Intensive blood pressure target fails to cut events in type 2 diabetes; CMS finalizes 2027 fee schedule; hormone therapy shows no cardiovascular harm

• Research Nov 7, 2026
  Systolic target below 120 mm Hg does not significantly cut cardiovascular events in OPTIMAL-DIABETES trial of 9,476 adults
  In the trial at 33 sites in Brazil, adults 50 and older with type 2 diabetes and elevated systolic blood pressure were treated to below 120 mm Hg or below 140 mm Hg. Major cardiovascular events occurred in 6.0% of the intensive group and 6.7% of the standard group, and the results were not statistically significant, according to the American Heart Association (AHA). Kidney events, mainly declines in function, occurred in 5.7% versus 3.7%, while end-stage renal disease was similar. The trial was presented Nov. 7 at the AHA Scientific Sessions and published in the New England Journal of Medicine.
  Source: American Heart Association
• Payment Nov 4, 2026
  CMS final 2027 physician fee schedule lowers conversion factor and requires an initiating visit for remote monitoring
  The Centers for Medicare & Medicaid Services (CMS) finalized the calendar year 2027 Medicare physician fee schedule Nov. 4, with a nonqualifying alternative payment model conversion factor of $32.63, a projected decrease of 2.31%. Practitioners reporting remote physiologic or remote therapeutic monitoring must furnish a separately reportable initiating visit, and CMS delayed to Jan. 1, 2029, a requirement limiting payment to services performed by practice-employed clinical staff. The rule also recognizes diabetes self-management training and medical nutrition therapy as stand-alone visits under the rural health clinic benefit.
  Source: CMS
• Research Nov 2, 2026
  37% of patients stay euthyroid after stopping thyroid hormone, 41% with initial subclinical hypothyroidism, meta-analysis finds
  An updated systematic review and meta-analysis in Thyroid, published online Nov. 2, included 23 studies, 22 of them observational. In 21 studies with 2,020 participants, 37% (CI 26% to 48%) remained euthyroid after thyroid hormone was discontinued: 41% (CI 21% to 65%) of those with initial subclinical hypothyroidism and 11% (CI 2% to 38%) of those with initial overt hypothyroidism. In 11 studies, 60% restarted therapy. The authors said the findings support considering deprescribing in selected patients, particularly those without clear indications for treatment initiation, with close biochemical monitoring.
  Sources: Thyroid, Thyroid (PubMed)
• Research Nov 6, 2026
  Hormone therapy started at ages 45 to 59 shows no rise in cardiovascular events in 52,330-woman cohort at AHA
  In a retrospective matched cohort followed for a mean of 12 years, women who started hormone therapy had atherosclerotic cardiovascular disease rates of 7.82 per 1,000 person-years versus 7.99 for controls (adjusted hazard ratio 0.98; 95% CI 0.93 to 1.04), with venous thromboembolism at 0.56 per 1,000 person-years in both groups, Healio reported from the American Heart Association Scientific Sessions. The abstract has not been peer reviewed. The investigator said the observational study cannot prove causation and that hormone therapy should treat menopausal symptoms, not serve as cardiovascular prevention.
  Source: Healio

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