Keeping health professionals current with useful, quick updates on drugs & therapy - with CE for pharmacists, pharmacy technicians and advanced practice RNs.

Cardiovascular disease (CVD), which includes high blood pressure, stroke, heart failure, and coronary heart disease, is prevalent and costly. Coronary heart disease is the most common form, accounting for 43% of all deaths attributed to CVD. The underlying pathophysiology of CVD is atherosclerosis; hence the term atherosclerotic cardiovascular disease (ASCVD). Risk factor management and treatment are essential to prevent CVD progression, cardiovascular events, and costly healthcare. It is important for both prescribers and pharmacists to educate patients about a heart healthy lifestyle and promote adherence to drug therapy to prevent disease progression and lower the costs associated with CVD.

In November 2018, the American College of Cardiology and the American Heart Association (ACC/AHA) cholesterol guideline was published online. The writing committee included physicians from several specialty areas, pharmacists, a nurse practitioner, a physician assistant, and a layperson. In addition to the ACC/AHA, the writing committee included representatives from 10 other national organizations. The guideline provides an evidence-based and patient-centered approach to the assessment and treatment of ASCVD. The 2018 guideline builds on many of the concepts introduced in the 2013 ACC/AHA cholesterol guideline, including the emphasis on using a high or moderate-intensity statin as first-line therapy based on patient risk, the use of the 10-year ASCVD risk estimator for certain patients, measuring lipids to monitor response to therapy and adherence, and the patient-clinician discussion...

This issue highlights the use of continuous glucose monitoring (CGM) systems, sodium glucose transport protein-2 (SGLT2) inhibitors, newer insulin formulations, and the expert guideline recommendations focused on individualization of therapy.

In 2017, the Centers for Disease Control reported that over 30 million people in the US (~10% of the population) have diabetes, including 7.2 million who are undiagnosed. The total estimated cost of diagnosed diabetes in the US was $327 billion in 2017.2 Individuals with diabetes incur average annual medical expenses of about $16,750 – more than twice the expense for people without diabetes.

Over the last decade, the options for managing diabetes have grown dramatically – including new medication classes (eg, glucagon- like peptide-1 agonists, sodium-glucose transport protein-2 inhibitors), new insulin analogs (eg, insulin degludec, biosimilar insulins), and new technologies to help patients monitor their diabetes (eg, continuous glucose monitoring).

Clinical practice guidelines have increased the emphasis on individualizing treatment options and goals to meet the needs of each patient. Patients have more say in the management of their diabetes and overall health. It is essential that healthcare providers help patients navigate the vast pool of information available at their fingertips. Diabetes patients can easily get confused by the often-conflicting information or misinformation available on television and the internet, and from friends and family members. Community providers need a good, working knowledge of patient-specific diabetes management, including current treatments and technologies...