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Javier E

Jonathan Haidt on the 'National Crisis' of Gen Z - WSJ - 0 views

www.wsj.com/...lity-gap-childhood-11672401345

social media psychology research education crisis culture Gen Z mental health defense creativity

shared by Javier E on 03 Jan 23 - No Cached
  • he has in mind the younger cohort, Generation Z, usually defined as those born between 1997 and 2012. “When you look at Americans born after 1995,” Mr. Haidt says, “what you find is that they have extraordinarily high rates of anxiety, depression, self-harm, suicide and fragility.” There has “never been a generation this depressed, anxious and fragile.”
  • He attributes this to the combination of social media and a culture that emphasizes victimhood
  • Social media is Mr. Haidt’s present obsession. He’s working on two books that address its harmful impact on American society: “Kids in Space: Why Teen Mental Health Is Collapsing” and “Life After Babel: Adapting to a World We Can No Longer Share.
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  • What happened in 2012, when the oldest Gen-Z babies were in their middle teens? That was the year Facebook acquired Instagram and young people flocked to the latter site. It was also “the beginning of the selfie era.”
  • Mr. Haidt’s research, confirmed by that of others, shows that depression rates started to rise “all of a sudden” around 2013, “especially for teen girls,” but “it’s only Gen Z, not the older generations.” If you’d stopped collecting data in 2011, he says, you’d see little change from previous years. “By 2015 it’s an epidemic.” (His data are available in an open-source document.)
  • Mr. Haidt imagines “literally launching our children into outer space” and letting their bodies grow there: “They would come out deformed and broken. Their limbs wouldn’t be right. You can’t physically grow up in outer space. Human bodies can’t do that.” Yet “we basically do that to them socially. We launched them into outer space around the year 2012,” he says, “and then we expect that they will grow up normally without having normal human experiences.”
  • He calls this phenomenon “compare and despair” and says: “It seems social because you’re communicating with people. But it’s performative. You don’t actually get social relationships. You get weak, fake social links.”
  • That meant the first social-media generation was one of “weakened kids” who “hadn’t practiced the skills of adulthood in a low-stakes environment” with other children. They were deprived of “the normal toughening, the normal strengthening, the normal anti-fragility.
  • Now, their childhood “is largely just through the phone. They no longer even hang out together.” Teenagers even drive less than earlier generations did.
  • Mr. Haidt especially worries about girls. By 2020 more than 25% of female teenagers had “a major depression.” The comparable number for boys was just under 9%.
  • The comparable numbers for millennials at the same age registered at half the Gen-Z rate: about 13% for girls and 5% for boys. “Kids are on their devices all the time,”
  • Most girls, by contrast, are drawn to “visual platforms,” Instagram and TikTok in particular. “Those are about display and performance. You post your perfect life, and then you flip through the photos of other girls who have a more perfect life, and you feel depressed.
  • Mr. Haidt says he has no antipathy toward the young, and he calls millennials “amazing.”
  • “Social media is incompatible with liberal democracy because it has moved conversation, and interaction, into the center of the Colosseum. We’re not there to talk to each other. We’re there to perform” before spectators who “want blood.”
  • To illustrate his point about Gen Z, Mr. Haidt challenges people to name young people today who are “really changing the world, who are doing big things that have an impact beyond their closed ecosystem.”
  • He can think of only two, neither of them American: Greta Thunberg, 19, the Swedish climate militant, and Malala Yousafzai, 25, the Pakistani advocate for female education
  • I’m predicting that they will be less effective, less impactful, than previous generations.” Why? “You should always keep your eye on whether people are in ‘discover mode’ or ‘defend mode.’ ” In the former mode, you seize opportunities to be creative. In the latter, “you’re not creative, you’re not future-thinking, you’re focused on threats in the present.”
  • University students who matriculated starting in 2014 or so have arrived on campus in defend mode: “Here they are in the safest, most welcoming, most inclusive, most antiracist places on the planet, but many of them were acting like they were entering some sort of dystopian, threatening, immoral world.”
  • 56% of liberal women 18 to 29 responded affirmatively to the question: Has a doctor or other healthcare provider ever told you that you have a mental health condition? “Some of that,” Mr. Haidt says, “has to be just self-presentational,” meaning imagined.
  • This new ideology . . . valorizes victimhood. And if your sub-community motivates you to say you have an anxiety disorder, how is this going to affect you for the rest of your life?” He answers his own question: “You’re not going to take chances, you’re going to ask for accommodations, you’re going to play it safe, you’re not going to swing for the fences, you’re not going to start your own company.”
  • Whereas millennial women are doing well, “Gen-Z women, because they’re so anxious, are going to be less successful than Gen-Z men—and that’s saying a lot, because Gen-Z men are messed up, too.”
  • The problem, he says, is distinct to the U.S. and other English-speaking developed countries: “You don’t find it as much in Europe, and hardly at all in Asia.” Ideas that are “nurtured around American issues of race and gender spread instantly to the U.K. and Canada. But they don’t necessarily spread to France and Germany, China and Japan.”
  • something I hear from a lot of managers, that it’s very difficult to supervise their Gen-Z employees, that it’s very difficult to give them feedback.” That makes it hard for them to advance professionally by learning to do their jobs better.
  • “this could severely damage American capitalism.” When managers are “afraid to speak up honestly because they’ll be shamed on Twitter or Slack, then that organization becomes stupid.” Mr. Haidt says he’s “seen a lot of this, beginning in American universities in 2015. They all got stupid in the same way. They all implemented policies that backfire.”
  • Mr. Haidt, who describes himself as “a classical liberal like John Stuart Mill,” also laments the impact of social media on political discourse
  • Social media and selfies hit a generation that had led an overprotected childhood, in which the age at which children were allowed outside on their own by parents had risen from the norm of previous generations, 7 or 8, to between 10 and 12.
  • Is there a solution? “I’d raise the age of Internet adulthood to 16,” he says—“and enforce it.”
  • By contrast, “life went onto phone-based apps 10 years ago, and the protections we have for children are zero, absolutely zero.” The damage to Generation Z from social media “so vastly exceeds the damage from Covid that we’re going to have to act.”
  • Gen Z, he says, “is not in denial. They recognize that this app-based life is really bad for them.” He reports that they wish they had childhoods more like those of their parents, in which they could play outside and have adventur
Javier E

Plagues of the Body and Plagues of the Mind - The Bulwark - 0 views

www.thebulwark.com/lagues-of-the-mind-orhan-pamuk

turkey literature authoritarian nationalism history culture politics narrative postmodernism myth

shared by Javier E on 04 Jan 23 - No Cached
  • Though Pamuk is playful where Tolstoy is strident, behind all the beautiful descriptions of Mingherian flowers and mountains of rose-colored marble, he is undeniably making an argument. If Tolstoy’s great theme in War and Peace is the powerlessness of humanity to remake the world through acts of will alone, Pamuk’s is the role of accident in shaping history and its writing. Tolstoy’s enemy was Napoleon, the embodiment of modernity’s hubris. Pamuk’s is the historiographic crimes of nationalism.
  • This is a bold thing to say in Turkey, a country that has gone to great lengths to promulgate a heroic and highly sanitized account of its founding. It is even bolder when one notes that Mingheria’s struggle for independence, and its troubled post-independence history, function very well as an allegory of Turkey itself. Major Kâmil is, like Mustafa Kemal Atatürk, an Ottoman war hero and secularist who tries to found a country divided by ethnic and religious rivalries on a conception of linguistic and ethnic nationalism.
  • Mingheria becomes independent not only through the great accident of the plague, but also through thousands of tiny accidents at crucial moments. The problem with nations, the book suggests, is that they take all these small instances in which things could just as well have been otherwise and cast them as a monumental inevitability. Once a nation-state comes into existence, the machinery of education and civic ritual and the instruments of propaganda and state violence are wielded to turn chance into fate. And that fate becomes inexorable.
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  • Like all of these books, it is about the power and untrustworthiness of written texts—history texts in particular. These various strands don’t always cohere. The question of who killed Bonkowski Pasha is part of the main story of the novel, and yet it disappears for chapters at a time. Perhaps more seriously, the postmodern elements sometimes sit uncomfortably with the torrents of historical and sensory detail
Javier E

The Class Politics of Instagram Face - Tablet Magazine - 0 views

www.tabletmag.com/...class-politics-instagram-face

face class be beauty cosmetics surgery age women

shared by Javier E on 10 Apr 23 - No Cached
  • by approaching universality, Instagram Face actually secured its role as an instrument of class distinction—a mark of a certain kind of woman. The women who don’t mind looking like others, or the conspicuousness of the work they’ve had done
  • Instagram Face goes with implants, middle-aged dates and nails too long to pick up the check. Batting false eyelashes, there in the restaurant it orders for dinner all the food groups of nouveau riche Dubai: caviar, truffle, fillers, foie gras, Botox, bottle service, bodycon silhouettes. The look, in that restaurant and everywhere, has reached a definite status. It’s the girlfriend, not the wife.
  • Does cosmetic work have a particular class? It has a price tag, which can amount to the same thing, unless that price drops low enough.
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  • Before the introduction of Botox and hyaluronic acid dermal fillers in 2002 and 2003, respectively, aesthetic work was serious, expensive. Nose jobs and face lifts required general anesthesia, not insignificant recovery time, and cost thousands of dollars (in 2000, a facelift was $5,416 on average, and a rhinoplasty $4,109, around $9,400 and $7,000 adjusted).
  • In contrast, the average price of a syringe of hyaluronic acid filler today is $684, while treating, for example, the forehead and eyes with Botox will put you out anywhere from $300 to $600
  • We copied the beautiful and the rich, not in facsimile, but in homage.
  • In 2018, use of Botox and fillers was up 18% and 20% from five years prior. Philosophies of prejuvenation have made Botox use jump 22% among 22- to 37-year-olds in half a decade as well. By 2030, global noninvasive aesthetic treatments are predicted to triple.
  • The trouble is that a status symbol, without status, is common.
  • Beauty has always been exclusive. When someone strikes you as pretty, it means they are something that everyone else is not.
  • It’s a zero-sum game, as relative as our morals. Naturally, we hoard of beauty what we can. It’s why we call grooming tips “secrets.”
  • Largely the secrets started with the wealthy, who possess the requisite money and leisure to spare on their appearances
  • Botox and filler only accelerated a trend that began in the ’70s and ’80s and is just now reaching its saturation point.
  • we didn’t have the tools for anything more than emulation. Fake breasts and overdrawn lips only approximated real ones; a birthmark drawn with pencil would always be just that.
  • Instagram Face, on the other hand, distinguishes itself by its sheer reproducibility. Not only because of those new cosmetic technologies, which can truly reshape features, at reasonable cost and with little risk.
  • built in to the whole premise of reversible, low-stakes modification is an indefinite flux, and thus a lack of discretion.
  • Instagram Face has replicated outward, with trendsetters giving up competing with one another in favor of looking eerily alike. And obviously it has replicated down.
  • Eva looks like Eva. If she has procedures in common with Kim K, you couldn’t tell. “I look at my features and I think long and hard of how I can, without looking different and while keeping as natural as possible, make them look better and more proportional. I’m against everything that is too invasive. My problem with Instagram Face is that if you want to look like someone else, you should be in therapy.”
  • natural looks have always been, and still are, more valuable than artificial ones. Partly because of our urge to legitimize in any way we can the advantages we have over other people. Hotness is a class struggle.
  • As more and more women post videos of themselves eating, sleeping, dressing, dancing, and Only-Fanning online, in a logical bid for economic ascendance, the women who haven’t needed to do that gain a new status symbol.
  • Privacy. A life which is not a ticketed show. An intimacy that does not admit advertisers. A face that does not broadcast its insecurity, or the work undergone to correct it.
  • Upper class, private women get discrete work done. The differences aren’t in the procedures themselves—they’re the same—but in disposition
  • Eva, who lives between central London, Geneva, and the south of France, says: “I do stuff, but none of the stuff I do is at all in my head associated with Instagram Face. Essentially you do similar procedures, but the end goal is completely different. Because they are trying to get the result of looking like another human being, and I’m just beautifying myself.”
  • But the more rapidly it replicates, and the clearer our manuals for quick imitation become, the closer we get to singularity—that moment Kim Kardashian fears unlike any other: the moment when it becomes unclear whether we’re copying her, or whether she is copying us.
  • what he restores is complicated and yet not complicated at all. It’s herself, the fingerprint of her features. Her aura, her presence and genealogy, her authenticity in space and time.
  • Dr. Taktouk’s approach is “not so formulaic.” He aims to give his patients the “better versions of themselves.” “It’s not about trying to be anyone else,” he says, “or creating a conveyor belt of patients. It’s about working with your best features, enhancing them, but still looking like you.”
  • “Vulgar” says that in pursuing indistinguishability, women have been duped into another punishing divide. “Vulgar” says that the subtlety of his work is what signals its special class—and that the women who’ve obtained Instagram Face for mobility’s sake have unwittingly shut themselves out of it.
  • While younger women are dissolving their gratuitous work, the 64-year-old Madonna appeared at the Grammy Awards in early February, looking so tragically unlike herself that the internet launched an immediate postmortem.
  • The folly of Instagram Face is that in pursuing a bionic ideal, it turns cosmetic technology away from not just the reality of class and power, but also the great, poignant, painful human project of trying to reverse time. It misses the point of what we find beautiful: that which is ephemeral, and can’t be reproduced
  • Age is just one of the hierarchies Instagram Face can’t topple, in the history of women striving versus the women already arrived. What exactly have they arrived at?
  • Youth, temporarily. Wealth. Emotional security. Privacy. Personal choices, like cosmetic decisions, which are not so public, and do not have to be defended as empowered, in the defeatist humiliation of our times
  • Maybe they’ve arrived at love, which for women has never been separate from the things I’ve already mentioned.
  • I can’t help but recall the time I was chatting with a plastic surgeon. I began to point to my features, my flaws. I asked her, “What would you do to me, if I were your patient?” I had many ideas. She gazed at me, and then noticed my ring. “Nothing,” she said. “You’re already married.”
Javier E

For Lee Tilghman, There Is Life After Influencing - The New York Times - 0 views

www.nytimes.com/...lee-tilghman-influencer.html

influencer social media lifestyle

shared by Javier E on 12 Apr 23 - No Cached
  • At her first full-time job since leaving influencing, the erstwhile smoothie-bowl virtuoso Lee Tilghman stunned a new co-worker with her enthusiasm for the 9-to-5 grind.
  • The co-worker pulled her aside that first morning, wanting to impress upon her the stakes of that decision. “This is terrible,” he told her. “Like, I’m at a desk.”“You don’t get it,” Ms. Tilghman remembered saying. “You think you’re a slave, but you’re not.” He had it backward, she added. “When you’re an influencer, then you have chains on.’”
  • In the late 2010s, for a certain subset of millennial women, Ms. Tilghman was wellness culture, a warm-blooded mood board of Outdoor Voices workout sets, coconut oil and headstands. She had earned north of $300,000 a year — and then dropped more than 150,000 followers, her entire management team, and most of her savings to become an I.R.L. person.
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  • The corporate gig, as a social media director for a tech platform, was a revelation. “I could just show up to work and do work,” Ms. Tilghman said. After she was done, she could leave. She didn’t have to be a brand. There’s no comments section at an office job.
  • In 2019, a Morning Consult report found that 54 percent of Gen Z and millennial Americans were interested in becoming influencers. (Eighty-six percent said they would be willing to post sponsored content for money.)
  • If social media has made audiences anxious, it’s driving creators to the brink. In 2021, the TikTok breakout star Charli D’Amelio said she had “lost the passion” for posting videos. A few months later, Erin Kern announced to her 600,000 Instagram followers that she would be deactivating her account @cottonstem; she had been losing her hair, and her doctors blamed work-induced stress
  • Other influencers faded without fanfare — teens whose mental health had taken too much of a hit and amateur influencers who stopped posting after an algorithm tweak tanked their metrics. Some had been at this for a decade or more, starting at 12 or 14 or 19.
  • She posted less, testing out new identities that she hoped wouldn’t touch off the same spiral that wellness had. There were dancing videos, dog photos, interior design. None of it stuck. (“You can change the niche, but you’re still going to be performing your life for content,” she explained over lunch.)
  • Ms. Tilghman’s problem — as the interest in the workshop, which she decided to cap at 15, demonstrated — is that she has an undeniable knack for this. In 2022, she started a Substack to continue writing, thinking of it as a calling card while she applied to editorial jobs; it soon amassed 20,000 subscribers. It once had a different name, but now it’s called “Offline Time.” The paid tier costs $5 a month.
  • Casey Lewis, who helms the After School newsletter about Gen Z consumer trends, predicts more pivots and exits. TikTok has elevated creators faster than other platforms and burned them out quicker, she said.
  • Ms. Lewis expects a swell of former influencers taking jobs with P.R. agencies, marketing firms and product development conglomerates. She pointed out that creators have experience not just in video and photo editing, but in image management, crisis communication and rapid response. “Those skills do transfer,” she said.
Javier E

Elon Musk May Kill Us Even If Donald Trump Doesn't - 0 views

jamestraub.substack.com/...usk-may-kill-us-even-if-donald

social media regulation effects

shared by Javier E on 15 Jan 24 - No Cached
  • In his extraordinary 2021 book, The Constitution of Knowledge: A Defense of Truth, Jonathan Rauch, a scholar at Brookings, writes that modern societies have developed an implicit “epistemic” compact–an agreement about how we determine truth–that rests on a broad public acceptance of science and reason, and a respect and forbearance towards institutions charged with advancing knowledge.
  • Today, Rauch writes, those institutions have given way to digital “platforms” that traffic in “information” rather than knowledge and disseminate that information not according to its accuracy but its popularity. And what is popular is sensation, shock, outrage. The old elite consensus has given way to an algorithm. Donald Trump, an entrepreneur of outrage, capitalized on the new technology to lead what Rauch calls “an epistemic secession.”
  • Rauch foresees the arrival of “Internet 3.0,” in which the big companies accept that content regulation is in their interest and erect suitable “guardrails.” In conversation with me, Rauch said that social media companies now recognize that their algorithm are “toxic,” and spoke hopefully of alternative models like Mastodon, which eschews algorithms and allows users to curate their own feeds
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  • In an Atlantic essay, “Why The Past Ten Years of American Life have Been Uniquely Stupid,” and in a follow-up piece, Haidt argued that the Age of Gutenberg–of books and the depth understanding that comes with them–ended somewhere around 2014 with the rise of “Share,” “Like” and “Retweet” buttons that opened the way for trolls, hucksters and Trumpists
  • The new age of “hyper-virality,” he writes, has given us both January 6 and cancel culture–ugly polarization in both directions. On the subject of stupidification, we should add the fact that high school students now get virtually their entire stock of knowledge about the world from digital platforms.
  • Haidt proposed several reforms, including modifying Facebook’s “Share” function and requiring “user verification” to get rid of trolls. But he doesn’t really believe in his own medicine
  • Haidt said that the era of “shared understanding” is over–forever. When I asked if he could envision changes that would help protect democracy, Haidt quoted Goldfinger: “Do you expect me to talk?” “No, Mr. Bond, I expect you to die!”
  • Social media is a public health hazard–the cognitive equivalent of tobacco and sugary drinks. Adopting a public health model, we could, for examople, ban the use of algorithms to reduce virality, or even require social media platforms to adopt a subscription rather than advertising revenue model and thus remove their incentive to amass ev er more eyeballs.
  • We could, but we won’t, because unlike other public health hazards, digital platforms are forms of speech. Fox New is probably responsible for more polarization than all social media put together, but the federal government could not compel it–and all other media firms–to change its revenue model.
  • If Mark Zuckerberg or Elon Musk won’t do so out of concern for the public good–a pretty safe bet–they could be compelled to do so only by public or competitive pressure. 
  • Taiwan has provide resilient because its society is resilient; people reject China’s lies. We, here, don’t lack for fact-checkers, but rather for people willing to believe them. The problem is not the technology, but ourselves.
  • you have to wonder if people really are repelled by our poisonous discourse, or by the hailstorm of disinformation, or if they just want to live comfortably inside their own bubble, and not somebody else’
  • If Jonathan Haidt is right, it’s not because we’ve created a self-replicating machine that is destined to annihilate reason; it’s because we are the self-replicating machine.
Javier E

Opinion | The Question of Transgender Care - The New York Times - 0 views

www.nytimes.com/...nsgender-care-cass-report.html

epistemic bubble evidence ethic belief trans debate humility research

shared by Javier E on 19 Apr 24 - No Cached
  • Doctors and researchers have proposed various theories to try to explain these trends. One is that greater social acceptance of trans people has enabled people to seek these therapies. Another is that teenagers are being influenced by the popularity of searching and experimenting around identity. A third is that the rise of teen mental health issues may be contributing to gender dysphoria.
  • Some activists and medical practitioners on the left have come to see the surge in requests for medical transitioning as a piece of the new civil rights issue of our time — offering recognition to people of all gender identities.
  • Transition through medical interventions was embraced by providers in the United States and Europe after a pair of small Dutch studies showed that such treatment improved patients’ well-being
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  • a 2022 Reuters investigation found that some American clinics were quite aggressive with treatment: None of the 18 U.S. clinics that Reuters looked at performed long assessments on their patients, and some prescribed puberty blockers on the first visit.
  • As Cass writes in her report, “The toxicity of the debate is exceptional.” She continues, “There are few other areas of health care where professionals are so afraid to openly discuss their views, where people are vilified on social media and where name-calling echoes the worst bullying behavior.”
  • The report’s greatest strength is its epistemic humility. Cass is continually asking, “What do we really know?” She is carefully examining the various studies — which are high quality, which are not. She is down in the academic weeds.
  • he notes that the quality of the research in this field is poor. The current treatments are “built on shaky foundations,” she writes in The BMJ. Practitioners have raced ahead with therapies when we don’t know what the effects will be. As Cass tells The BMJ, “I can’t think of another area of pediatric care where we give young people a potentially irreversible treatment and have no idea what happens to them in adulthood.”
  • She writes in her report, “The option to provide masculinizing/feminizing hormones from age 16 is available, but the review would recommend extreme caution.
  • her core conclusion is this: “For most young people, a medical pathway will not be the best way to manage their gender-related distress.” She realizes that this conclusion will not please many of the young people she has come to know, but this is where the evidence has taken her.
  • In 1877 a British philosopher and mathematician named William Kingdon Clifford published an essay called “The Ethics of Belief.” In it he argued that if a shipowner ignored evidence that his craft had problems and sent the ship to sea having convinced himself it was safe, then of course we would blame him if the ship went down and all aboard were lost. To have a belief is to bear responsibility, and one thus has a moral responsibility to dig arduously into the evidence, avoid ideological thinking and take into account self-serving biases.
  • “It is wrong always, everywhere, and for anyone, to believe anything upon insufficient evidence,” Clifford wrote
  • A belief, he continued, is a public possession. If too many people believe things without evidence, “the danger to society is not merely that it should believe wrong things, though that is great enough; but that it should become credulous, and lose the habit of testing things and inquiring into them; for then it must sink back into savagery.”
  • Since the Trump years, this habit of not consulting the evidence has become the underlying crisis in so many realms. People segregate into intellectually cohesive teams, which are always dumber than intellectually diverse teams. Issues are settled by intimidation, not evidence
  • Our natural human tendency is to be too confident in our knowledge, too quick to ignore contrary evidence. But these days it has become acceptable to luxuriate in those epistemic shortcomings, not to struggle against them. See, for example, the modern Republican Party.
Javier E

We Live In Imaginary Worlds - by Freya India - After Babel - 0 views

www.afterbabel.com/...we-live-in-imaginary-worlds

artificial worlds social media AI nature IRL

shared by Javier E on 21 Oct 24 - No Cached
  • It’s only going to get more addictive, more customized, more controllable. Already we can customize AI girlfriends with traits like “hot, funny, bold”, “shy, modest, considerate” or “smart, strict, rational”, making sure she is “judgement-free” and laughs at all our jokes. “Control it all the way you want to,” promises Eva AI.
  • We have to bring children back into the real world. We have to bring childhood back to Earth.
  • But first we have to let them, and ourselves, feel that loneliness. Feel it enough that we are forced to do something, to build something. To get up and get out.
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  • The problem here is not just the imaginary friends or imaginary communities. It’s that more and more of us don’t have the real thing.
  • As Jon put it in The Anxious Generation, there was Act I of the Tragedy: the disappearance of the play-based childhood. Then came Act II: the rise of the phone-based childhood. But as he and Zach began to realize, there was actually an Act before both of these—the loss of local community.
Javier E

Heart-Valve Patients Should Have Earlier Surgery, Study Suggests - The New York Times - 0 views

www.nytimes.com/...e-surgery-aortic-stenosis.html

surgery aortic valve stenosis study research

shared by Javier E on 30 Oct 24 - No Cached
  • For decades, people with failing heart valves who nevertheless felt all right would walk out of the cardiologist’s office with the same “wait and see” treatment plan: Come back in six or 12 months. No reason to go under the knife just yet
  • The trial, whose results were published this week in The New England Journal of Medicine, could change the way doctors treat severe aortic stenosis, a narrowing of the valve that controls blood flow from the heart.
  • Replacing people’s heart valves, even if they were not yet experiencing any ill effects, appeared to roughly halve their risk of being unexpectedly hospitalized for heart problems over at least two years, the trial found.
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  • Patients who were put on the more conservative treatment plan overwhelmingly ended up needing surgery anyway: Roughly 70 percent of them developed symptoms and needed to have their valves replaced within two years, suggesting that the disease worsens more quickly than previously understood.
  • Cardiologists have long known that patients like those in the trial — people with failing heart valves but no symptoms — could sometimes deteriorate or even die.
  • Cardiologists were wary of replacing valves partly because, until recent decades, that would have required open-heart surgery, a risk that hardly seemed worth taking for patients who were able to go about their lives without trouble.
  • The emergence of a less invasive surgery opened the door to a different approach. In that surgery, called transcatheter aortic valve replacement, or TAVR, cardiologists insert a replacement valve through a patient’s groin and thread it all the way to the heart.
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