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Nobody is immune from the hazards of summer wildfires, even the experts. At the University of Washington, researchers study both how to mitigate and understand wildfire behavior and how air quality degrades as a result of burning blazes. While UW faculty contribute to a rapidly emerging body of research into the risks of fire and smoke season, they also contend with the decisions that the rest of us face: how to protect themselves and their families, where to find reliable information, and how to manage the anxieties of summer smoke. 

Who better to learn from? As fires rage and smoke smothers the Pacific Northwest — including historic and devastating blazes in Spokane — UW News sat down with five UW experts in fire science, forestry, air pollution and more to ask how they manage wildfire season. 

This summer, the U.S. has been inundated with wildfire smoke, sometimes from fires burning hundreds of miles away. What sources do you use to track wildfires and air quality?

Ernesto Alvarado, research associate professor of environmental and forest sciences: The most reliable source, in my opinion, is the Fire and Smoke Map from AirNow.gov. This map consolidates data from various government sources related to wildfires, prescribed burns, smoke emissions and up-to-date models. It serves as a comprehensive resource for smoke emissions information.

Susan Prichard, research scientist in environmental and forest sciences: For smoke forecasts, I often turn to AirNow, but the Washington Smoke Blog is an excellent friend when we have been inundated with smoke for days and I’m looking for extended forecasts and analyses. Purple Air is also an incredibly helpful site. I’m careful to check if the readings are U.S. EPA PM2.5 with the conversion applied — otherwise the readings generally are higher than reality.

Brian Harvey, professor of environmental and forest sciences: For personal use and immediate up-to-date information, I really like Watch Duty. As a free app that has lots of options and configurations, it can be really helpful for getting immediate information on any ongoing fire incident and incorporates information from multiple sources. Second, for more detailed maps, photos, and daily incident updates, I frequently check Inciweb, which is the U.S. government interagency website that provides real-time public information and updates on fire incidents. As a forest fire scientist, I also use these sources for archived information about past fires that can better help us in our research.

Let’s say you’re planning a weekend trip, or a hike you’ve been looking forward to. How do you predict and plan around fire and smoke? 

E. Alvarado: I’ll plan my outdoor activities while considering potential smoke impacts. I’ll choose an area that’s unlikely to be affected by smoke for the duration of the activity. During the fire season, I’ll avoid areas with thermal inversions, which can trap smoke at night. For example, canyons or valleys surrounded by mountains are risky.

To predict future smoke concentrations, the National Weather Service is the most reliable source of information. Their weather predictions can indicate fire weather for the duration of the forecast. This is also important for hiking the rest of the year to stay informed about the weather for any outdoor activity.

BH: FireSmoke.ca has nice maps of the U.S. and Canada with high-resolution smoke forecasts over the coming day or two. These maps can be really helpful for planning ahead, though are always subject to change based on changing fire behavior or weather conditions. With our lab group doing field work outdoors all summer long every summer, these are critical tools for us to be able to do our work. 

Do you have an AQI threshold where you’re no longer comfortable being outside? Does that vary depending on what you’re doing outside? If so, how?

Edmund Seto, professor of environmental and occupational health sciences: The AQI is designed for communicating health risk to both general populations as well as populations that may be more susceptible to smoke.  Rather than focusing on the AQI number, I instead focus on the public health messaging (the “Description of Air Quality” column in this figure):

Elena Austin, associate professor of environmental and occupational health sciences: I generally become more concerned when air quality has remained consistently elevated for about 24 hours, because I think about smoke exposure cumulatively over the course of the day.

SP: If it looks like air quality is going to degrade over an AQI of 80, I start thinking about my health and what level of activity I’m going to do. As the science on smoke and human health only becomes more cautionary, I save strenuous exercise like running or climbing mountains for times when the AQI is below 80. 

If you have to be outside during smoky days, how do you protect yourself? 

E. Alvarado: Starting from AQI in the yellow zone, I may wear a N95 mask. However, above the orange zone, an N95 mask is mandatory.

ES: If working outdoors during smoky days, you and your employer should be aware that in Washington State, Labor and Industries has established rules to protect workers from hazardous smoke exposures. Also be aware that oftentimes smoke and heat co-occur, and there are heat exposure rules for working outdoors too.

E. Austin: I always make contingency plans while hiking and camping. In that case, I identify egress routes prior to departing in case a wildfire event limits my ability to return using the route I had planned. I also sign up for emergency text alerts for the county where I am spending time, and check the current fire activity and nearby evacuation status. 

How do you keep your indoor spaces safe during smoke waves?

ES: Thinking ahead and preparing your indoor space for regularly occurring wildfire smoke episodes is just as important as planning for other emergency events.  Can you close doors and windows tightly and have good weather sealing to avoid smoke from infiltrating indoors? Can you set your ventilation system to recirculate air?  Have you replaced your ventilation system (e.g., furnace) filter recently? Have you considered getting a portable HEPA-rated air cleaner that is sized appropriately for your bedroom or living area?  Have you considered building a DIY box-fan filter?

E. Austin: I create a smoke-ready space in my home. This is a separate area, where I set my ventilation system to recirculate indoor air rather than bringing in outdoor air. I also run a HEPA filter, rated to perform well for the square footage of my space, during wildfire events. Lastly, I try to reduce air exchange between the indoor space and outdoors by closing all windows, only opening outdoor doors when necessary, and weatherizing the space around doors and windows prior to the event.

SP: For indoor air, we make sure our HEPA air filters are clean at the end of each fire season so that they are ready to go the following year. When there’s smoke in the air, we make sure windows and doors are closed and use our air filters. We also just got a heat pump so that we can keep windows closed when smoke is a factor at night.

If you find yourself in close proximity to an active wildfire, what steps do you suggest taking?

BH: I suggest being as conservative and cautious as possible. Conditions can change rapidly, and being in the direct line of where a fire is spreading can be extremely dangerous and life-threatening. So first, I would make sure that there is a clear and safe route to safety via a road, trail, path, etc. Second, assessing the situation through any official information or local authorities is critical. If the fire has not been reported, calling 911 immediately is important to alert responders and others. If an evacuation order is issued, leaving immediately is critical to get to safety ASAP.

E. Austin: Many local districts allow you to register your phone and/or email to receive real-time alerts. I also suggest identifying your evacuation route, any obstacles or bottlenecks that would slow down your evacuation and to preplan and even pack critical items that you would need to take with you in an emergency.

SP: I live in the Methow Valley, and we’ve been evacuated around five times in the last 20 years. As a fire ecologist who studies fire behavior and smoke, one of the most upsetting things for me has been to watch neighbors and friends stay to protect their places. We quickly pack a few valuable things — photo albums, laptops, wallets, and passports — and leave. My main message to friends over the years is that it’s not worth the risk — if flames are close that means that smoke and super-heated air may be close, too, and deadly.

How do you manage the stress and anxiety of fire season both here and elsewhere?

E. Austin: I manage that stress by preparing my home before fire season, relying on a small number of curated information sources rather than trying to identify reliable sources in the moment or checking multiple apps, and I try to make flexible backup plans for outdoor activities. I also suggest planning ahead to learn how to obtain and effectively use an N95 respirator to reduce exposures either at work or when outdoors for recreational activities.

SP: Fire and smoke season are stressful. I’ve dealt with some stress and anxiety not only from fast-moving wildfires but also from long-duration smoke events that feel like they will never clear. We have a strong community that is very supportive and understands how fire season can bring up some PTSD-type symptoms. We take care of our place and make sure that we have as low of risk in and around our home as possible. We also remind ourselves how very lucky we are to be able to have flexibility in our work schedules and plenty of friends and family elsewhere to be able to leave when wildfires hit close to home.

BH: Fire is an integral part of life on earth, and in regions like the Pacific Northwest, fire is a key process that will continue to shape this region well into the future. Knowing that it is not if, but when, fire will return to any given area helps me embrace the reality of fire season. Like anything in life, being informed and prepared is a great way to lower stress and anxiety that comes with uncertainty. 

The UW has dozens of experts in wildfires, smoke and related topics. To reach an expert, contact Alden Woods at acwoods@uw.edu.

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Schizophrenia affects approximately 23 million people worldwide, with onset usually occurring during a person’s late adolescence to their 20s. Impairments associated with schizophrenia include hallucinations, delusions and disorganized thinking and behavior.

Now, researchers at the University of Washington are investigating how genetic changes impact the severity of schizophrenia symptoms. A new study, published in the American Journal of Psychiatry, supports the idea that deletions in genes that regulate early brain and neuron development are associated with more severe features of schizophrenia spectrum disorders, particularly lower cognitive abilities.

How schizophrenia manifests — and how severely — differs between patients. Poorer cognitive functioning in schizophrenia is associated with more treatment-resistant forms of the disease. Jennifer Forsyth, co-author and assistant professor of psychology at the UW, said understanding early developmental genetic factors could help identify people who could benefit from earlier, targeted inventions.

“For a subset of individuals, we may need to be thinking about how we can create treatments earlier in brain development that will help compensate for the fact that certain genes are being deleted,” Forsyth said. “Is there some kind of medication that can help with that? Down the road, could there be gene therapies for some of these individuals? I do think this research is going to be important for changing treatment direction.”

The researchers studied the DNA of more than 600 people with schizophrenia spectrum disorders. The team compared these results to data from patients’ relatives, people without schizophrenia and nearly 10,000 children participating in the Adolescent Brain Cognitive Development Study. 

People with schizophrenia who carried the deletions tended to perform worse on cognitive tests — showing poorer memory, thinking and attention skills than people with schizophrenia who didn’t carry the deletions. Similar, weaker associations were also seen in the general population, which suggests these variants may influence brain development more broadly, even in individuals without schizophrenia.

The study also showed these specific genetic deletions were associated with differences in brain structure, including higher gray matter volume and cortical thickness. This is the opposite pattern researchers typically see on average in schizophrenia, Forsyth said, which again suggests variability between patients.

“This study helps us understand the specific way somebody manifests a disorder,” Forsyth said. “It’s sort of a cumulative effect of different risk profiles. We all carry tons of genetic variants, and the specific types of variants we have and how they combine is very complicated. These things aren’t totally deterministic, but I do think understanding which specific aspects of brain development are affected by the genetic variants a person carries, and how this shapes how the disorder manifests, can start to inform how we think about different treatment approaches.”

Other UW co-authors from the Department of Psychology were graduate students Jinhan Zhu, Zachary Trevorrow and Mahnoor Hyat, undergraduate research assistant Ariana Chavannes, research coordinator Sam Sievertsen and research technologist Sophie Ferreira-Ianone. Matthew Conomos, a UW senior research scientist in biostatistics, was also a co-author.

A full list of co-authors is included with the study.

This study was funded by the National Institute of Mental Health, the Brain and Behavior Research Foundation, the National Center for Advancing Translational Sciences UCLA Clinical and Translational Science Institute, the UCLA Brain Research Institute and the Shear Family Foundation.

For more information, contact Forsyth at jenforsy@uw.edu.

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Drug development is among the slowest, most failure-prone processes in modern science, with about 90% of drug candidates never reaching the market. Today, artificial intelligence methods have accelerated the first step — plucking promising molecules out of endless possibilities — but countless challenges remain. A successful drug must be not only safe and effective, but also able to bypass the body’s defenses and reach the right target.

Most drug candidates fail such optimizations. That’s where a new research institute at the University of Washington has focused its attention. Housed in the UW School of Pharmacy, the Institute for Innovations in Drug Delivery and Disposition (I2D3) brings together experts in artificial intelligence, drug discovery, pharmacology, data science and biotechnology to ease the bottleneck between promising molecules and successful drugs. 

The Institute opened in July 2026 and is led by three UW faculty members: Gaurav Bhardwaj, an associate professor of medicinal chemistry who oversees the Institute’s AI-enabled molecular design; Nina Isoherranen, the Milo Gibaldi Chair of Pharmaceutics and expert in drug metabolism and disposition; and Marco Pravetoni, a professor of psychiatry and behavioral science in the UW School of Medicine, who leads drug discovery, translation and commercialization efforts.

UW News spoke with the three co-directors about why drug candidates fail, how AI is speeding drug development and how I2D3 hopes to help get drugs to market more quickly.

What separates a promising molecule from a full-fledged drug? What properties need to be considered, and how can a developer work toward them?

Gaurav Bhardwaj: It really depends on the disease indication you are targeting and the therapeutic modality. Let’s say you have a promising molecule that interacts with the disease-causing protein. Delivery becomes equally important — do we need an orally delivered drug? Do we need to cross the blood-brain barrier? If the disease requires daily dosing, then injectable or IV methods aren’t optimal. If it’s delivered orally, then the molecule needs to be able to get across the gut barrier, and also needs to be stable enough that it doesn’t get chewed up by the body. It also needs to stay in the body for a reasonable time. A successful drug molecule has to meet all these and more criteria, and ultimately all these criteria are encoded by the sequence and structure of the molecule.

The Institute is devoted to aspects of drug development that are often overlooked. What problem do you see the Institute being able to help solve? 

GB: Traditional drug discovery and development is a trial-and-error-based process. Either you find a useful molecule in nature and spend years optimizing it for human use, or you create many random combinations of molecules and hope that one of them has the function you need. Both of these approaches are highly unsuccessful, which has created a bottleneck.

Now the field is also focusing on an idea called rational drug design. It started long before AI but is now becoming even more common. People are using AI methods to design new molecules. However, a lot of that work has focused on the first step — finding a molecule that binds to a specific protein, or has a specific function in the body. That’s still not a drug, it’s just more candidates.

The bottleneck has now shifted. It’s no longer finding that first molecule, but now, how do you add all the other drug-like properties? That’s what the Institute is trying to do. Let’s build the models that ultimately make molecules that are going to be successful all the way through the drug development pipeline. 

Marco Pravetoni: I see our work also as accelerating discovery. I work on substance use disorders, and my lab develops vaccines, antibodies and next-generation antibody-like molecules that target drugs in the body. With these new tools, instead of working to design 10 antibody candidates in a lab, we could design 1,000 or more, and then we can accumulate enough data to reduce any risks, so that what we bring to clinical trials is more likely to be successful. AI can do a lot of that.

How can you make it more likely that a drug candidate succeeds in trials? 

Nina Isoherranen: Part of it is predicting what’s going to happen to a drug in humans before it’s ever given to humans. That should increase the success rate and eliminate the waste of doing a lot of unsuccessful trials. 

We can also build machine learning and AI approaches to predict drug disposition in an individual person. What we talk about today are ‘digital twins,’ which refers to a computational model of the individual patient and their characteristics. For example, how does your kidney function? What is your body mass index? And so forth. Then we generate a digital version of you. We can then predict how a certain drug would behave in your body and build the best strategy. 

There’s also an access-to-treatment question here. Pregnancy is a great example — we often don’t know how drugs work in pregnant women because we’ve never done trials. To be safe, we say that pregnant people shouldn’t take those drugs, but that means they don’t have access to a potentially hugely beneficial medication. If we can use AI and machine learning to predict how pregnant people respond to medications and how their bodies handle drugs differently from nonpregnant people we can make more medications accessible

Now with AI and machine learning, I think we can get to a place where we can truly sample the full space of possibilities. 

How can the methods you’re building help with these individualized treatments? 

NI: We know that drugs behave differently in different people. Even if we give them the exact same drugs and concentrations, people may still have different responses because of factors inherent to our bodies.

During drug development the candidate drug needs to be studied to see responses in different populations. Before you get a drug approved, you need to understand how liver disease, for example, is going to change exposure to that drug and whether you need to change the dosing. There’s a lot of guidance on drug interactions. Pharmacists manage drug interactions all the time, but it gets very complicated when you combine multiple patient factors. Now, if we have good predictive tools, we can predict what’s going to happen without having to do trials. 

The ultimate goal here is to be able to predict, using model computational tools, what’s going to happen in individual humans before you ever give them a drug. What’s the right dose? The right timing? 

UW has established itself as a leader in these fields already. I’m thinking especially of the UW Medicine Institute for Protein Design, whose director, David Baker, recently won the Nobel Prize in Chemistry. How does I2D3 fit into the broader UW ecosystem? 

MP: IPD is a world leader in designing novel proteins, and the UW also has outstanding capabilities in clinical testing and implementation through the Institute of Translational Health Sciences. However, there remains a critical translational space between discovery and clinical application —  one that focuses on the pharmaceutical development needed to turn promising innovations into viable therapeutic products. That’s where I2D3 can play a leading role.

For example, when researchers at IPD develop a new protein, I2D3 can partner with them early to address formulation, manufacturability, stability, delivery, and other key pharmaceutical considerations that are essential for advancing a discovery toward the clinic and ultimately the marketplace. I2D3 would serve as a core translational partner, helping bridge the gap between innovation and implementation.

IPD brings unmatched strengths in protein design, ITHS provides expertise in clinical translation, and I2D3 contributes the drug development and pharmaceutical sciences capabilities needed to move discoveries across the translational continuum. Together, these organizations can create a powerful and highly integrated ecosystem.

For more information, visit i2d3.washington.edu. To reach the researchers, contact Alden Woods at acwoods@uw.edu.

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Over the past five years, the national conversation around health and nutrition has become dominated by the term ‘ultra-processed foods.’ Most prominently, Health and Human Services Secretary Robert F. Kennedy Jr.’s MAHA movement blames these foods for a host of chronic health issues and has launched an often-contradictory campaign to remove some UPFs from the food supply. 

But there’s a glaring problem: Nobody can agree on how, exactly, to define ultra-processed foods. The lack of a clear definition has stymied legislative and regulatory efforts to curb UPF consumption, and caused confusion for people evaluating their own diets. 

This spring, a panel of 14 nutrition, food science, policy and legal experts gathered to create a more practical and operational definition. The panel’s final report, published in May, suggests an ingredient-based approach to identify ultra-processed foods, while also recommending a series of policies to reduce people’s exposure to them. 

The panel was co-chaired by Jim Krieger, clinical professor emeritus of health systems and population health at the UW and executive director of the nonprofit group Healthy Food America. UW News sat down with Krieger to discuss the new definition, the debate around ultra-processed foods and how people can limit their consumption.

How have we traditionally defined ultra-processed foods, and where does that definition fall short? 

Jim Krieger: The ultra-processed food concept was developed by Carlos Monteiro, who’s a physician and epidemiologist at the University of Sao Paolo in Brazil. He was trying to understand an increase in obesity and chronic disease rates, particularly in kids and young adults, and noticed some important changes in the diet that weren’t fully explained by just the usual nutrient profiling — like fat, sugar, salt. Monteiro came up with this concept of ultra-processed foods. The categorization system is called Nova, which means ‘new’ in Portuguese, and classifies foods across a spectrum beginning with unprocessed ingredients and ending in ultra-processed. Ultra-processed foods are the ones that are the most highly processed industrial products, basically. 

The Nova definition is geared toward research, to really examine the effects of ultra-processed foods on a range of health outcomes. Using it, numerous studies have found ultra-processed foods to be associated with a whole host of health problems, like diabetes and heart disease and depression. That’s the basis to say, well, there’s probably sufficient evidence to figure out what we can do to reduce exposure to ultra-processed foods by reducing sales and consumption. That requires policy, and to have policy you need to have a definition of ultra-processed food that’s suitable for regulation or legislation, and that’s where the rub comes. The definition for research doesn’t really work in a policy context, because the Nova research definition uses multiple factors, including ingredients, processing techniques, and other factors to identify products as ultraprocessed. Applying Nova can require individual-level review of ambiguous products by skilled nutrition experts that may not be feasible in policy contexts.

You co-chaired a panel of 14 experts who came up with a new definition. What did that work look like, and what’s your new definition?

One criticism of the movement against UPFs has been that some foods that are technically ultra-processed are actually quite nutritious. I’m thinking of products like yogurts, whole-grain breads and tofu. How does your definition account for that?

JK: You want your definition to be sensitive enough to pick up most UPFs, but also specific — that is, not capture foods that are not truly UPFs or even those that can be part of a healthy diet. The way we addressed that was the FDA, a couple years ago, developed criteria for what they call a ‘Healthy’ claim. If a company wants to say its products are healthy and put that on the package, it has to meet FDA-approved criteria. 

We decided that even if a product is ultra-processed, if it meets the FDA’s criteria for a ‘Healthy’ food, then it should be exempted from policy. That cuts out edge cases — healthier foods that are also UPFs.

Your final report also dives into policy and makes recommendations for lawmakers to consider. What is the current status of ultra-processed food policy across the U.S.? 

JK: Over the last couple of years there has been a flurry of activity, particularly at the state legislative level. Some states say they’re getting rid of ultra-processed foods in school meals, for example, but they have a somewhat random list of ingredients or additives they don’t like. 

A few states have tried to take a more evidence-based approach. The best example of that is California, where they passed legislation to phase out ultra-processed foods in school meals. They used the same kind of ingredient-list approach that we recommend, simplified a little bit. However, for a food to be a UPF under California’s definition, it must also be high in fat, sugar or salt, which raises a problem — about 35% of all ultra-processed foods do not have those levels. Proposed legislation in states like Pennsylvania have avoided this problem by sticking with the Nova-based definition, as recommended by our expert panel, rather than adding on fat, sugar and salt criteria.  

There’s also been a huge amount of movement in a couple of countries, especially in Latin America. Furthest along is Colombia, where the government just issued a regulation to require ultra-processed food labels on packages. They’re basically using the Nova definition as well.

There are policies moving now, which is why we felt it was important to say, use a good definition of ultra-processed for what you’re doing, and then think about certain policy ideas as the best bets for doing something about the problem. For us, those ideas include requiring labels on packages identifying a product as ultra-processed and removing UPFs from food served in schools, childcare and in government facilities. 

Many of the factors that lead people to choose ultra-processed foods are systemic. As an example, food deserts leave some people without easy access to affordable fresh foods. How did the panel consider those factors in making your policy recommendations?

JK: Increasing access to healthy foods gets into another set of policies that are well-described and, to varying extents, are being put into place. Our panel focused specifically on UPF policies. We did assess whether any of our policy recommendations would have unintended consequences of making food less available or affordable for people with low incomes and then we figured out strategies for mitigating those effects. 

A great example would be if you tax even a subset of ultra-processed foods, that’s going to make them less affordable, and that’s a challenge. We recommend that the tax revenues raised from these policies go toward vouchers or incentives for people with lower incomes that they can cash in for fruits and vegetables at a more affordable price. 

We also rejected some policy ideas. One was restricting the use of SNAP (the Supplemental Nutrition Assistance Program, commonly known as food stamps) benefits for purchasing ultra-processed foods. We felt that would have too much of a negative impact on food affordability for people using SNAP, so we did not recommend that. 

What comes next for this research? 

JK: Our next step is to share this definition with as many policymakers as we can, and then offer them technical support if they want to figure out how to use this in legislation or regulation. The second thing is if any legislators, policymakers or advocates want to pursue policies, we’re available to provide technical support and assistance. 

There’s also a bunch of additional research that would be useful. We have some of those recommendations at the end of the report, but as an example, there’s controversy right now over different subgroups of UPFs and whether some are more harmful than others. The research that’s been done so far has been somewhat confusing and flawed. There’s also research on how, exactly, ultra-processed foods cause all these problems. There are a lot of great, interesting hypotheses, but I wouldn’t say any of them are definitive. 

As an expert in this field, how do you approach ultra-processed foods in your own life, and how would you recommend people think about reducing their own consumption? 

JK: Right now, about 60% of the calories that Americans consume are ultra-processed foods. Starting there, small and incremental steps are great. You can’t totally change your diet overnight, so the bottom-line message is to think about small things you can do. 

The first challenge is identifying UPFs, which is where we started this conversation. If there are ingredients in food that you don’t have in your kitchen, it’s likely going to be a UPF, and if it’s a long ingredient list that looks like a chemistry lab, it’s probably a UPF. Then you can consider what the food looks like. If it’s super bright, like Froot Loops or Doritos, that probably means it’s a UPF. 

But then once you’ve identified ultra-processed foods, what do you do? Let’s think about one thing you want to do. Say you drink a lot of sweetened beverages. You can think of what you can swap in that works for you, like sparkling water that doesn’t have a lot of additives, or coffee or tea.

As for me, I don’t eat many ultra-processed foods. When I started doing this work, when my kids were younger, I fed them all sorts of UPFs. I certainly wouldn’t do that now and wish I had known better. But if I want to have something that’s ultra-processed, that’s fine, it’s not going to kill you to have just a little bit. As long as your overall dietary pattern is healthy, then that’s great. 

The panel was co-chaired by Krieger and Lindsey Smith Taillie of the University of North Carolina at Chapel Hill and convened by Mary Story and Megan Elsener Lott of Duke University. A full list of panel members is included in the panel’s technical report. This work was funded by Healthy Eating Research and the Robert Wood Johnson Foundation. 

For more information or to contact Krieger, email Alden Woods at acwoods@uw.edu. 

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The human mouth is full of wonders. It’s home to hundreds of species of bacteria, fungi, viruses and protozoa, which work in delicate harmony to maintain our oral health. Sometimes, though, this complex system — known as the oral microbiome — can fall out of balance. Anaerobic bacteria build up on the tongue and in the little pockets between our teeth and gums. There, they break down organic matter and spew out a foul odor. This, the current theory goes, is what causes many chronic cases of bad breath, or halitosis.

To rebalance the oral microbiome and cure chronic halitosis, researchers at the University of Washington are embarking on a first-of-its-kind experiment. These clinical trials transplant bacteria and other minuscule critters from healthy donors into patients with halitosis. If successful, the healthy microbiota will crowd out the bad and patients’ bad breath will improve.

“We know the oral microbiome can get out of whack. The question is, can you rebalance it? That is the hypothesis we’re proposing,” said Alvin Wee, a UW professor of restorative dentistry and co-lead of the project. 

The experimental procedures build off recent breakthroughs in fecal microbiota transplants, commonly known as stool transplants, which have become a go-to treatment for gastrointestinal infections and bacterial imbalances. 

The research team has so far completed four transplants, with preliminary evaluations underway. They’re seeking pairs of participants — a patient with chronic halitosis and a donor, ideally an intimate partner, family member or trusted friend — to undergo these relatively simple procedures.

To start, researchers complete a full periodontal exam of the donor to ensure their microbiome is healthy. Then they collect bacteria from the donor and suspend it in a small volume of saline. At the same time, recipients undergo a deep cleaning to remove the harmful bacteria and disrupt the biofilm — the thin, sticky layer of microorganisms that lines surfaces in the mouth. Recipients rinse with the donor solution, and researchers inject a concentrated version into the gumline. Ninety days after the transplant, participants self-report whether their breath has improved. 

“What we’re trying to do is severely disrupt the original bacteria, and then we bring in the new guys to take hold and establish a new biofilm,” said co-lead Alex Pozhitkov, a research scientist and affiliate faculty member in the UW School of Dentistry. “If we bring enough of the new bacteria and they outcompete the ones that we disrupted, the healthy ones will take over. It’s a numbers game.” 

This research was funded by the Dean and Margaret Spencer Clinical Research Fund. Co-investigators include professor of clinical practice Diane Daubert and professor Daniel Chan, both of the UW School of Dentistry. For more information, to reach the researchers or to inquire about participating, contact Pozhitkov at pozhit@uw.edu or Wee at awe@uw.edu.

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• Being physically active was tied to a 9% to 19% lower risk of stroke or death for moderate to high physical activity levels, in an analysis of more than 87,000 adults in Norway.
• Study participants had nearly the same health benefits from physical activity, regardless of whether they had an irregular heart rhythm known as atrial fibrillation or not.
• While the largest benefit was noted among study participants who were the most active, benefits were also noted for people reporting low to moderate activity levels.

Embargoed until 4 a.m. CT/5 a.m. ET Wednesday, Aug. 5, 2026

DALLAS, Aug. 5, 2026 — Being physically active was linked to a lower risk of stroke and death for adults with atrial fibrillation, or AFib, according to new, independent research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

“In general, people with AFib appear to be less active than the general population,” said lead study author Kristoffer Johansen, Ph.D., a researcher at the School of Sport Sciences, Faculty of Health Sciences at UiT The Arctic University of Norway, Tromsø. “The results from our study indicate that physical activity was associated with a reduced risk of stroke and death in individuals with and without atrial fibrillation. So, regular physical activity is important for all and could be an important preventive strategy for people with AFib.”

AFib is a quivering or irregular heartbeat that occurs in the heart’s upper chamber known as the atria. According to the American Heart Association, it can lead to blood clots, stroke and other heart-related conditions. The prevalence of AFib in the U.S. was estimated at 10.55 million, equivalent to 4.48% of the adult U.S. population, according to data reported in the American Heart Association’s 2026 Heart Disease and Stroke Statistics.  

The American Heart Association recommends all adults spend less time sitting and get

at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week. In addition, adults should participate in moderate muscle-strengthening activity at least twice a week.

The study tracked more than 87,000 adults in Norway for about 15 years, capturing information about AFib, stroke and death from national health registries.

What did the analysis find?

• Compared to adults who were inactive, adults with a low, moderate or high level of physical activity had a 9%, 19% and 18% lower risk of stroke, respectively.
• Having a low, moderate or high level of physical activity was associated with an 11%, 18% and 22% lower risk of death from any cause, respectively.
• These benefits were similar regardless of whether a person had AFib or not. This suggests that having AFib does not change the relationship between physical activity and stroke.
• For people with AFib, staying active was tied to living an average of 0.5 to 1.2 years longer compared to those who were inactive.

Previous research has suggested that people with AFib derive health benefits from regular physical activity. However, results have been somewhat inconclusive regarding the association between physical activity and stroke, Johansen said. This study suggests a positive impact of physical activity for people with AFib on both stroke risk and living longer.

“I hope our results will increase awareness among clinicians and people with AFib about the benefits of even low levels of physical activity,” Johansen said. “Real health benefits can happen no matter when a person starts getting active, and even a little exercise is better than nothing.”

Mina Chung, M.D., FAHA, co-chair of a 2023 joint guideline for Diagnosis and Management of Atrial Fibrillation from the American Heart Association and other organizations, said this study “adds important evidence linking physical activity with lower risks of stroke and death in people with and without AFib.  

“It’s important to remember that physical activity may also reflect overall health. Still, the results motivate patients to be as active as they can – even lower levels of activity were associated with benefit, while moderate to high levels were linked to greater benefit,” added Chung, who is also a professor of medicine at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and cardiologist in the department of cardiovascular medicine, the section of cardiac electrophysiology & pacing within the Heart, Vascular & Thoracic Institute and the Department of Heart, Blood & Kidney Research at the Cleveland Clinic Research and the Cleveland Clinic.

What are the study details, background, design and limitations?

• The study included health information for 87,340 participants from two large Norwegian health studies: the HUNT Study (including participants from the third and fourth survey conducted in 2006-08 and 2017-19) and the Tromsø Study (including participants from the sixth and seventh survey conducted in 2007-08 and 2015-16). Participants’ average age was about 51 years at time of enrollment in the studies. About 47% were men and more than 6,500 participants had AFib.
• Researchers divided people into four groups based on the level of regular physical activity participants reported, ranging from inactive to highly active. They specifically noted their frequency of physical activity ranging from never to almost every day; the duration of exercise ranging from less than 15 minutes to more than one hour; and the intensity of the exercise, ranging from “I take it easy without breaking into a sweat or losing my breath” to “I push myself to near-exhaustion.”
• The study used a multiple-records approach, meaning that if someone developed AFib during the follow-up, they were reclassified to the AFib group to ensure that the results of the AFib group were more accurate.
• Limitations: Instead of randomly assigning people to a specific treatment or control group in a lab, individuals reporting different physical activity levels at the start of the study were followed over time. The consequence of this participant non-randomized  grouping is that other unmeasured or imprecisely measured factors may have influenced the relationship between physical activity and stroke/death. For example, more active individuals tend to live a healthier lifestyle in general. Therefore, despite the fact that a statistical correction was made for several factors, the authors cannot exclude the possibility that other factors could have partially explained why physically active individuals had a lower risk of stroke and death. Also, people in the study reported their own activity levels, meaning they might have said they exercised more than they really did.

Johansen said similar results would be expected if this analysis was conducted based on adults in the U.S.

Co-authors, disclosures and funding sources are listed in the manuscript.

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of release link.
• After Aug. 5, view the manuscript online.
• American Heart Association health information: Getting Physically Active
• American Heart Association health initiative: Healthy for Good™
• American Heart Association news release: Move more for your health, not just for the scale (June 2026)
• Follow American Heart Association/American Stroke Association news on X @HeartNews
• Follow news from the Journal of the American Heart Association on X @JAHA_AHA

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and AHA/ASA Expert Perspective: 214-706-1173

Bridgette McNeill: bridgette.mcneill@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

• A study evaluating the American Heart Association/American College of Cardiology 2025 guideline on high blood pressure found that among 81 million U.S. adults with high blood pressure and no cardiovascular disease, nearly 23 million (28%) may be newly eligible for blood pressure-lowering medication.
• More than 9 million people who may need medical treatment to achieve optimal blood pressure may not currently be getting it.
• Researchers found that people with high blood pressure and higher cardiovascular disease risk may need more than lifestyle changes to manage their blood pressure. Combining lifestyle changes along with taking blood pressure medication can be an effective strategy to lower blood pressure.

Embargoed until 4 a.m. CT/5 a.m. ET Wednesday, July 29, 2026

DALLAS, July 29, 2026 — Nearly 23 million Americans with blood pressure 130/80 mm Hg or higher may be eligible for blood-pressure-lowering medications based on the 2025 American Heart Association/American College of Cardiology guideline, according to new, independent research published today in the Journal of the American Heart Association, an open access, peer-reviewed scientific journal of the American Heart Association.

The 2025 American Heart Association/American College of Cardiology High Blood Pressure guideline advises lifestyle changes — eating a healthy diet, managing weight, getting regular physical activity and reducing salt and alcohol — as a key part of treatment for high blood pressure, with medication prescribed if appropriate. The guideline also suggests healthcare professionals use the American Heart Association’s PREVENT^TM (Predicting Risk of cardiovascular disease EVENTs) risk equations to calculate 10-year cardiovascular disease risk among adults (ages 30-79 without known cardiovascular disease) with high blood pressure who do not have established cardiovascular disease.

This study is one of the first detailed assessments of the 2025 guideline on high blood pressure and updated cardiovascular disease risk estimates using the PREVENT risk equations.

“Through this study, our goal was to understand how many people may qualify for treatment according to the updated recommendations in the guideline and estimate how many deaths from any cause and from cardiovascular disease may be prevented in the long term if the guideline recommendations were applied and untreated patients received care that included medication,” said study lead author Mustafa Al-Jarshawi, M.B.Ch.B., M.Sc., MRCPUK, PgCert, an academic clinical fellow in cardiology, member of the Cardiovascular Research Group at the Centre for Prognosis Research at Keele University in the United Kingdom and honorary research fellow at the Centre for Health Informatics, University of Manchester.

Researchers examined links between blood pressure treatments and rates of deaths from all causes and from cardiovascular conditions. Their analysis predicted how many lives may be saved if treatment plans outlined in the 2025 guideline were prescribed.

The data analysis found:

• 81 million U.S. adults had a diagnosis of high blood pressure. Of these, 22.8 million (28%) were guideline-eligible for therapy based on a blood pressure reading of 130/80 mm Hg or higher. 13.1 million (57%) adults were already receiving treatment for high blood pressure, while 9.7 million (43%) remained untreated. Please note: The blood pressure readings were measured during one office visit for the National Health and Nutrition Examination Survey (NHANES) collected between 2009 and 2018. The current guideline advises taking multiple readings during multiple office visits. This is an important study limitation.
• The analysis estimates that, among eligible adults, receiving blood pressure-lowering medications was associated with a 23% lower risk of dying from any cause and a 50% lower risk of dying from heart-related issues. This was compared to eligible adults who do not receive treatment.
• If treatment with medications was extended to all untreated but eligible adults, the analysis estimates approximately 200,000 all-cause deaths and 162,000 cardiovascular deaths may be prevented during the next decade.
• People eligible for high blood pressure treatment with medication who would benefit most were older, with an average age of 66, and had more health conditions, including diabetes, chronic kidney disease and other cardiovascular disease risk factors.

“What stood out most was the size of the treatment gap — more than 40% of people who were clearly eligible under the new guideline were not receiving treatment, as well as the scale of the potential benefit,” Al-Jarshawi said.

“Lifestyle modification remains the foundation of high blood pressure management. Maintaining a healthy weight, consuming a heart-healthy diet, reducing sodium intake, increasing physical activity, getting enough sleep, managing stress and limiting alcohol can meaningfully lower blood pressure and overall cardiovascular risk,” said study senior author Mamas A. Mamas, M.D, DPhil., Professor of Cardiology at Keele University and Honorary Professor of Population Health at the University of Manchester. “For many people, especially those with blood pressure under 140/90 mm Hg and no history of heart disease, stroke, chronic kidney disease or diabetes, lifestyle changes can be enough at first. If your 10-year risk of heart disease is low, with a PREVENT score under 7.5%, maintaining a healthy lifestyle can help you delay or avoid needing medication. Even if you do need medication to lower blood pressure, making lifestyle changes is important for effective treatment and overall health.”

“The 2025 guideline emphasizes a personalized approach to managing high blood pressure by considering blood pressure levels plus 10-year and 30-year overall cardiovascular disease risk. The American Heart Association’s PREVENT risk equations help to identify individuals who could benefit from treatment before a major cardiac event,” said Chair of the American Heart Association’s 2025 guideline writing committee Daniel W. Jones, M.D., FAHA.

“Controlling blood pressure is crucial for long-term health. While lifestyle changes are the foundation for better overall health, people with high blood pressure and higher risk for cardiovascular disease may also need medication to reduce the risk of serious complications from untreated high blood pressure. Healthcare professionals should assess overall cardiovascular risk and work together with their patients to combine lifestyle strategies and medication for optimal blood pressure control.” Jones, who was not involved in this study, is a past volunteer president of the American Heart Association (2007-2008) and is dean and professor emeritus of the University of Mississippi School of Medicine in Jackson, Mississippi.

Study details, background, design and limitations:

• The study had 53% male and 47% female participants, 9.4% had chronic kidney disease, 17 % had diabetes, 47% had dyslipidemia and 15% were current smokers.
• The participants self-identified as 70% white adults, 12% Black adults, 7.2% Mexican American adults, 5.8% multiracial adults and 4.2% other Hispanic adults.
• Study limitations include that researchers did not randomly assign the treatment, which means other unmeasured factors may have influenced treatment and the results. Since blood pressure was measured during a single NHANES visit and researchers examined treatment at only one point in time, the study could not capture how patients’ medication use or treatment routines may have changed over time as they worked with their healthcare teams.

Co-authors, disclosures and funding sources are listed in the manuscript.

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of release link.
• After July 29, view the manuscript online.
• American Heart Association news release: New high blood pressure guideline emphasizes prevention, early treatment to reduce CVD risk (August 2025)
• American Heart Association health information: High Blood Pressure
• American Heart Association health information: Life's Essential 8
• American Heart Association health information: Managing Stress to Control High Blood Pressure
• American Heart Association health information: Managing Blood Pressure with a Heart-Healthy Diet
• Follow American Heart Association/American Stroke Association news on X @HeartNews
• Follow news from the Journal of the American Heart Association on X @JAHA_AHA

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and AHA/ASA Expert Perspective: 214-706-1173

Karen Astle: Karen.Astle@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

• In an analysis of the Global Burden of Disease Study compared with U.S. Census data from 1990-2021, researchers found that people with congenital heart disease living in states with lower average household incomes and fewer people with health insurance had higher rates of death and disability.
• The research authors hypothesize that this difference may be due to easier access to specialized care and treatment from adult congenital heart disease cardiologists in communities with higher income levels and more residents with health insurance. Congenital heart disease requires lifelong, regular access to specialized cardiac care.
• Expanding access to expert care, particularly in under-resourced regions of the U.S., could play a profound role in improving survival and quality of life for adult congenital heart disease patients.

Embargoed until 4 a.m. CT/5 a.m. ET Wed., July 15, 2026

DALLAS, July 15, 2026 — People with congenital heart disease living in states with low household incomes and limited access to health insurance and the specialized care they need may be more likely to become disabled or die from congenital heart disease, according to new, independent research published today in the Journal of the American Heart Association, an open-access, peer-reviewed journal of the American Heart Association.

Over the past 30 years, more children with congenital heart disease have survived into adulthood due to better surgical and catheter-based treatments, as well as improvements in medical care. As these children grow into adults, they continue to require specialized cardiac care, as recommended by evidence-based American Heart Association/American College of Cardiology guidelines, to maintain lifelong health and well-being. 

This is one of the first studies to examine the connection between the health and survival of adults with congenital heart disease based on state-level data from the Global Burden of Disease Study along with income and insurance data from the U.S. Census, spanning from 1990 to 2021. Researchers examined the relationship among income levels, disability and death rates for nearly 300,000 adults with congenital heart disease aged 20 years and older.

“Understanding how social and economic factors can influence survival and outcomes is essential. Long-term outcomes and quality of life depend heavily on access to specialized, lifelong care for people with congenital heart disease,” said senior author Anitha John, M.D., Ph.D., medical director of the Washington Adult Congenital Heart Program at Children’s National in Washington, D.C. “Seeing how these factors affect patients long term allows us to better identify people at highest risk for complications. Then we can work toward improving access and reducing care gaps for people who have congenital heart disease.”

What are the key findings of the analysis?

• As median household income increased in a state, the death rate for people with congenital heart disease decreased.
• The relationship between death rate and individual income levels was stronger than the connection between death rates and the percentage of residents without insurance in each state. This suggests that simply having health insurance did not guarantee that people accessed the specialized care required for congenital heart disease. One reason for this might be differences in types of insurance coverage versus the overall presence of insurance.
• Geography and access to resources (namely, specialized cardiac care) likely play a profound role in death and disability in adults with congenital heart disease in the U.S. More research is needed to understand these connections and their impact on the health, well-being and survival of people with congenital heart disease.  

“While having health insurance does matter, it does not explain the differences we found in terms of how long people with congenital heart disease live,” John said. “This indicates that insurance alone doesn’t guarantee access to care. People may still face barriers if their insurance doesn’t cover specialized heart care or if out-of-pocket costs are too high. In many cases, specialized care may not be available in their area at all. We need to make sure everyone with congenital heart disease has the same access to specialty care throughout their lifetime, regardless of where they live.”

“We also need more trained specialists in adult congenital heart conditions. These medical experts should be more evenly distributed across the country, particularly where congenital heart disease patients live and work. Additionally, we need better systems to help patients get referred to the right care throughout their lives,” she said. “Expanding telehealth and improving insurance networks may also help to improve access.”

Michelle Gurvitz, M.D., an American Heart Association volunteer expert and chair of the writing committee for the 2025 ACC/AHA/HRS/ISACHD/SCAI joint Guideline for the Management of Adults With Congenital Heart Disease, said, “The 2025 guideline outlines when to seek expert assistance and how specialists can work together with other healthcare providers to enhance access to care. Many patients stop receiving specialized care when they transition from pediatric to adult care. Additionally, this study shows that some patients cannot see specialists because of issues such as insurance or their location.” Gurvitz, who was not involved in this study, is also a cardiologist at Boston Children’s Hospital and an associate professor of pediatrics at Harvard Medical School.

According to the American Heart Association’s 2026 Heart Disease and Stroke Statistics, congenital heart defects (heart or blood vessel issues that are present at birth) are one of the most common birth defects around the world. Congenital heart disease is the leading cause of death in the U.S. from a condition present since birth.

What are the study details, background, design and limitations?

• Researchers reviewed data on death rates and ”disability-adjusted life years“ – the number of healthy life years lost due to a condition.
• Income levels, including household income and insurance status (considered uninsured if they lacked coverage for a full year), detailed by state were secured from the U.S. Census Bureau data.
• The findings show associations among the data points such as income, but cannot be interpreted as cause and effect. The associations found in the analysis may be influenced by factors like access to care, which the researchers could not directly measure.

Co-authors, disclosures and funding sources are listed in the manuscript.

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of the release link
• After July 15, view the manuscript online.
• American Heart Association news release: ACC/AHA issue new guideline on managing congenital heart disease in adults (Dec. 2025)
• American Heart Association news release: Research grants awarded to advance understanding of no. 1 birth defect (Feb. 2025)
• American Heart Association scientific statement: Coordinated care important for children with Down syndrome and congenital heart disease  (Sept. 2024)
• American Heart Association scientific statement: Latest research redefines neurodevelopmental risks, outcomes for congenital heart disease  (Feb. 2024)
• American Heart Association news release: Adults with congenital heart disease faced higher risk of abnormal heart rhythms (April 2024)
• Follow American Heart Association/American Stroke Association news on X @HeartNews
• Follow news from the Journal of the American Heart Association on X @JAHA_AHA

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and AHA Expert Perspective: 214-706-1173

Karen Astle: Karen.Astle@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

• A lab study investigating mouse and human cardiac tissue found a potential link between gum disease (periodontitis) and a narrowing of the aortic valves (aortic valve stenosis).
• Currently, there is no medication or treatment available that can prevent or slow the progression of aortic valve stenosis.
• However, these findings suggest that treating gum disease and associated inflammation of the gums might help prevent the most common form of heart valve disease.
• Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as full manuscripts in a peer-reviewed scientific journal.

Embargoed until 8 a.m. CT/9 a.m. ET, Sunday, July 12, 2026

BOSTON, July 12, 2026 — Gum disease bacteria may spur calcium buildup in the heart’s aortic valve, leading to a common and serious heart valve disease, according to preliminary, independent research presented at the American Heart Association’s Basic Cardiovascular Sciences Scientific Sessions 2026. The meeting, in Boston, July 13-16, 2026, is one of the largest meetings globally dedicated to fundamental and translational research in cardiovascular science.

According to the American Heart Association, calcific aortic valve stenosis (CAVS) occurs when the aortic valve thickens and calcifies, restricting blood flow from the heart to the rest of the body. In early stages, there may be no symptoms; however, as the condition progresses, it can cause fatigue, chest pain, shortness of breath, fainting, heart failure and sometimes premature death. Standard treatment for severe CAVS is valve replacement surgery.

This study identifies a potential biological pathway linking chronic oral gum disease and infection to calcific aortic valve stenosis.

“There are currently no medications proven to prevent or slow the progression of CAVS. We hope our findings demonstrating the link between periodontal disease and CAVS will stimulate further research into new preventive and therapeutic approaches for this condition,” said co-lead author of the study, Chenyang Li, M.D., a Ph.D. candidate in the department of cardiology at the State Key Laboratory of Cardiovascular Disease of Fuwai Hospital’s National Center for Cardiovascular Diseases, the Chinese Academy of Medical Sciences and Peking Union Medical College all in Beijing.

The researchers focused on the bacteria called Porphyromonas gingivalis (P. gingivalis), which plays a disproportionately large role in causing gum inflammation and the destruction of gum tissue. P. gingivalis has also previously been associated with systemic inflammation and the risk of cardiovascular disease, including plaque buildup in the arteries and coronary artery disease.

The researchers measured different bacterial levels in human cardiac valve tissue removed during valve replacement surgery. They studied samples from people with CAVS and from those with other valve diseases.

“We were surprised by how much P. gingivalis was present in the calcified aortic valves,” Li said. “Although it was not one of the most abundant bacteria overall, it showed one of the largest differences between valves with CAVS and valves without CAVS. This unexpected finding led us to investigate its potential role in the development of CAVS.”

Using mice, researchers also explored how P. gingivalis might be linked to the development of CAVS. Researchers gave mice live and heat-inactivated P. gingivalis to see if the bacteria built up in the aortic valve, caused more calcification and led to symptoms of aortic stenosis. Some mice received antibiotics, while in others the IL-1β inflammatory pathway was genetically disabled or removed.

Researchers found that repeated exposure of mice to live P. gingivalis led to the accumulation of bacteria in aortic valves, increased valve calcification and symptoms of aortic stenosis, while preventive antibiotic treatment reduced these effects. In the mouse valve cells, P. gingivalis activated interleukin-1 beta (IL-1b), an inflammation-spurring protein made mainly by the body's immune cells.

In further testing, when researchers genetically deleted IL-1b in the mice, calcification and valve symptoms were significantly reduced even in the presence of P. gingivalis.

“The key message is simple: take good care of your oral health,” Li said. ”Good oral hygiene and treatment of periodontal disease are important for overall health and may also have benefits for cardiovascular health. While it is still too early to recommend specific treatments for preventing CAVS, our findings suggest that periodontal health could be an important piece of the puzzle.”

“This study adds to the growing evidence that oral health and heart health are closely connected,” said Eduardo Sanchez, M.D., M.P.H., FAHA, chief medical officer for prevention for the American Heart Association. “For many people, regular visits to the dentist are their only connection to the healthcare system. That makes dental professionals important partners in spotting health conditions, including periodontal disease early — which can lead to quicker healthcare referrals and results, better health and lives saved.”

The American Heart Association’s Healthy Smiles, Healthy Hearts™ initiative provides dental care teams with professional education highlighting the connection between oral health and heart health, a standard blood pressure screening and referral guide for patients in dental settings, and educational materials for patients to help improve both their oral and heart health.

The study has limitations because its findings have not been confirmed in people. The researchers have started a clinical study to further evaluate the link between gum disease and CAVS.

Co-authors, their disclosures and funding sources are listed in the abstract.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary independent research until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of the news release link.
• American Heart Association Scientific Statement news release: Gum disease may be linked to plaque buildup in arteries, higher risk of major CVD events (Dec. 2025)
• American Heart Association news release: New resources help dentists identify patients at risk for cardiovascular disease (Nov. 2025)
• American Heart Association news release: Regular dental flossing may lower risk of stroke from blood clots, irregular heartbeats (Jan. 2025)
• American Heart Association news release: Treating gum disease after heart rhythm ablation reduced risk of AFib recurrence (April 2024)
• American Heart Association health information: Oral Health
• Follow AHA/ASA news from the meeting on Twitter @HeartNews, #BCVS26

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BCVS is one of the largest meetings in the world dedicated to fundamental and translational research to improve heart health, a goal that the pandemic has only made more critical. Presented by the American Heart Association’s Basic Cardiovascular Sciences Council, the 2026, in-person conference attracts leading researchers in fields such as microRNAs, cardiac gene and cell therapy, cardiac development and also includes tissue engineering and iPS cells. Follow the conference on X at #BCVS26.

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and AHA Expert Perspective:

AHA Communications & Media Relations in Dallas: ahacommunications@heart.org

Karen Astle: Karen.astle@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

• A new, global analysis finds atrial fibrillation/flutter and breast cancer rates may follow similar risk factors and patterns across regions, particularly among women ages 55 and older.
• In about 40% of the 204 countries and regions evaluated, the rates of both breast cancer and atrial fibrillation/flutter were similar in older women, with the highest-risk zones in Western nations.
• Researchers identified modifiable risk factors, particularly alcohol use and smoking, which could substantially reduce the impact of both conditions.

Embargoed until 4 a.m. CT/5 a.m. ET Wed., July 8, 2026

DALLAS, July 8, 2026 — Alcohol use and smoking were linked to breast cancer and atrial fibrillation/flutter in women ages 55 years and older in multiple regions of the world, according to new, independent research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

The number of breast cancer and atrial fibrillation, also called AFib or irregular heartbeat, cases represent a growing global health burden, according to study authors. Why these conditions have similar rates in specific parts of the world is not well understood.

“Identifying shared risk factors is important for developing interventions that support optimal health, such as smoking cessation and alcohol restriction, which could potentially reduce the global incidence of breast cancer and atrial fibrillation/flutter substantially,” said study co-author Shu Wang, M.D., Ph.D., director of the Breast Disease Center at Peking University People’s Hospital in Beijing.

In this analysis, researchers investigated the rates of breast cancer and atrial fibrillation/flutter in women ages 55 and older in 204 countries and regions worldwide. They evaluated women’s exposure to 58 shared and distinct health, behavioral and lifestyle risk factors, including smoking, alcohol use, body mass index and physical activity.

What are the results of the analysis?

• Researchers noted 80 countries or territories of 202 (39%) had similar rates of both breast cancer and atrial fibrillation/flutter. About 65 countries (32%) were noted to be breast cancer-dominant, and 57 countries (28%) were atrial fibrillation/flutter-dominant.
• After accounting for multiple variables, smoking and alcohol use were linked to higher rates of both breast cancer and atrial fibrillation/flutter.
• An additional analysis found that reducing alcohol intake and smoking could potentially reduce the risk of breast cancer by about 15% and the risk of atrial fibrillation/flutter by about 12% worldwide.
• Alcohol use was found to be a significant contributor to breast cancer (9.27% of cases) and atrial fibrillation/flutter (7.57% of cases).
• High-income and developed nations, such as the U.S., Canada, Australia, New Zealand and much of Europe, exhibited elevated rates of both breast cancer and AFib, aligning with previous research linking Western diets and sedentary lifestyles to increased risks of cardiovascular and metabolic conditions and cancer.

“One of the most surprising aspects of our findings was how common both breast cancer and atrial fibrillation/flutter diagnoses were among women ages 55 and older in high-income regions, which highlights the influence of lifestyle,” Wang said. “This is the first study combining global data with machine learning to show the relationship between the conditions, their location across the world and the shared risk factors of these two conditions.”

The study results revealed high-risk zones were mostly in Western countries where there was greater exposure to smoking and alcohol use compared to Eastern regions, which can be attributed to differences in lifestyle, as well as social and community differences. Additionally, Western nations were more likely to have exposure to more types of risk factors, such as higher body mass index and more sedentary lifestyles, due to industrialization and transitions to more Western diets.

"Nowadays, more and more people are paying attention to the link between cancer and cardiovascular health," said study co-authors Zeye Liu, M.D., Ph.D., a surgeon in the department of cardiac surgery of Peking University People’s Hospital, and Yi Shi, M.D., Ph.D., the director of the department of cardiac surgery at Peking University People’s Hospital in Beijing. "Breast cancer and atrial fibrillation/flutter rise together across many regions of the world and share the same modifiable risk factors. From a cardiovascular perspective, this means that reducing smoking and alcohol use could help lower the risk of both conditions at the same time."

“Many of the same modifiable factors,­­ including smoking, alcohol use, poor diet, physical inactivity and obesity, ­­contribute to both breast cancer and cardiovascular disease including atrial fibrillation/flutter, as confirmed by this study’s findings,” said Laxmi Mehta, M.D., FAHA, chair of the American Heart Association’s Council on Clinical Cardiology. “This overlap underscores the importance of integrated lifestyle strategies to reduce risk of cardiovascular disease and cancer. The American Heart Association’s Life’s Essential 8 highlights key behaviors and health factors essential for prevention and reducing risk.” Mehta, who was not involved in the study, is also the director of preventative cardiology & women's cardiovascular health, the Sarah Ross Soter Endowed Chair in Women’s Cardiovascular Health Research and professor of internal medicine at The Ohio State University Wexner Medical Center in Columbus, Ohio.

The American Heart Association has previously identified that breast cancer and cardiovascular disease share some common risk factors that may be prevented through modifications like a healthy diet, physical activity, abstinence from tobacco and low alcohol intake, according to a 2018 Scientific Statement.

The newly developed spatial risk maps as part of this study can help guide region-specific prevention strategies and provide precise targets for future research. According to the researchers, the next step will be to incorporate long-term research, genetic and metabolic data into the analysis. Additionally, expanding the study to include socioeconomic factors will help develop individualized and region-specific prevention strategies.

What are the details, background, design and limitations of the study?

• Researchers evaluated data from the Global Burden of Disease 2021 database to understand the incidence of breast cancer and atrial fibrillation/flutter, identifying the shared and distinct risk factors of both conditions.
• The analysis focused on women 55 years of age and older in 204 countries and territories worldwide.
• This is the first study to utilize machine learning to investigate the patterns across the globe, the relationship to breast cancer and atrial fibrillation/flutter co-occurring and the underlying region-specific risk drivers. Researchers created worldwide maps for healthcare professionals and policymakers to address prevention strategies customized to each region.
• The analysis examined exposure to 58 risk factors that were both shared between conditions and distinct, that spanned environmental, lifestyle and metabolic factors, with 2 key risk factors primarily contributing to both conditions.
• Study limitations include that it reviewed a large global database with broad healthcare information by country, which lacks data at the individual level, and the findings cannot prove any direct cause and effect. In addition, the country-level data may be limited based on the country’s resources to collect information, potential differences in screening and possibly inconsistent parameters for the conditions.

Co-authors, disclosures and funding sources are listed in the manuscript.

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Additional Resources:

• Multimedia is available on the right column of release link.
• After July 8, 2026, view the manuscript online.
• American Heart Association news release: 6 in 10 U.S. women projected to have at least one type of cardiovascular disease by 2050 (Feb. 2026)
• American Heart Association Scientific Statement: Alcohol Use and Cardiovascular Disease (July 2025)
• American Heart Association health information: What is Atrial Fibrillation?
• American Heart Association health initiative: Go Red for Women
• Follow American Heart Association/American Stroke Association news on X @HeartNews
• Follow news from the Journal of the American Heart Association on X @JAHA_AHA

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