Evolving Mortality Trends in Heart Failure and Vascular Disease: The Critical Role of Pharmacists in Addressing Cardiovascular Risk

At the American Heart Association 2025 Scientific Sessions, Zia Ul Haq, MPH, MBBS, discusses findings from his presentation, “Trends in Heart Failure and Vascular Disease Mortality Among U.S. Adults Aged 55 and Older, 1999–2019: A Retrospective Analysis.” The study highlights shifts in cardiovascular and vascular disease mortality over the past two decades, emphasizing the need for continued research to better understand contributing factors such as obesity, type 2 diabetes, hypertension, and vaping. He also underscores the crucial role pharmacists play in improving cardiovascular outcomes through guideline-directed therapy, medication adherence support, and patient education on treatment options and risk reduction strategies.

Pharmacy Times: Your study shows heart failure and vascular disease deaths are rising again after years of decline. What do you think is causing this increase?

Zia Ul Haq, MPH, MBBS: Yeah, I think that’s a very critical question, but it’s also very important to understand this particular study design and the findings in this study. What we did was a retrospective analysis of mortality and health trends in the United States over the last 20 years.

Being humble and acknowledging the limitations of this study, unfortunately, our study does not look at the risk factors or the root causes that may lead to this trend. That said, and while acknowledging these limitations, I think it’s important to comment on the broader body of research related to potential root causes.

There are factors such as the increase in obesity during that decade, higher prevalence of type 2 diabetes, hypertension, vaping, and other behaviors that contribute to cardiovascular disease. Through that lens, we may be able to better understand what causes these trends.

I also want to stress that there is a need for further research to help explain these patterns based on the evidence we currently have.

Pharmacy Times: How can pharmacists help prevent heart failure and vascular disease or support patients who are at higher risk?

Ul Haq: The role of the pharmacist is very crucial, especially when it comes to providing accessibility and access to quality health care. One of the major areas where pharmacists play an important role is in guideline-directed medical therapy. Many patients with cardiovascular disease also have other comorbidities and are often prescribed multiple medications. This raises challenges related to adherence and polypharmacy—areas where pharmacists’ expertise is essential.

In addition, patient education is a key responsibility for pharmacists. Helping patients understand potential side effects, available treatment options, and newly developed therapies is critical to ensuring optimal outcomes.

Finally, our study emphasizes the issue of high mortality, underscoring the importance of identifying and addressing risk factors for cardiovascular disease. Pharmacists have a significant role to play in this effort through prevention, education, and ongoing patient support.