New Year, New Goals: Review of the 2017 ACC/AHA Hypertension Guidelines

It’s about time to start thinking about New Year’s resolutions, so why not add 130/80 mmHg to your list of goals for 2018? A major overhaul of the blood pressure guidelines were recently published, and they include stricter blood pressure goals, restaging of hypertension, and stronger recommendations for out-of-office blood pressure monitoring. Read on for details!

Dietary Supplements and Heart Health

Dietary supplements – which include herbal medications, vitamins, minerals, amino acid supplements, and dietary substances – have become a multi-billion dollar industry in the United States. Today, approximately one-half of American adults reports using some form of dietary supplements. The purpose of this blog will be to briefly review evidence for common dietary supplements touted for heart health and to provide evidence-based resources for practitioners and patients to utilize.

No Love Lost for Intravenous Labetalol Infusions: Risks of Prolonged Use

Labetalol is a beta blocker with potent antihypertensive effects, and it may be administered orally or intravenously. The latter feature makes it especially useful for the acute management of elevated blood pressure but prolonged infusions can result in hemodynamic collapse. In this entry, two cases are discussed and recommendations are made for the appropriate management of continuous labetalol infusions.

Pharmacists’ Role in Conducting the Cardiovascular Physical Examination

Physical examination has become a “lost art” for many clinicians across a variety of disciplines. Many pharmacists have not had formal physical examination training in school and those that have rarely utilize these skills after completing their training. Pharmacists are poised to employ physical examination in their patient care setting to evaluate the effects of therapy, triage patients, and guide clinical decision-making. This piece describes a general overview of the importance of physical examination and provides readers with a list of tools that pharmacists can use to reinforce prior knowledge of the cardiovascular physical examination.

Muddying the Water: Reduced vs. Preserved Ejection Fraction in Trials of Acute Decompensated Heart Failure

Evidence from randomized controlled trials has demonstrated that the cornerstone pharmacologic therapies used in the management of chronic heart failure with reduced ejection fraction (HFrEF) do not confer the same benefits in patients with preserved ejection fraction (HFpEF). So why do we enroll both subgroups in trials of acute decompensated heart failure (ADHF)? In this entry, we’ll explore differences in pathophysiology between HFrEF and HFpEF and how they may result in variable responses to pharmacologic therapies commonly used in ADHF, particularly diuretics and vasodilators.

Anticoagulation Safety (Part 1 of 2): Common Drug Errors with NOACs… I Mean DOACs!

Anticoagulants are some of the most commonly implicated drugs in emergency department visits and hospitalizations due to adverse drug events. Medication errors can significantly influence these events, and pharmacists are at the forefront for preventing medication errors from reaching the patient. Part 1 of this 2 part series on anticoagulation safety will focus on common medication errors involving direct oral anticoagulants. Part 2 will focus on ways pharmacists can help prevent medication errors with anticoagulants, particularly as it relates to anticoagulation stewardship programs.

Novel Potassium-Lowering Agents in Combination with Chronic Heart Failure Therapies

Agents such as patiromer and sodium zirconium cyclosilicate can reduce serum potassium concentrations. But do they have a role in patients with heart failure with reduced ejection fraction (HFrEF)? In this piece, we explore whether these agents could reduce the risk of hyperkalemia when initiating, continuing, or dose-titrating guideline-directed medical therapies in HFrEF.