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Women As One Award winner leads the charge in VESALIUS-CV results

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By Women As One

When the VESALIUS-CV trial was conceived in 2018, it began a multi-year effort to answer a critical question in preventive cardiology.

Could evolocumab, marketed as Repatha, a human monoclonal antibody that inhibits PCSK9, reduce major cardiovascular events in patients at high risk but without a prior myocardial infarction or stroke?

The scientific stakes were high. For one of its leaders, Dr Erin Bohula, the journey was also deeply meaningful.

Dr Bohula is a cardiologist at Brigham and Women’s Hospital in Boston and an assistant professor at Harvard Medical School.

She joined the trial early in its development and ultimately became a co-principal investigator.

“I started as an investigator and moved up to become co-PI,” she shared in an exclusive Women As One interview at AHA 2025, shortly after presenting the trial’s findings during the Late-Breaking Science session.

“It has been a journey of growth, and to now be part of something that will change practice is incredibly exciting.”

The science and the stage

VESALIUS-CV, supported by Amgen, is one of the largest primary-prevention studies of a PCSK9 inhibitor conducted to date.

The trial enrolled patients with significant cardiovascular risk profiles, including extensive atherosclerotic burden or high-risk comorbidities, but no prior major atherosclerotic event.

Its design sought to determine whether achieving very low LDL levels with evolocumab could meaningfully reduce cardiovascular outcomes long before the first heart attack or stroke occurs.

The trial results delivered an important message.

Earlier and more intensive lipid lowering has the potential to shift the trajectory of disease, not only in those recovering from events but in those who have never had one.

Its scientific impact is matched by the significance of its leadership.

Having a woman guiding a trial of this scale reinforces a growing truth within cardiovascular research.

Women are not only participants in clinical studies. They are shaping the scientific agenda.

As Dr Bohula described the experience of preparing for AHA 2025, her emotion was evident.

“We are very happy that everyone’s effort has paid off to deliver a strong result. What is most rewarding is knowing this data will help patients.”

Why representation in leadership matters

The success of VESALIUS-CV contributes to a larger cultural and clinical reality. Leadership diversity strengthens clinical research.

“Historically, women have been underrepresented in both cardiology and clinical trials,” she noted.

“I truly believe one way to change that is to ensure the leadership team reflects the populations we want to enroll.”

Diverse leadership improves trust, broadens recruitment, and ensures study findings are more generalizable.

“When women see women leading trials, they are more likely to see themselves participating.

“Representation opens doors.”

Mentorship as a catalyst

When asked what advice she would offer early-career women in cardiology, Dr Bohula did not hesitate. Mentorship.

“That has really been the key for me. I have had mentors who appreciated my value and gave me platforms to grow. That is what made the difference.”

She emphasised the importance of both formal mentorship programs and informal supporters who advocate for women behind the scenes.

“Find the people who believe in you. That is what gets you from the back of the room to the podium.”

The role of industry and advocacy

Organisations such as Women As One and intentional efforts from industry sponsors are helping shift the landscape for women in cardiovascular research.

“Women As One gave me an award years ago, and with it came support to attend a major meeting. That one opportunity connected me with people in the field and gave me the chance to be seen and heard.”

She added that industry sponsors have meaningful influence over who receives leadership opportunities.

“Industry has a huge opportunity to be intentional about who they invite into leadership roles, who sits on advisory boards, and who they elevate.

“And I have seen that change happening.”

Why this work matters

VESALIUS-CV is a milestone in preventive cardiology.

It demonstrates the long-term benefits of aggressive LDL lowering in high-risk individuals before events occur.

It also underscores that who leads the science matters just as much as the data itself.

At Women As One, we remain committed to ensuring that more women across all stages of their careers have the mentorship, opportunities, and visibility they need to shape the future of cardiovascular research.

When women lead, the entire field moves forward.

Learn more about Women As One at womenasone.org

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Elation Health acquires EHR startup Aster

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Elation Health has acquired Aster, a women’s health EHR startup created by sisters Fifi Kara and Dr Lailah Kara-Newton.

The deal, announced on 3 June 2026, will see Aster’s team join Elation Health as the company expands development of what it describes as the first agentic operating system for primary care.

An EHR, or electronic health record, is a digital system used by healthcare providers to store and manage patient information.

Aster was founded by Kara and Kara-Newton as an AI-native EHR platform for women’s health providers.

Elation Health said the acquisition would allow Aster to learn from its expertise in AI agents and support development of its agentic operating system for primary care.

Kyna Fong, co-founder and chief executive of Elation Health, said: “The Aster team impressed us with their vision and creative inventions to support independent practices.”

Fong said Elation, like Aster, was founded by siblings who wanted to change the healthcare system.

She added: “That shared north star means they understand what we’re building and why it matters. It was clear right away they would significantly add to our capabilities.”

Kara has spent 10 years creating consumer and business-to-business products across the UK, Europe and the US, and recently supported Meta’s Health & Fitness team, according to Aster’s website.

Kara-Newton previously worked as a hospital doctor in the NHS across medical and surgical specialties, including breast surgery, general surgery, emergency medicine and obstetrics and gynaecology.

Aster launched in 2023 after raising US$2.8m from Zeal Capital Partners, Cornerstone Ventures, Octopus Ventures and others.

Kara, Kara-Newton and Aster’s chief technology officer, Nacho Vazquez, will all join Elation.

Kara said: “From the moment we met Kyna Fong, Ashley Rogers, and the Elation leadership team, it was clear we were aligned on what matters most: that clinicians deserve truly incredible software that brings joy back to their practice. Together, we can now bring that vision to millions of primary care patients across the country.”

The sisters said their work was shaped by Kara-Newton’s first pregnancy, when undiagnosed pre-eclampsia led to an emergency caesarean section and neonatal intensive care admission for her son.

The founders said they wanted to build technology that could help prevent similar outcomes for other women.

The acquisition comes amid continued concern over maternal health inequalities in the US.

In the US, Black maternal mortality remains alarmingly high, with rates nearly double those of white women, and experts point to unequal access to care, implicit bias and fragmented approaches to care.

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Mental health

Pilates may improve heart and metabolic health in sedentary women, study finds

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A four-week Pilates programme may improve heart, metabolic and stress measures in previously sedentary women, a small study suggests.

Pilates is a mind-body form of exercise that has been linked to better fitness, balance, posture, muscular endurance, mental wellbeing and quality of life in different groups.

Built around breathing, concentration, control, precision, centring and flow, Pilates is already used in physiotherapy, rehabilitation and preventive health. The new study looked at whether a structured four-week programme could affect cardiovascular, metabolic, body and stress-related measures in sedentary adult women.

The longitudinal study included 30 sedentary women split into two age groups, 30 to 40 and 50 to 60.

All participants completed a standardised, supervised Pilates programme lasting four weeks, with three sessions a week lasting 50 to 60 minutes.

Researchers measured resting heart rate, systolic and diastolic blood pressure, body mass index, abdominal circumference, fasting blood glucose and serum cortisol at the start and end of the programme.

Systolic and diastolic blood pressure are the top and bottom readings in a blood pressure test. Cortisol is a hormone linked to the body’s stress response.

The four-week Pilates programme was linked to improvements in cardiovascular, metabolic, body and neuroendocrine measures, although not every change reached statistical significance within each age group.

In the younger group, significant reductions were seen in heart rate, blood pressure, body mass index and fasting blood glucose after the intervention.

The reduction in blood pressure after the programme was significantly greater in the older group than in the younger group.

Older participants also showed a greater reduction in glucose and cortisol levels after the intervention than younger participants.

Analysis also found significant links between cardiovascular, metabolic and neuroendocrine changes.

In the younger group, this was particularly seen between heart rate and blood pressure responses.

In the older group, it was particularly seen between changes in body mass index and fasting glucose.

The findings suggest Pilates could be a useful multidimensional exercise approach for cardiometabolic health and stress regulation in previously sedentary women.

The researchers said the larger reduction in blood pressure seen in the older group may reflect a higher cardiometabolic burden at the start, leaving more room for improvement after the programme.

The greater reduction in fasting glucose and cortisol in older participants may similarly suggest that people with higher baseline metabolic and neuroendocrine dysfunction could benefit more from structured exercise such as Pilates.

Although Pilates is known to improve body composition through energy use, neuromuscular activation and support for healthier habits, the researchers said the fall in body mass index over four weeks is unlikely to be explained by Pilates alone.

They noted that participants were also told to avoid alcohol, sugar-containing products and sugar-sweetened drinks during the intervention, which may have contributed to the change.

In the younger group, the link between heart rate and blood pressure suggested coordinated cardiovascular responses after Pilates.

The researchers also found that cortisol appeared to be linked to blood pressure and body mass index, suggesting stress-related changes may be tied to cardiovascular and body regulation after the intervention.

In the older group, the link between body mass index and fasting glucose highlighted the relationship between body fat and metabolic regulation.

A positive link between blood pressure and body mass index in this group also suggested that improvements in vascular regulation may be associated with reductions in body mass.

Overall, the findings suggest Pilates-related physiological changes may involve interconnected cardiovascular, body, metabolic and neuroendocrine mechanisms, with different response patterns by age.

The study has important limits. It did not include a non-exercise control group, so it cannot prove Pilates directly caused the changes.

The sample size was also small, which limits how far the findings can be applied more widely.

The authors also noted that cortisol was measured using a single fasting morning sample, which limits conclusions about broader hypothalamic-pituitary-adrenal axis regulation, the system involved in the body’s stress response.

They said larger studies with longer follow-up will be needed to confirm whether Pilates causes these physiological changes over time.

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Fertility

AMH testing: the most misunderstood number in fertility – what it can and can’t tell you

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Article produced in association with Spital Clinic

AMH has become one of the most-requested blood tests in private women’s health. The number it gives back is useful, but only when it is read in context.

AMH testing in the UK has gone mainstream over the past few years. Home-testing kits sell it as a snapshot of “your fertility”.

Private clinics include it in screening packages. On social media, individual AMH results are now routinely treated as a verdict on whether a woman will be able to have children.

That reading isn’t accurate. Anti-Müllerian Hormone (AMH) does carry useful information, but only inside a wider clinical picture.

Looked at on its own, it produces a lot of unnecessary anxiety, and often hides the questions that matter more.

What AMH measures

AMH is a hormone produced by the small follicles in the ovaries, the ones that haven’t yet been recruited for ovulation. Because these follicles are relatively stable across the menstrual cycle, the test can be done on any day, without needing to be timed to a period.

A higher AMH level tends to indicate a larger pool of these follicles. A lower level suggests the pool is smaller. That, broadly, is what the result shows.

The HFEA, the UK’s independent regulator of fertility treatment, describes AMH as an indicator of ovarian reserve, while making clear that fertility test results of this kind “are not guaranteed” as a predictor of fertility outcomes.

Put simply: AMH is a count of what is there. It says nothing about how well the body will use it, and it cannot predict if or when conception will happen.

Where AMH fits in a modern fertility assessment

In current UK private practice, AMH is rarely tested in isolation. A meaningful fertility assessment will pair it with a fuller hormone profile (FSH, LH, oestradiol, prolactin and thyroid function), along with markers such as Day 21 progesterone, vitamin D and rubella immunity where relevant.

This is the structure used in a trying-to-conceive screening, and there is a reason for it: each of these tests answers a different question that AMH on its own cannot.

It is this combination, not the AMH number on its own, that gives a clinician enough information to say anything meaningful about an individual’s reproductive picture.

Misconception 1: “A low AMH means natural pregnancy isn’t possible”

This is the misconception that causes the most distress, and it is consistently wrong.

Several large prospective studies of women in their 30s and 40s trying to conceive naturally have found that women whose biomarkers, including AMH, pointed to a diminished ovarian reserve were no less likely to conceive within twelve cycles than women with reassuring results.

That is why neither UK regulators nor national guidance treat AMH as a test that can predict natural fertility in women who have no known infertility issue.

The reason is simple. Natural conception only requires one good egg, released in a normal cycle, in the right window.

AMH doesn’t measure egg quality, and it doesn’t reveal whether ovulation is happening. A woman with low AMH may still ovulate every month with high-quality eggs.

A woman with high AMH (often the pattern seen in polycystic ovary syndrome) may not be ovulating regularly at all.

The NHS emphasises that age is the strongest single predictor of natural fertility. A 35-year-old with a low AMH and regular cycles is, on average, more likely to conceive naturally than a 40-year-old with a normal AMH and irregular ones.

If AMH comes back low for someone who is trying to conceive, the more useful question isn’t whether pregnancy is still possible (the answer is almost always yes), but whether there is reason to investigate the wider picture now rather than waiting twelve months.

Misconception 2: “A normal AMH means everything is fine”

The opposite assumption is just as risky.

AMH tells you about egg quantity. It does not tell you about:

  • Egg quality, which is closely tied to age
  • Whether ovulation is happening regularly
  • Whether the fallopian tubes are open
  • Whether there are structural issues such as fibroids, polyps, ovarian cysts or endometriosis
  • Sperm parameters in a male partner
  • Whether implantation will succeed

A reassuringly normal AMH at 38 still sits alongside age-related changes in egg quality. A slightly lower-than-average AMH at 28 may carry no real-world implications at all.

That is why no UK clinical body recommends AMH as a routine screening test for healthy women who have no fertility concerns. NICE’s fertility guideline, NG73, treats AMH as one component of a broader investigation, not as a verdict in itself.

Imaging is the natural counterpart to the blood test. A transvaginal pelvic ultrasound directly visualises the small follicles that produce AMH, the antral follicle count. It also picks up structural findings a blood test will never reveal, including ovarian cysts, fibroids, polycystic ovarian morphology, and abnormalities in the uterine cavity. A full ovarian reserve assessment normally includes both.

Where the AMH number actually matters

There are three settings in which AMH carries real, decision-relevant information.

Before IVF or egg freezing. AMH is one of the better predictors of how the ovaries are likely to respond to stimulation medication.

A higher AMH usually predicts more eggs collected per cycle, and a very low AMH may shape decisions about protocol or whether to bank cycles before treatment.

During a fertility investigation. If a couple has been trying for twelve months, or six months if the woman is over 35, AMH becomes part of a wider assessment that should also include ovarian ultrasound, a fuller hormone profile, semen analysis and an assessment of tubal patency.

As context for women planning ahead. Women who want to understand their reproductive options before they are ready to conceive (for example, ahead of a decision about egg freezing) can find AMH informative, provided it is interpreted alongside age, antral follicle count, and other markers, by a clinician who can place the number in context.

Reading the number properly

For anyone who has had an AMH test, three things make the result more useful:

  1. Pair it with age. A “normal” AMH at 25 means something very different from the same number at 38. Age is doing more work in the equation than the AMH value itself.
  2. Pair it with imaging. Ultrasound shows what is actually in the ovaries today, rather than relying on a single biochemical marker.
  3. Read it with a clinician. A number on a screen, with no context, no follow-up and no plan, is the worst way to use a test that, properly interpreted, can be very informative.

AMH is a useful tool. It just isn’t the headline it has often been turned into.

Disclaimer

This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment. Clinical guidance referenced reflects published HFEA, NHS and NICE information available as at May 2026. Individual circumstances vary; readers are advised to consult a qualified healthcare professional before acting on any information in this article. This piece was produced in association with Spital Clinic, which provided background clinical information for editorial purposes. Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.

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