AHA 2026: Pharmacists at the Center of Cardiometabolic Care

When the American Heart Association (AHA) Scientific Sessions 2026 convened in Chicago, Illinois, from November 6 to 9, 2026, the data spanned a new class of incretin-based therapy, longer-term results for the first oral proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, blood pressure effects of an oral glucagon-like peptide-1 (GLP-1) receptor agonist, and real-world models of heart failure (HF) care. Across Pharmacy Times interviews and abstract coverage from the meeting, a common theme emerged: pharmacists are increasingly central to how new cardiometabolic therapies are titrated, monitored, and sustained.^1-4

Presenters ranged from trial principal investigators, including Biykem Bozkurt, MD, PhD, of Baylor College of Medicine, and Christie Ballantyne, MD, also of Baylor College of Medicine, to pharmacist leaders such as Cody Parsons, PharmD, APh, BCCCP, of Stanford Health Care. On tolerability and dosing for a new agent, Bozkurt put it plainly: "Pharmacists are critical in identifying individual needs, tolerability, and AE profile."^1-3

Investigators Share Valuable Insights on Cardiometabolic Care

A New Incretin Class Clears a Safety Bar

In the phase 3 SYNCHRONIZE-CVOT trial (NCT06077864), survodutide (Zealand Pharma, Boehringer Ingelheim), an investigational once-weekly glucagon/GLP-1 receptor dual agonist, did not increase the risk of 5-point major adverse cardiovascular events versus placebo in adults with obesity or overweight and elevated cardiovascular risk (HR, 0.89; 95% CI, 0.67-1.18). Bozkurt, the trial's principal investigator, explained that because glucagon receptor agonism may have direct effects on the cardiovascular system, the new class needed its own noninferiority trial. Because the CIs crossed 1, the results establish safety rather than benefit.^1,5

Tolerability is where pharmacists will be most involved. Discontinuation due to gastrointestinal adverse events occurred in approximately 19.3% and 20.8% of participants receiving the 3.6 mg and 6.0 mg doses, respectively, compared with 1.9% with placebo, mostly during dose escalation under a protocol that allowed limited flexibility. "I think we should allow titration according to tolerability as well as ability to adhere to the dose on an individual basis," Bozkurt said. She also urged pharmacists to shift patient conversations beyond the scale, citing reductions in waist circumference, systolic blood pressure, and high-sensitivity C-reactive protein.^1,6

Oral PCSK9 Inhibition Holds Up Over Time

Ballantyne presented interim results from the open-label CORALreef Extension study (NCT06492291) of enlicitide (Lipfendra; Merck). He said 87% of eligible participants chose to enroll, low-density lipoprotein cholesterol reductions were sustained, participants who had received a placebo saw a similar benefit, and no new safety signals emerged across approximately 4200 patient-years of exposure. A blinded cardiovascular outcomes trial remains ongoing.²

For pharmacists, Ballantyne pointed to adherence in asymptomatic conditions. He noted that some pharmacies offer lipid checks and that telling patients they are getting a good result and need to keep taking the medication supports long-term adherence.⁷

Building Pharmacists Into HF Care

Parsons described how Stanford embeds pharmacists at every key phase of HF care: inpatient admission, transitions of care, and a pharmacist-run outpatient cardiometabolic service where protected access lets patients be seen far more often than typical cardiology clinic visits allow. Through the AHA's IMPLEMENT-EF initiative, dedicated pharmacists rounding and providing disease and medication education was identified as 1 of 4 workflows in an ideal care model.³

For health systems looking to replicate the model, Parsons recommended an "embed, measure, and sustain" approach: place pharmacists where medication management is hardest; track prescribing, optimal medical therapy scores, and admissions and readmissions; and bill for services when possible.⁸

Diet, Adiposity, and HFpEF

Amier Haidar, MD, MPH, a cardiology fellow at UTHealth Houston, discussed his team's analysis, which found the link between ultraprocessed foods and HF was strongest for HF with preserved ejection fraction (HFpEF), which is driven largely by diet-related cardiometabolic factors. Central adiposity, measured by waist-to-height ratio, accounted for about half of the association. Haidar encouraged pharmacists to keep counseling simple: "At each visit, if [pharmacists] can just make 1 or 2 suggestions that patients can take with them, I think that can be very effective."^9,10

Durable Results in Pediatric oHCM

At the Hypertrophic Cardiomyopathy Medical Society Scientific Sessions, held in Chicago on November 6 in tandem with, 56-week SCOUT-HCM (NCT06253221) data showed that adolescents with obstructive hypertrophic cardiomyopathy who received mavacamten (Camzyos; Bristol Myers Squibb) maintained reductions in left ventricular outflow tract gradient, and no patient had a left ventricular ejection fraction below 50%. Joseph Rossano, MD, MS, of Children's Hospital of Philadelphia, highlighted the pharmacist's role under the drug's Risk Evaluation and Mitigation Strategy program, noting that doses "may need to be adjusted over time, and the medication can interact with other medications, so I think those are areas where pharmacists play a very important role."¹¹

Abstract Research From Across the Spectrum

Post hoc analyses of the ATTAIN-1 and ATTAIN-2 trials found that orforglipron (Foundayo; Eli Lilly) lowered systolic blood pressure at 72 weeks vs placebo (6.1 vs 0.8 mmHg and 4.9 vs 1.5 mmHg, respectively), with the largest absolute reductions in patients with stage 2 hypertension. Weight reduction explained about 58% and 80.8% of the change, respectively, raising practical questions about monitoring patients who already take antihypertensive therapy.⁴

A national analysis of 11,181 women aged 30 to 79 years linked a history of gestational diabetes to a higher probability of stage 4 cardiovascular-kidney-metabolic syndrome (relative risk, 1.55; 95% CI, 1.13-1.97). For pharmacists, a gestational diabetes history noted during a medication review may be a cue to ask about follow-up for blood pressure, glucose, lipids, and kidney function.¹²

Pharmacists at the Center of Cardiometabolic Care

Together, the expert perspectives and research from AHA 2026 point in the same direction. Pharmacists are being asked to individualize titration for a new incretin class, reinforce adherence to newer lipid-lowering therapy, anchor HF care across the hospital and clinic, counsel on diet in ways patients can sustain, and manage interactions and monitoring for targeted cardiomyopathy therapy.

REFERENCES

1. Halpern L. Survodutide shows cardiovascular safety in SYNCHRONIZE-CVOT. Pharmacy Times. November 9, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/view/survodutide-shows-cardiovascular-safety-in-synchronize-cvot

2. Ballantyne C, Halpern L. Oral PCSK9 inhibitor enlicitide sustains LDL-C reductions. Pharmacy Times. November 9, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/view/oral-pcsk9-inhibitor-enlicitide-sustains-ldl-c-reductions

3. Parsons C, Halpern L. How Stanford pharmacists help close heart failure therapy gaps. Pharmacy Times. November 7, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/view/how-stanford-pharmacists-help-close-heart-failure-therapy-gaps

4. Halpern L. Orforglipron lowers systolic BP in ATTAIN-1, ATTAIN-2 analyses. Pharmacy Times. November 8, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/view/orforglipron-lowers-systolic-bp-in-attain-1-attain-2-analyses

5. Bozkurt B, Halpern L. SYNCHRONIZE-CVOT: testing a new incretin class for CV safety. Pharmacy Times. November 9, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/view/synchronize-cvot-testing-a-new-incretin-class-for-cv-safety

6. Bozkurt B, Halpern L. Beyond weight loss: survodutide's cardiometabolic effects. Pharmacy Times. November 10, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/view/beyond-weight-loss-survodutide-s-cardiometabolic-effects

7. Ballantyne C, Halpern L. Pharmacist feedback can help sustain lipid therapy adherence. Pharmacy Times. November 10, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/shorts/pharmacist-feedback-can-help-sustain-lipid-therapy-adherence

8. Parsons C, Halpern L. Embed, measure, sustain: a model for heart failure pharmacy care. Pharmacy Times. November 9, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/view/embed-measure-sustain-a-model-for-heart-failure-pharmacy-care

9. Haidar A, Halpern L. Ultraprocessed foods and heart failure: the HFpEF connection. Pharmacy Times. November 5, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/shorts/ultraprocessed-foods-and-heart-failure-the-hfpef-connection

10. Haidar A, Halpern L. How pharmacists can counsel patients on ultraprocessed foods. Pharmacy Times. November 6, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/shorts/how-pharmacists-can-counsel-patients-on-ultraprocessed-foods

11. Halpern L. Mavacamten benefit holds at 56 weeks in adolescents with oHCM. Pharmacy Times. November 10, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/view/mavacamten-benefit-holds-at-56-weeks-in-adolescents-with-ohcm

12. Halpern L. Gestational diabetes: new data on treatment, long-term risk. Pharmacy Times. November 5, 2026. Accessed November 12, 2026. https://www.pharmacytimes.com/view/gestational-diabetes-new-data-on-treatment-long-term-risk