National Heart Month: How to stay heart smart
Heart disease is one of the major causes of death among Americans. As a pharmacist, I’m encouraged by the newer medications coming to market to help combat this disease.
And, in recognition of February as National Heart Month, Allscripts is donating to the American Heart Association based on employee participation in National Wear Red Day.
Dangerous heart conditions
The CDC’s Division for Heart Disease and Stroke Prevention (DHDSP) is focusing on how patients can control high blood pressure to protect their hearts. When thinking of heart-related conditions, hypertension (“the silent killer”) is a common dangerous condition, but so is heart failure. Heart failure is defined as a progressive clinical syndrome arising from structural or functional impairments of ventricular filling or ejection of blood.
Proper management of heart failure includes clinical evaluation, diagnostic testing and guideline-based use of pharmacotherapies and procedures. Traditional pharmacotherapy includes angiotensin-converting enzyme inhibitors, angiotensin receptor blockers (ARBs), beta-blockers, loop diuretics, hydral nitrates and aldosterone antagonists.
Newer pharmacotherapies include a selective inhibitor of lf current in the sinoatrial node and a combination ARB/prodrug neprilysin inhibitor.
Veradigm, an Allscripts company, published a whitepaper on “Reduced Ejection Fraction/Systolic Heart Failure: A Real-World Case Study Using Electronic Health Records” summarizing the utility of these agents in managing this type of heart failure. New therapies targeted to different receptors are under development in a quest for greater efficacy and safer side effect profiles.
Over the past few years, five medications that currently have FDA-approved diabetic Type 2 indications were found to help with concurrent heart failure syndrome through Cardiovascular Outcome Trials (CVOTs).
According to their individual prescribing information, each agent has been FDA approved to show some property of reducing the risk of major adverse cardiovascular events such as heart attack, stroke, or death in adults with Type 2 diabetes and known heart disease, and/or reduce the risk of hospitalization.
These new indications are significant because there is a well-established link between cardiovascular disease and Type 2 diabetes due to the risk of a major adverse cardiovascular event, even when patients are at their goal sugar level. There are three Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors along with two Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists. For more detail on the evidence of some of these discoveries and new indications, view another Veradigm whitepaper: “Type 2 Diabetes and Management of Cardiovascular and Renal Comorbidities: A Cohort Analysis with Case Study Using Electronic Health Records.”
How to help heart health
You can give back throughout the year by encouraging family, friends, coworkers and patients get their blood pressure checked regularly at minimum. Blood pressure machines can commonly be found at local drug stores and will display the recommended ranges.
Other ways to help with heart health include a low-sodium diet, meditation and exercising for 30 minutes a day, all if cleared by your physician.
Important signs and symptoms of heart and vascular conditions to monitor for include but are not limited to: shortness of breath (dyspnea), fatigue and weakness, rapid or irregular heartbeat, dizziness, swelling in the legs (includes ankle and feet), increase need to urinate at night, and chest pain. If anyone experiences any of these symptoms, consider setting up a screening with your doctor to discuss in further detail, or call 911 or head to your local emergency room if you need immediate help.