Preventing Cardiovascular Mortality Through Early Intervention and Collaborative Care

At the American Heart Association 2025 Scientific Sessions, Zia Ul Haq, MPH, MBBS, discusses how most cardiovascular-related deaths continue to occur in inpatient settings, highlighting significant gaps in disease prevention and early risk management. He emphasizes that current efforts often focus on rescuing patients once they reach the hospital rather than preventing disease onset through early intervention. Ul Haq notes that aggressive early management—such as detecting elevated blood pressure, identifying dietary risk factors, and diagnosing type 2 diabetes earlier—can help reduce the overall disease burden. He also underscores the vital role of pharmacists in prevention, citing their contributions through telehealth monitoring, home health visits, and patient education to support early detection and adherence to therapeutic and preventive strategies.

Pharmacy Times: You found big differences by region and race. What might be behind those gaps, and how can they be reduced?

Zia Ul Haq, MPH, MBBS: You're right. We did find differences in terms of age-adjusted mortality rate, especially among Black individuals and people residing in rural areas of the United States. In the 2019 snapshot of the age-adjusted mortality rate, these groups had the highest trends in mortality. When looking at the United States as a whole, the western and southern regions saw the worst trends in age-adjusted mortality rates for cardiovascular disease.

But I’ll go back to what I said earlier—this particular study unfortunately did not look at what could be the root causes explaining these findings, and it’s very important to acknowledge that limitation. Other data, research, and credible studies have shown that there are differences in access to quality healthcare, socioeconomic status, and environmental stress levels among different communities, which could help explain this. But again, there is a need for further research to understand exactly what the correlation is between those factors and the worsening cardiovascular disease mortality trends.

Pharmacy Times: Since many deaths happen in hospitals, what can be done in outpatient or community settings to better manage these patients?

Ul Haq: I think you hit the key takeaway for this study. The fact that most deaths are occurring in inpatient care tells us that we are not doing enough for the prevention of these diseases and addressing the risk factors. We are trying to rescue patients once they show up in hospitals, but maybe we are not putting enough effort into preventing them from developing the disease in the first place.

I think the solution—and what can really be done—lies in aggressive early management that includes early detection of increases in blood pressure, dietary factors, and the early detection and diagnosis of type 2 diabetes. I’ll also loop in the role of the pharmacist here, because telehealth monitoring, home health visits, and especially patient education regarding different therapeutic options and preventative measures that can help address the burden of disease before it progresses to critical conditions in healthcare are very important.