The Role of Pharmacists in Cardiovascular Health: A Collaborative Approach to Treatment, Counseling, and Nutrition

Cardiovascular disease (CVD) continues to be the leading cause of death in the US, accounting for nearly 1 in every 5 deaths each year.¹ As health care continues to evolve, pharmacists play an important role in the management and prevention of cardiovascular conditions, offering an opportunity to bridge the gap between medical treatment and patient education. Food is being seen more as not just something we eat, but a key factor that we can modify to prevent and mitigate disease—essentially, food as medicine.² Pharmacists can incorporate nutrition-based strategies alongside guideline-directed medical therapy to enhance cardiovascular outcomes for patients.

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Pharmacists as Key Players in Cardiovascular Treatment Plans

Pharmacists are already crucial in managing medications for conditions like hypertension, hyperlipidemia, diabetes, and heart failure—all of which are significant risk factors for CVD.³ By taking advantage of their regular interactions with patients and their clinical knowledge, pharmacists are perfectly positioned to optimize medications, monitor adherence, and educate patients.

In community settings, pharmacists often identify untreated or undertreated cardiovascular risk factors and start conversations about lifestyle interventions.⁴ They play an important role by counseling patients on their treatment regimens and helping them understand how their condition affects their overall health. Effective counseling helps patients better understand their medication regimens, allowing them to make informed decisions about their own care. In clinics or ambulatory care settings, they work under collaborative practice agreements to adjust medications, order labs, and provide comprehensive care.⁵

Food as Medicine: A Natural Extension

The idea of using food as medicine has gained traction in recent years, especially when it comes to heart health. It involves using whole foods and specific eating patterns to help prevent and manage chronic illnesses. Diets like the DASH (Dietary Approaches to Stop Hypertension) and Mediterranean diets have proven cardiovascular benefits, such as reducing cholesterol, lowering blood pressure, and improving glycemic control.^6,7 Pharmacists play a crucial role in guiding and counseling patients through these dietary options, debunking nutrition myths, and referring them to registered dietitians or specialists when necessary.

Pharmacist-led programs that focus on nutritional education have shown promising results, this is not exclusive to the CVD space. For example, a randomized, controlled trial demonstrated that when community pharmacists and nurses worked together to support patients with diabetes, there was a significant improvement in blood pressure control.⁸

Simple changes, such as incorporating heart-healthy foods into a diet, can lead to big improvements in health. Heart-healthy foods include the following: leafy greens, which are rich in potassium and fiber; berries, which are high in antioxidants; fatty fish such as salmon, which are a very beneficial source of omega-3s; and whole grains such as brown rice and oats, which can help lower low-density lipoprotein cholesterol. Additionally, nuts such as almonds and walnuts—when consumed in moderation—can also support heart health by providing healthy fats and plant-based protein.⁹

As pharmacists, we can maximize cardiovascular health by blending the advantages of prescription therapy and good nutrition. For example, when initiating statin therapy, pharmacists can counsel patients on how to cut down on dietary cholesterol. When managing hypertension, recommending a reduced sodium intake along with potassium-rich foods can complement pharmacologic treatment. Additionally, the combination of angiotensin-converting enzyme (ACE) inhibitors with guidance on increasing leafy greens and preparing low-sodium meals offers both medicinal and dietary benefits. These combined approaches not only empower patients but may also lighten their medication load and help prevent disease progression.⁹

Making Heart Health Part of Everyday Practice

To truly make a difference, pharmacists must integrate food as medicine into chronic disease programs. This could include teaming up with local farms, organizing grocery store tours, hosting cooking demos, and even launching produce prescription initiatives. While reimbursement remains a challenge, the Centers for Medicare and Medicaid Services and private insurers are starting to look into value-based models that incorporate nutrition counseling. Collaborating with registered dieticians and primary care providers can allow pharmacists to scale their efforts to reduce cardiovascular events through a preventive, whole-patient approach.¹⁰

Conclusion

As the burden of cardiovascular disease continues to rise and we shift towards a more integrated health care system, pharmacists are in a prime position to make a significant difference in both the prevention and treatment of these conditions. By adopting the concept of food as medicine, pharmacists can broaden their role and influence in cardiovascular health—connecting their clinical expertise with the everyday habits of patients to foster better health outcomes.

REFERENCES

1. US Centers for Disease Control and Prevention. Heart Disease Facts. Updated February 27, 2024. Accessed May 23, 2025. https://www.cdc.gov/heart-disease/data-research/facts-stats/index.html

2. Mozaffarian D, Blanck HM, Garfield KM, Wassung A, Petersen R. A Food is Medicine approach to achieve nutrition security and improve health. Nat Med. 2022;28(11):2238-2240. doi:10.1038/s41591-022-02027-3.

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4. Blalock SJ, Roberts AW, Lauffenburger JC, Thompson T, O'Connor SK. The effect of community pharmacy-based interventions on patient health outcomes: a systematic review. Med Care Res Rev. 2013;70(3):235-266. doi:10.1177/1077558712459215

5. Zellmer WA. Collaborative drug therapy management. Am J Health Syst Pharm. 1995;52(15):1732. doi:10.1093/ajhp/52.15.1732

6. Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the DASH diet. N Engl J Med. 2001;344(1):3-10. doi:10.1056/NEJM200101043440101

7. Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-1290. doi:10.1056/NEJMoa1200303

8. Tsuyuki RT, Houle SKD, Charrois TL, et al. A randomized trial of the effect of community pharmacist and nurse care on improving blood pressure management in patients with diabetes mellitus: study of cardiovascular risk intervention by pharmacists–hypertension (SCRIP-HTN). J Clin Hypertens (Greenwich). 2021;23(6):1120-1127. doi:10.1016/j.jcph.2021.01.007

9. McCabe C, Smith M, Marcus D. Clinical interventions for food-drug interactions: a pharmacist’s perspective. J Clin Pharm Ther. 2022;47(1):45-52. doi:10.1111/jcpt.13510

10. Nutrition Counseling Coverage Act of 2021, HR 6971, 116th Cong (2019-2020). Accessed May 23, 2025. https://www.congress.gov/bill/116th-congress/house-bill/6971