September 2025 Dispatch for the CV Team

Every month, Section Editor L.A. McKeown curates a roundup of recent news beyond our regular TCTMD coverage, with tidbits from journals and medical meetings around the globe that are of special interest to heart teams and allied cardiovascular professionals.

The September issue of The Lancet Regional Health—Europe focuses on sex and healthcare disparities in ischemic heart disease. These articles offer perspectives that range from marginalized populations to older adults and patients with mental health disorders.

In postmenopausal women with type 2 diabetes, oral hormone replacement therapy (HRT) may increase the risk of CV events. Presenting data from a real-world study at the recent European Association for the Study of Diabetes annual meeting, researchers reported that women who took oral HRT had double the risk of developing pulmonary embolism and a 21% increased risk of heart disease compared with those receiving transdermal HRT. The authors say different absorption may be responsible for the disparate risk profiles of oral and transdermal HRT, and conclude that this population of women should not be prescribed oral estrogen therapies.

Among patients who undergo an uneventful elective TAVI, there appear to be no differences in outcomes—the composite of death, vascular access-related complications, any bleeding requiring hospitalization, all stroke, or new permanent pacemaker implantation at 30 days—between those discharged the same day and those who stayed at least one night in the hospital following the procedure. While RCTs are needed, the authors of this single-center study published in Structural Heart say, with robust protocols a same-day discharge is safe and feasible and contributes to a better patient experience.

Symptomatic patients with a coronary artery calcium (CAC) score of 0 but elevated LDL cholesterol are more vulnerable to developing noncalcified plaque and having future coronary heart disease (CHD) events, a large cohort study from Denmark suggests. Published in the European Heart Journal, the article suggests that LDL lowering is important despite a low CAC score, particularly in patients age 45 and younger who have the highest likelihood of all age groups to have a 0 CAC score.

Earlier implementation of lifestyle modifications that prioritize nutrition, physical activity, sleep, social connections, stress management, and limiting alcohol has the potential to improve cardiovascular health and to prevent or reduce future cardiovascular events in women. An article in the American Journal of Preventive Medicine discusses these six pillars of lifestyle medicine and how they can be aligned to support heart health.

A survey of more than 37,000 adults in the United States suggests that dietary salt substitutes are not widely used in the population at large or by the majority of patients with hypertension who are eligible to use them. The researchers, who presented the data as a poster at the American Heart Association’s Hypertension Scientific Sessions 2025, encourage healthcare professionals to discuss safe use of salt substitutes with their patients who have persistent or hard-to-manage hypertension.

Racial and ethnic disparities impact the type of STEMI care that a patient receives at every step of the process, a cross-sectional study shows. Among people who initially presented at a non-PCI-capable hospital and were transferred, Black patients were 20% less likely to get PCI at the receiving hospital compared with white patients, the researchers report in JAMA Network Open. These and other disparities noted in the article point toward the need for standardization of hospital protocols at PCI-capable hospitals, which the authors say would “ensure eligible patients with STEMI receive PCI” and could go a long way toward improving equity and reducing implicit bias.

A study of more than 1,000 online stock photo images of people taking their own blood pressure (BP), or having someone else do it, found that only one in seven depicted the process accurately as guidelines recommend. Common errors in the photos included the person’s back being unsupported, the forearm not resting on a surface, and feet not being flat on the floor. This has the researchers of the study concerned given that many people tend to remember images more than words. Reporting in Hypertension, they say these inaccurate images, coupled with healthcare professionals not taking the guideline-endorsed approach to testing in their offices, “may mislead the public and compromise the correct understanding and practice of BP measurement.”

A case example is used in a viewpoint published in JACC: Advances to consider how ‘do not resuscitate’ (DNR) status can change during and immediately after cardiac interventions and what those changes mean for patient care and honoring autonomy. Its authors assert that by “offering greater nuance in periprocedural DNR status and advocating for supportive reporting practices, clinicians can better align decision-making with patient values in the cardiac catheterization setting.”

Mexico has experienced a spike in CV disease in the last decade despite improved cholesterol control and increased use of statins in the population, a study presented at ACC Latin America 2025 shows. While public health measures like taxes on sugary drinks, improved food labels, elimination of industrially produced trans-fatty acids, and prohibiting the advertisement and sale of ultraprocessed foods and sugary drinks in learning environments have been effective, the investigators say more strategies are needed. Among the suggested improvements are better use of evidence-based guidelines and healthcare protocols, as well as ensuring that mechanisms are in place to get medication and supplies where they are needed to avoid delays in screening strategies, prevent treatment abandonment, and reduce the risk of future complications.

News Highlights From TCTMD:

Good LDL Control When PCSK9 Inhibitors Given In-Hospital After Interventions

Half of Patients Stop Semaglutide for Weight Loss by 1 Year

Nonatherosclerotic Causes of MI Common in Younger Patients

Disconnect Exists Between What Patients Hear vs What Clinicians Try to Say

Lactate Clearance May Act as ‘Early Warning Sign’ in Cardiogenic Shock