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A Healthier Way to Commute? Cycling Reduces Mortality in Patients with Diabetes

Physical activity is critical to preventing and treating diabetes and reduces cardiovascular disease (CVD) and mortality.  Although moderate-to-high intensity aerobic exercise of any type is likely beneficial, cycling is particularly attractive because it is a low-impact exercise (e.g. easier on the joints) and can potentially be used as a transportation method.

Guest Author:  Kristin Lutek, PharmD, BCACP, CDCES

Special Guest:  Seena L. Haines, PharmD, BCACP, NBC-HWC

Music by Good Talk

The Top Ten Things Every Clinician Should Know About Sacubitril/Valsartan

Sacubitril/valsartan is considered part of the backbone of guideline-recommended therapies for the management of patients with heart failure. In 2021, sacubitril/valsartan became the preferred treatment over an ACEi or ARB in patients with heart failure with reduced ejection fraction (HFrEF) because it reduces the risk of cardiovascular death and hospitalization for heart failure in nearly all adult patients with chronic heart failure. All clinicians should be familiar with the indications, dosing, safety, and monitoring of sacubitril/valsartan.  Affordability, access, and inappropriate dose titration remain major barriers to achieving optimal outcomes.

Guest Authors:  Jessica Wooster, PharmD, BCACP and Elizabeth Yett, PharmD, BCACP

Special Guest:  Dustin (DJ) Clark, PharmD, BCACP

Music by: Good Talk

Don’t Miss a Beat: The Importance of Influenza Vaccination in Patients with Coronary Disease

Unfortunately, many patients with CAD do not receive the influenza vaccine every year.  And many patients being discharged from hospital after an acute coronary event don't receive it either. The IAMI (Influenza Vaccination After Myocardial Infarction) study was the first, large, randomized, double-blind, placebo-controlled, multi-center trial to investigate whether influenza vaccination could reduce the rate of cardiovascular events in high-risk adults with CAD.

Guest Authors:  Noelle Cordova, PharmD and Laura McAuliffe, PharmD, BCACP, CDCES

Music by Good Talk

Sequential Additions or Multicomponent Combination? Should Our Approach to Hypertension Be Re-examined?

Traditionally, hypertension management involves a stepwise approach where agents are titrated and added. Thus, achieving optimal BP control requires close follow-up, time, and resources.  Outside of these logistics, providers are prone to clinical inertia (aka fail to advance therapy when they should) and sometimes “push back” from patients who experience the burdens of treatment and follow-up. Perhaps it’s time to reconsider our approach to managing hypertension.

Guest Authors:  Erin Connolly, PharmD and Laura Varnum, PharmD, BCACP

Music by Good Talk

Preserving hope for patients with Heart Failure with Preserved Ejection Fraction (HFpEF)?

Although guideline-directed medical therapy substantially improves morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), treatments that clearly improve outcomes in those with HF and an EF >40% remain elusive. Unfortunately, the incidence and prevalence of HF are expected to substantially increase in the coming decades.  More evidence and effective treatments for those with HF with preserved ejection fraction are clearly needed.  Enter the EMPEROR-Preserved trial.

Guest Authors:  Gabrielle Givens, PharmD, BCPS and Robert Parker, PharmD

Music by Good Talk

What’s the Right Dose of Aspirin in Patients with Heart Disease?

There is no consensus regarding the preferred dosage of aspirin in patients with atherosclerotic cardiovascular disease (ASCVD) and this has led to variability in prescribing patterns. This is likely due to the lack of head-to-head trials evaluating different aspirin doses and data weighing the clinical benefits and adverse effects experienced with aspirin. Until now?

Guest Authors: Ivy Nwogu, PharmD and Megan Supple, PharmD, BCACP, CPP

Music by Good Talk

Raised From The Grave: A Second Life for Sotagliflozin?

The prevalence of heart failure in patients with diabetes is four times higher than in the general population.  Likewise, chronic kidney disease (CKD) and diabetes are common morbidities. As new drug classes emerge in the management of diabetes and heart failure and CKD, it is important to thoroughly evaluate available literature and identify opportunities to reduce complications and costs. Sotagliflozin is a first-in-class dual SGLT-1 and 2 inhibitor approved in Europe.  Does it improve outcomes in patients with heart failure or CKD?

Guest Authors:  Maren Richards Brinton, PharmD and Jonathan C. Hughes, PharmD, BCPS, BCACP

Music by Good Talk

Tiny (n-of-1) Trials to Overcome Statin-Associated Muscle Pain

In blinded clinical trials the percentage of patients who experience muscle symptoms while taking a statin is typically in the 3-5% range.  In practice, the percentage of patients who report muscle symptoms is 10-25%.  This disparity between what has been observed in blinded trials and what patients experience when treated with a statin is due, in part, to the nocebo effect — a belief that a medication may cause harm.  How many lives could be saved if we routinely used tiny randomized, controlled, blinded trials to determine when statin therapy can be safely continued?

Guest Panelists: Elizabeth Hearn, PharmD; Stuart T Haines PharmD, BCPS, BCACP; and Kathryn (Katie) Kiser, PharmD, BCACP

Music by Good Talk

Is Home Blood Pressure Monitoring a “Home Run” for Blood Pressure Management?

Nearly 67 million people, which equates to 3 out of every 4 people, living with high blood pressure in the US remain uncontrolled, despite the clear and compelling benefits of achieving good control. Remote monitoring and self-management of BP may enable us to broadly achieve optimal BP control in most patients. Increased use of telehealth technology improves access to care, but the effects on the cost and quality of care, particularly in the context of hypertension management, have not been clearly established.

Guest Authors: Mary Taylor, PharmD and Megan Supple, PharmD, BCACP, CPP

Guest Panelist:  Joseph Saseen, PharmD, BCPS, BCACP, CLS

Music by Good Talk

FAST Take: Update on Febuxostat Cardiovascular Safety

We know gout is among the many comorbidities that increase the risk of cardiovascular disease (CVD). In 2018, the cardiovascular safety of febuxostat and allopurinol in patients with gout and cardiovascular morbidities (CARES) trial concluded that febuxostat was non-inferior to allopurinol. BUT, two of the secondary endpoints were very concerning. Febuxostat was inferior to allopurinol in terms of cardiovascular death and all-cause mortality. Many clinicians were left wondering whether febuxostat was cardiotoxic …. or conversely, perhaps allopurinol was cardioprotective. Will another cardiovascular outcome trial provide greater clarity to guide clinical practice?

Guest Authors: Sophia Dietrich, PharmD and Michael W. Nagy, PharmD, BCACP

Guest Panelist: Dawn Fuke, PharmD, BCPS

Music by Good Talk

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