Effects of Pharmaceutical Intervention on Cardiovascular Risk

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Guest Editor
Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy
Interests: hypercholesterolemia; cardiovascular prevention; cardiac rehabilitation; heart failure

Special Issue Information

Dear Colleagues,

Cardiovascular diseases are the leading cause of death worldwide, being responsible for about 30% of total mortality. Considering that cardiovascular diseases are largely preventable, prioritizing preventative measures is fundamentally important to reduce their impact on public health. The current approach to the prevention of cardiovascular diseases includes the promotion a healthy and physically active lifestyle as well as the administration of drugs for treating cardiovascular risk factors such as hypertension, hypercholesterolemia, or diabetes. Although effective and safe risk factor treatments have been developed in the last few decades, there is still much work to be conducted in this area. Risk factors are often poorly treated and therapeutic goals are often disregarded, even in patients considered to be at high cardiovascular risk. There is, therefore, a need to develop new drugs and optimize the use of medications currently available. At the same time, it is necessary to develop therapeutic strategies suited to the patient's risk profile, with the aim of pursuing an increasingly personalized approach, avoiding overtreatments, and minimizing drug-related side effects.

This Special Issue welcomes manuscripts focused on (1) investigating the effects of new drugs and new treatment strategies on cardiovascular risk factors; (2) optimizing the pharmacological management of patients belonging to different risk categories; and (3) assessing patients' adherence to primary prevention drugs and studying strategies for improving adherence to treatments.

Dr. Giuseppe Marazzi
Prof. Dr. Giuseppe Caminiti
Guest Editors

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Keywords

  • cardiovascular risk factors
  • primary prevention
  • hypercholesterolemia
  • diabetes
  • hypertension

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Published Papers (4 papers)

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Research

19 pages, 294 KiB  
Article
Therapeutic Education and Pharmacotherapeutic Follow-Up Protocol, a Useful Tool for the Improvement of Patients at Cardiovascular Risk in Community Pharmacies
by Pilar Buenavida Jurado, Mª José De la Matta Martín, Mª José Martín Calero and Rocío De la Puerta
J. Cardiovasc. Dev. Dis. 2025, 12(3), 80; https://doi.org/10.3390/jcdd12030080 - 20 Feb 2025
Viewed by 493
Abstract
The aim was to determine the influence of a complex intervention based on pharmacotherapeutic follow-up (PTF) and the application of therapeutic education (TE) protocols on the clinical and educational parameters of patients at cardiovascular risk (CVR) attending community pharmacies (CPs). A prospective, longitudinal, [...] Read more.
The aim was to determine the influence of a complex intervention based on pharmacotherapeutic follow-up (PTF) and the application of therapeutic education (TE) protocols on the clinical and educational parameters of patients at cardiovascular risk (CVR) attending community pharmacies (CPs). A prospective, longitudinal, randomized, controlled clinical trial was conducted over 6 months in patients from four Spanish CPs, divided into control (CG) and intervention (IG) groups. CG patients received usual pharmacy care and IG patients received a PTF- and TE-based intervention. The sample consisted of 85 elderly patients. After pharmaceutical follow-up of the IG patients, the following results were observed: significant reductions in cardiovascular risk (CVR) (p < 0.005), blood pressure (BP) (p < 0.05), and sedentary lifestyle (p < 0.001), as well as an improved knowledge of CVR and cardiovascular risk factors (CVRFs) (p < 0.001). Target values for BP were achieved in 27.2% of patients and for triglycerides in 12.4% of patients. The PTF of the patients showed that 29.2% did not have the expected response to some treatments, while 25% had untreated pathologies and 10% had adverse reactions. The TE protocols related to the patients’ educational needs, applied individually and in conjunction with the PTF, were able to improve their lifestyle habits, their knowledge of CVR, CVRFs, and pharmacotherapy, and their clinical parameters, and, thus, the level of development of their disease Full article
(This article belongs to the Special Issue Effects of Pharmaceutical Intervention on Cardiovascular Risk)
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12 pages, 1425 KiB  
Article
Clinical Significance of Serum Omega-3 Fatty Acids on Endothelial Function in Patients with Coronary Artery Disease Under Statin Therapy
by Kei Yunoki, Hiroaki Matsumi, Toru Miyoshi, Motoki Kubo, Yoshiki Hata and Shinsuke Yuasa
J. Cardiovasc. Dev. Dis. 2025, 12(2), 60; https://doi.org/10.3390/jcdd12020060 - 5 Feb 2025
Cited by 1 | Viewed by 833
Abstract
Vascular endothelial function plays an important role in the pathogenesis of atherosclerosis. The reduction in low-density lipoprotein cholesterol (LDL-C) is a key therapy for preventing coronary artery disease (CAD), but the role of omega-3 fatty acids as residual risk factors of CAD remains [...] Read more.
Vascular endothelial function plays an important role in the pathogenesis of atherosclerosis. The reduction in low-density lipoprotein cholesterol (LDL-C) is a key therapy for preventing coronary artery disease (CAD), but the role of omega-3 fatty acids as residual risk factors of CAD remains controversial. We studied the correlation between serum omega-3 fatty acid levels and endothelial function in patients with CAD receiving statin therapy and examined the effect of eicosapentaenoic acid (EPA) therapy on endothelial function. Methods: A total of 150 consecutive patients with CAD receiving statin therapy (LDL-C levels < 100 mg/dL) were enrolled. Serum omega-3 fatty acid levels were measured, and endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery. Subsequently, 65 patients with impaired FMD (<6%) and low EPA/arachidonic acid (AA) (<0.3) were administered EPA, and FMD was reassessed after 3 months. Results: A multivariate linear regression analysis demonstrated that serum docosahexaenoic acid (DHA) and EPA plus DHA levels were independent determinants of %FMD (β = 0.214 and 0.163, p < 0.05, respectively). The EPA therapy significantly improved %FMD (from 3.7 ± 1.0% to 4.1 ± 1.0%, p < 0.05) in patients with low EPA/AA, and especially in patients with low EPA/AA and high triglyceride levels (from 3.4 ± 1.0% to 4.0 ± 1.1%, p < 0.01). Conclusions: Serum omega-3 fatty acid levels were associated with endothelial dysfunction in patients with CAD receiving statin therapy. EPA therapy improves endothelial function in patients with low EPA/AA, especially those with low EPA/AA and high triglycerides. Full article
(This article belongs to the Special Issue Effects of Pharmaceutical Intervention on Cardiovascular Risk)
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10 pages, 572 KiB  
Article
Physician Perceptions of the Safety and Efficacy of GLP-1 Receptor Agonists: Underestimation of Cardiovascular Risk Reduction and Discrepancies with Clinical Evidence
by Srikanth Krishnan, Pratyaksh K. Srivastava, Jayram Attaluri, Rebecca Nayeri, Dhananjay Chatterjee, Jay Patel, Ali Nsair, Matthew Budoff and Arash Nayeri
J. Cardiovasc. Dev. Dis. 2025, 12(1), 19; https://doi.org/10.3390/jcdd12010019 - 7 Jan 2025
Cited by 1 | Viewed by 1439
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonists (GIP/GLP-1 RAs) are emerging as effective treatments for obesity and cardiometabolic disease. This study evaluated physician perceptions of the safety and efficacy of semaglutide and tirzepatide through a questionnaire administered to [...] Read more.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonists (GIP/GLP-1 RAs) are emerging as effective treatments for obesity and cardiometabolic disease. This study evaluated physician perceptions of the safety and efficacy of semaglutide and tirzepatide through a questionnaire administered to 165 attending physicians specializing in internal or family medicine, with 122 responses received. Physicians reported an average patient weight loss of 9.22%, significantly lower than the 14.9% and 18.5% reported in the STEP and SURMOUNT trials, respectively. Estimated side effect rates (32.62%) were markedly lower than trial-reported rates (89.7% and 80.5%), while estimated discontinuation rates (8.59%) exceeded trial data. Cardiovascular benefits were perceived by 48.4% of physicians in diabetic patients, consistent with random guessing, and by only 39.3% in nondiabetic patients, significantly below random guessing expectations. These results highlight discrepancies between physician perceptions and clinical evidence, suggesting gaps in understanding regarding these agents’ efficacy and safety profiles. Addressing these gaps could enhance physician knowledge, patient adherence, and clinical outcomes. Full article
(This article belongs to the Special Issue Effects of Pharmaceutical Intervention on Cardiovascular Risk)
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9 pages, 555 KiB  
Article
Addition of Bempedoic Acid to Statin–Ezetimibe versus Statin Titration in Patients with High Cardiovascular Risk: A Single-Centre Prospective Study
by Giuseppe Marazzi, Giuseppe Caminiti, Marco Alfonso Perrone, Giuseppe Campolongo, Luca Cacciotti, Domenico Mario Giamundo, Ferdinando Iellamo, Paolo Severino, Maurizio Volterrani and Giuseppe Rosano
J. Cardiovasc. Dev. Dis. 2024, 11(9), 286; https://doi.org/10.3390/jcdd11090286 - 14 Sep 2024
Viewed by 2538
Abstract
Reducing levels of low-density lipoprotein cholesterol (LDL-C) below recommended thresholds is a core component of cardiovascular prevention strategies. We hypothesized that the addition of bempedoic acid to patients already on statin–ezetimibe therapy was more effective than titrating the statin dose in reducing LDL-C. [...] Read more.
Reducing levels of low-density lipoprotein cholesterol (LDL-C) below recommended thresholds is a core component of cardiovascular prevention strategies. We hypothesized that the addition of bempedoic acid to patients already on statin–ezetimibe therapy was more effective than titrating the statin dose in reducing LDL-C. The study enrolled 120 patients at high cardiovascular risk and with LDL-C above 70 mg/dL. They were randomly divided into two groups: the bempedoic acid (BA) group, taking bempedoic acid in addition to statin plus ezitimibe, and the statin titration (ST) group, including patients who doubled the dose of statin. At 12 weeks, the BA group presented a more significant decrease in LDL-C compared to the ST group (−22.9% vs. 7.5% p 0.002). The total cholesterol decreased significantly in the BA group compared to ST (−14.8% vs.−4.7%; p 0.013) No significant between-group changes in HDL and triglycerides occurred. At 12 weeks, the number of patients who reached LDL-C lower than 70 mg/dL was 38 (63%) in the BA group versus 22 (37%) in the ST group (between groups, p 0.034). In the BA group, the LDL-lowering effect of bempedoic acid was similar between patients taking atorvastatin and rosuvastatin. No side effects occurred during the follow up period. In conclusion, the addition of bempedoic acid to statin–ezetimibe combined treatment was more effective than doubling the dose of statin in reducing LDL-C levels and increased the number of patients reaching the LDL-C goal. Full article
(This article belongs to the Special Issue Effects of Pharmaceutical Intervention on Cardiovascular Risk)
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