John Mandrola

Louisville

Writer and Podcaster at Sensible Medicine Newsletter

Heart rhythm doc, writer for @Medscape, host of This Week in Cardiology podcast, editor of Sensible Medicine. The more you see, the harder medicine gets.

Articles

Exercise is Great but It’s Not a Cancer Drug

5 days ago | sensible-med.com | John Mandrola

The CHALLENGE trial tested cancer outcomes from a structured exercise program. NEJM published the study, more than a 100 news sites covered it, and hundreds reposted it on social media. So you know the results were positive. Hugely positive, in fact. And who, I ask, does not love the story that exercise vanquishes cancer? Sensible Medicine is a place to get the real story. This is a classic case when you have to let go of your love of great stories to see the details.
May 30 2025 This Week in Cardiology

1 week ago | medscape.com | John Mandrola

Please note that the text below is not a full transcript and has not been copyedited. For more insight and commentary on these stories, subscribe to the This Week in Cardiology podcast, download the Medscape app or subscribe on Apple Podcasts, Spotify, or your preferred podcast provider. This podcast is intended for healthcare professionals only.
No, KETO-CTA Study Did Not Upend Causal Evidence on ASCVD

1 week ago | medscape.com | John Mandrola

Few argue that eating too many carbohydrates is a key cause of the obesity crisis. The ideal solution would be to moderate carbohydrate intake to the amounts consumed by Sicilians. But some people have gone to the extreme of eliminating nearly all carbs. One result of eating only fat and protein is ketosis. Another may be a rise in atherogenic lipid particles, such as low-density lipoprotein cholesterol (LDL-C).
How Not to Get Fooled by the Medical Literature - Part 3 : Bad Observational Epi & a Flawed Randomized Trial

1 week ago | sensible-med.com | Vinay Prasad |Adam Cifu |John Mandrola

The most common question we get asked is: is there a course on how to become better at critically reading medical research. Here it is!This is the third of 9 videos that we recorded as part of a course on clinical appraisal, and there will be many more to come. This and future videos will be made available as a thank you to paid subscribers.
Merch...

1 week ago | sensible-med.com | Adam Cifu |John Mandrola

Yup, it’s a little goofy but we have Merch. Just t-shirts but they’re actually kind of cool. You can see VP modeling one in this video. The link to the shop is here.
May 23 2025 This Week in Cardiology

2 weeks ago | medscape.com | John Mandrola

Please note that the text below is not a full transcript and has not been copyedited. For more insight and commentary on these stories, subscribe to the This Week in Cardiology podcast, download the Medscape app or subscribe on Apple Podcasts, Spotify, or your preferred podcast provider. This podcast is intended for healthcare professionals only.
FDA Town Hall Video with Prasad and Makary

2 weeks ago | sensible-med.com | John Mandrola

Do read Adam Cifu’s column this morning on the new leadership at FDA. Yesterday’s NEJM article by Prasad and Makary was excellent. It’s rational, calm, and their call for evidence is welcome. Always remember: established makers of drugs and devices overflow with funds. They can and will fund trials—if required. I attach the Town Hall video posted yesterday. It’s excellent. As always, when Vinay lectures, it is a tour de force of critical appraisal.
The Lessons of Day vs Night Administration of BP Medications

2 weeks ago | sensible-med.com | John Mandrola

The BedMed trial, published in JAMA this month, looks like a regular randomized controlled trial (RCT). One group of patients with high blood pressure took their meds in the morning, the other took the same meds at night. Major adverse cardiac events (MACE) were not different. The Canadian investigators randomized more than 3500 patients and followed them for nearly 5 years. I don’t know how much money and time were spent on the trial, but it was a lot.
Ask Us Anything

3 weeks ago | sensible-med.com | Vinay Prasad |Adam Cifu |John Mandrola

This is a long one! 83 minutes. This is the second podcast in which we answer questions from a our “ask us anything” post. We recorded this one before our most recent podcast — kind of like Abbey Road and Let it Be — so we were still graced by Vinay’s presence. In fact, we recorded it in his studio. We still have about a half dozen questions to answer; we will cover those on an upcoming podcast. Enjoy.
May 16 2025 This Week in Cardiology

3 weeks ago | medscape.com | John Mandrola

Please note that the text below is not a full transcript and has not been copyedited. For more insight and commentary on these stories, subscribe to the This Week in Cardiology podcast, download the Medscape app or subscribe on Apple Podcasts, Spotify, or your preferred podcast provider. This podcast is intended for healthcare professionals only.