, formerly called Blood Clot Education Group, is a space to connect with others and learn about all things related to blood clots.

Get accurate information on the latest research and treatments, and share your experiences.

• April 8, 2025

• May 7, 2025

• June 12, 2025

Blood Clot Support Group

Hosted by Joelle Hochman, RRT, Chair of Patient Engagement & Education. After experiencing a blood clot, it’s normal to have a lot of questions.

Many people are left feeling confused about why this happened to them and are anxious about it happening again.

• April 17, 2025

• May 15, 2025

• June 17, 2025

Women's Support Group (Quarterly)

In recognition of National Women's Health Week, we at VLN understand the unique concerns women face when managing blood clots.

Women have unique risk factors and may experience symptoms such as heavy periods, spotting between cycles, or bleeding after sex, especially when taking blood thinners.

To support you through these concerns, VLN hosts a quarterly women’s support group. It’s a welcoming space for women of all ages to connect, share experiences, and find strength together during their recovery journey.

• May 13, 2025

Bilingual Cardiovascular Disease Prevention and Treatment Virtual Patient Education Series

We’re excited to offer a bilingual virtual series on preventing and treating heart disease. Led by expert physicians, these sessions provide practical guidance on heart health in a supportive, interactive space.

Participants can join live Q&As and discussions tailored to their needs. To ensure accessibility, sessions are available in both English and Spanish, making it easy for you and your loved ones to participate and learn together.

• June 18, 2025

Long-PE and CTEPH Support Group (Quarterly)

Have you or someone you care for experienced a pulmonary embolism (PE)? VLN offers a dedicated support group for patients with post-PE syndrome and CTEPH (Chronic Thromboembolic Pulmonary Hypertension).

This group provides a safe space to connect with others, receive support, and learn more about managing life after PE.

• April 24, 2025

All meetings start at 7:00 PM EST

In all online groups, a clinician will be available to answer general questions about blood clots. Please note that they cannot provide personalized medical advice to any patients.

To register for these programs, please visit Patient Events on our website at https://vln.thrombosis.org

References:
Abstract 19: Dental Flossing May Lower the Risk for Incident Ischemic Stroke, Cardioembolic Stroke Subtype and AF – Stroke

Association Between Oral Health and Atrial Fibrillation: A Systematic Review - Heliyon

Atrial Fibrillation Risk and Discrimination of Cardioembolic from Noncardioembolic Stroke - Stroke

Cardioembolic Stroke – Circulation Research

Effects of Oral Inflammatory Diseases and Oral Hygiene on Atrial Fibrillation: A Systemic Review – International Journal of Clinical Practice

Impact of Oral Hygiene Practices in Reducing Cardiometabolic Risk, Incidence, and Mortality: A Systematic Review – International Journal of Environmental Research and Public Health

Ischemic Stroke (Clots) – American Stroke Association

Let's Talk About Hemorrhagic Stroke – American Stroke Association

Roles of Oral Infections in the Pathomechanism of Atherosclerosis - International Journal of Molecular Sciences

The Oral Microbiota, Microbial Metabolites, and Immuno-Inflammatory Mechanisms in Cardiovascular Disease – International Journal of Molecular Sciences

The Oral Microbiome: Role of Key Organisms and Complex Networks in Oral Health and Disease - Periodontology