The Pharmacist’s Role in Managing Cardiovascular Disease: Updates on Pharmacologic Therapies

Abstract

Cardiovascular disease (CVD) remains a leading cause of mortality, with pharmacologic treatment being the primary therapeutic approach. This article provides an update on pharmacologic therapies for hypertrophic cardiomyopathy (HCM), familial hypercholesterolemia (FH), and heart failure (HF). Mavacamten, a first-in-class cardiac myosin inhibitor, has been approved for treating symptomatic obstructive HCM, improving functional capacity and symptoms by reducing cardiac contractility and left ventricular outflow tract (LVOT) obstruction. Inclisiran, a novel synthetic small interfering ribonucleic acid (siRNA) therapy, offers a new approach for treating heterozygous FH by targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) mRNA, leading to enhanced low-density lipoprotein (LDL) clearance. For heart failure with reduced ejection fraction (HFrEF), guideline-directed medical therapy (GDMT) aims to mitigate compensatory mechanisms and improve survival outcomes. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, initially developed as glucose-lowering agents for type 2 diabetes, have demonstrated cardiovascular benefits and are now incorporated into GDMT for HFrEF. Empagliflozin has also received an expanded indication for heart failure with preserved ejection fraction (HFpEF) and heart failure with mildly reduced ejection fraction (HFmrEF). These advancements in pharmacologic therapies for CVD have significant implications for patient outcomes and nursing practice.