Should statin therapy be routinely initiated in middle‑aged adults with at least one atherosclerotic cardiovascular disease risk factor and LDL‑C levels above 100 mg/dL? Observational data consistently shows that lower LDL-C and non-HDL-C levels are associated with substantially reduced risks of atherosclerotic vascular disease. In the absence of randomized trial data in younger and middle-aged adults with low 10–30‑year risk, the role of additional risk stratification tools—such as hsCRP and coronary artery calcium scoring—becomes critical in guiding individualized decisions about when to begin lipid-lowering pharmacotherapy.

In this interview, William E. Boden MD, FACC and Roger S. Blumenthal, MD, FACC discuss 'Lower LDL-C for Longer? Defining the Optimal Timing and Intensity of Rx'.

The 2026 ACC/AHA Dyslipidemia Guidelines highlight that Lp(a) confers a graded ASCVD risk, with levels around 125 nmol/L (50 mg/dL) indicating meaningful risk and ~250 nmol/L (100 mg/dL) identifying a substantially higher‑risk phenotype. Coronary artery calcium scoring and hsCRP are recommended selectively to refine risk assessment when traditional estimates are uncertain. Importantly, harmonization with the ESC/EAS guidelines reinforces a unified approach to prevention. Overall, the message is to keep prevention simple — start with accurate risk assessment and prioritize blood pressure and lipid management, beginning with optimization of diet and physical activity.

In this interview, Kim Allan Williams, Sr., MD, MACC and Roger S. Blumenthal, MD, FACC discuss key takeaways from the 2026 Dyslipidemia Guideline.

ardiac and hepatic function are closely interconnected, with deterioration in one organ often accelerating disease progression in the other. Emerging evidence, including data suggesting semaglutide may slow or halt liver fibrosis progression, highlights the need to rethink how we manage patients with overlapping heart and liver disease. By examining the heart–liver axis, clinicians can gain insight into more integrated approaches to care and consider why this clinically important connection has only recently gained broader attention.

In this interview, Richard A. Chazal MD, MACC and Vishal N. Rao, MD, MPH examine the interconnectedness of cardiovascular (CV) and hepatic risk.

Cardiovascular-Kidney-Metabolic (CKM) syndrome encompasses a spectrum of interconnected cardiovascular, kidney, and metabolic conditions that progress through defined stages. A five-stage CKM treatment framework emphasizes timely identification of risk factors, structured and personalized risk discussions, and early, interdisciplinary intervention. By targeting obesity, diabetes, and chronic kidney disease, this approach supports comprehensive risk reduction and improved long-term cardiometabolic outcomes.

In this interview, Alison L. Bailey, MD, FACC and Chiadi E. Ndumele, MD, PhD discuss Addressing Cardiovascular-Kidney-Metabolic Syndrome Health.

Pulmonary arterial hypertension (PAH) remains a devastating, progressive disease with high morbidity and mortality despite advances in targeted therapies. Sotatercept, the most recent addition to the PAH treatment landscape, has demonstrated robust efficacy across multiple phase 3 randomized clinical trials. The HYPERION trial expands the evidence base by showing a favorable benefit–risk profile for sotatercept when used early in the disease course. Pooled analyses across trials further suggest that sotatercept may have a meaningful impact on mortality in patients with PAH.

In this interview, Mary Norine Walsh MD, MACC and Vallerie V. McLaughlin, MD, FACC discuss the phase 3 HYPERION trial.

Caffeinated coffee may reduce the risk of atrial fibrillation through several proposed mechanisms, including improved autonomic balance, antioxidant effects, and enhanced vascular function. While observational data have hinted at these benefits, randomized trial evidence has been limited. Findings from the DECAF Trial further demonstrate that atrial fibrillation patients do not need to avoid caffeinated coffee—and that it may even help lower their risk of future episodes.

In this interview, Matthew W. Martinez MD, FACC and Gregory M. Marcus, MD, FACC discuss the 'Does Eliminating Coffee Avoid Fibrillation (DECAF)' Trial.

The 2025 High Blood Pressure Guideline introduces key updates to the 2017 recommendations, reflecting the evolving understanding of hypertension and its long‑term impact on patient health. This update emphasizes evidence‑based strategies for diagnosis and management, highlighting the importance of standardized guidelines in improving outcomes. Key takeaways include refined treatment thresholds, enhanced risk‑stratification approaches, and clearer direction for individualized patient care. Looking ahead, the guideline underscores a forward‑thinking approach that integrates emerging research to support more proactive hypertension management.

In this interview, Clyde W. Yancy MD, MACC and Daniel W. Jones, MD discuss the 2025 AHA/ACC High Blood Pressure Guideline.

Heart and kidney disease are closely linked, as individuals with chronic kidney disease (CKD) face a significantly higher risk of cardiovascular events and heart failure. Because this cardiometabolic connection is so strong, identifying high‑risk individuals early is essential to preventing progression of both conditions. A holistic approach—including guideline‑directed therapies that target blood pressure, glucose, and inflammation—can simultaneously lower the risk of heart disease and slow kidney decline. Newer treatments now allow clinicians to address both organs together, improving long‑term health outcomes.

In this interview, Allen J. Taylor, MD, FACC and Janani Rangaswami, MD examine "Cardiovascular-Kidney Therapies in CKD".

The findings from the TUXEDO‑2 trial provide important clinical insights for managing high‑risk patients with diabetes and multivessel coronary disease undergoing stenting. By directly comparing ticagrelor and prasugrel within a dual antiplatelet therapy regimen, the trial helps clarify whether one agent offers superior protection in this complex population. These results may influence clinical decision‑making, particularly if meaningful differences in outcomes are demonstrated.

In this interview, Sidney C. Smith Jr., MD, MACC and Sripal Bangalore, MD, MHA discuss the TUXEDO-2 Trial.

The GOFRESH trial showed that providing DASH‑patterned groceries through a structured grocery‑ordering strategy meaningfully lowered systolic blood pressure and LDL cholesterol among Black families living in a Boston‑area food desert. These results highlight the powerful role of nutrition by showing that accessible, culturally relevant food‑as‑medicine strategies can deliver measurable cardiovascular benefits while helping reduce disparities and equipping patients with practical tools for healthier living.

In this interview, Cindy L. Grines MD, FACC and Stephen Juraschek, MD, PhD discuss how findings from the GOFRESH trial may be used to improve hypertension management and overall patient care.

1. Turkson-Ocran RN, Cluett JL, Fitzpatrick SL, et al. Rationale and Design of the Groceries for Black Residents of Boston to Stop Hypertension Among Adults Without Treated Hypertension (GoFresh) Trial. Am J Hypertens. 2023;36(5):256-263. doi:10.1093/ajh/hpad008

1. Ferro KM, Seager R, McManus K, et al. Nutrition Intervention of Groceries for Black Residents of Boston to Stop Hypertension (GoFresh) Among Adults With or Without Treated Hypertension Trial: Rationale, Design, and Evidence to Promote Implementation. Preprint. Res Sq. 2025;rs.3.rs-6222158. Published 2025 Jul 7. doi:10.21203/rs.3.rs-6222158/v1