iForumRx.org header image 1

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

Who CARES? Getting to the Heart of Allopurinol and Febuxostat CV Outcomes

Should we target uric acid levels when working to reduce cardiovascular risk? Cardiovascular (CV) disease remains the leading cause of death with many contributing risk factors, including hyperuricemia. Evidence suggests an elevation in uric acid levels is associated with and can lead to worse outcomes for individuals with CV disease and heart failure.  The Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) trial was conducted to evaluate whether febuxostat was noninferior to allopurinol with regard to CV events in patients with gout and CV disease.

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

Music by Good Talk

Top Ten Things Every Clinician Should Know About the 2018 Cholesterol Guidelines

The American Heart Association / American College of Cardiology (AHA/ACC) Task Force recently published the 2018 Guideline on the Management of Blood Cholesterol. The guidelines writing committee had representation from 12 organizations, including the National Lipid Association, American Diabetes Association, and the American Pharmacists Association — all of whom endorsed the guidelines. The previous guidelines (published in 2013) were intended to answer some specific clinical questions and significantly changed our approach to treatment. The 2018 guidelines provide a more comprehensive set of recommendations, akin to the (older) National Heart, Lung, and Blood Institute Adult Treatment Panel (ATP) III guidelines last published in 2002!

Guest Authors:  Dawn Fuke, Pharm.D., BCPS, and Zach Conroy, PharmD, BCACP

Music by Good Talk

LDL Limbo: How Low is Too Low?

There has been significant debate regarding the safety of achieving very low LDL-C levels, including a potential negative impact on cognitive function. The current ACC/AHA guidelines (circa 2013) suggest decreasing the statin dose in patients with two consecutive LDL-C levels below 40 mg/dL based on expert opinion. The lack of evidence has been a major challenge for clinicians and it is unclear whether medication doses should be reduced in high-risk patients who may benefit from very low LDL-C levels.  A recently published meta-analysis sought to address this clinical dilemma.

Podcast Case: Very Low LDL Case

Guest Authors:  Apryl Anderson, PharmD and Dave Dixon, PharmD, BCPS, BCACP, CLS, CDE

Music by Good Talk


Inflammatory Statements about Cardiovascular Risk Reduction: The CANTOS Trial

We’ve all seen and used the American College of Cardiology 10-year atherosclerotic cardiovascular disease (ASCVD) risk calculator. There are several modifiable risk factors such as blood pressure, cholesterol, and smoking status that, if addressed, can lower ASCVD risk. But are there other modifiable risk factors that we are failing to account for and might be able to address? New evidence suggests systemic inflammation may be one.

Guest Authors:  Ian Hatlee, Pharm.D and Scott Pearson, Pharm.D.

Music by Good Talk

TEXT ME — Text Messaging to Promote Behavior Change

With over 75% of people using mobile phones worldwide, text messaging might be a simple, cost-effective platform to encourage lifestyle changes. Several healthcare-related applications and mobile phone text messaging systems have already been designed; yet, very few have undergone rigorous testing to confirm clinical benefit.  The investigators of the Tobacco, Exercise, and Diet Messages (TEXT ME) trial designed a text message-based intervention to encourage lifestyle modifications and evaluated its impact on cardiovascular risk in patients with established CHD. The TEXT ME study provides robust findings to support a simple, inexpensive intervention to modify cardiovascular risk … at least over the short term.

Pulling Ahead After a SPRINT – Evidence for Lower Blood Pressure Goals

The debate over the intensity of blood pressure (BP) lowering for patients with hypertension has been going on for decades.  Additional fuel to the fire was recently added with the early halt and publication of the Systolic Blood Pressure Intervention Trial (SPRINT).  So “how low should you go” for patients with high BP? Do lower BP goals reduce CV outcomes and death, particularly in patients at high risk?  Do they cause greater adverse effects? Or perhaps even worsen CV outcomes? These questions were examined in SPRINT.

CVD Risk Scores - Are They Accurate?

How well do cardiovascular disease risk calculators really perform?  Do they over or underestimate risk?  Should we rely on them to make treatment decisions?

Podbean App

Play this podcast on Podbean App