Atherosclerotic Cardiovascular Disease (ASCVD)
Atherosclerotic Cardiovascular Disease (ASCVD)
Health Equity
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When the recommended plan isn’t feasible
Medication costs, coverage restrictions, language barriers, transportation, and work or caregiving demands can limit treatment options. An unfilled prescription or missed follow-up may reflect those barriers rather than a patient’s willingness to participate in care. Treatment discussions should account for what patients can realistically access and sustain.
Support requires infrastructure
Prior authorizations, medication access, interpreters, follow-up testing, and cardiac rehab require time and coordination. Where available, shared workflows with pharmacy, nursing, and care coordination can reduce the burden on patients and clinicians. Clear ownership of next steps helps prevent delays and missed follow-up.
Look for patterns in missed care
When data and staff capacity allow, examine where screening, treatment intensification, or referrals fall short, and whether gaps differ by language, insurance coverage, sex, or race and ethnicity. The purpose is to identify barriers that your practice or health system can realistically address.
Resources & References
Guidelines
Full guidelines, practical tools, and supporting publications are listed separately below.
- 2026 ACC/AHA Dyslipidemia Guideline
- 2023 AHA/ACC Chronic Coronary Disease Guideline
- 2025 ACC/AHA Acute Coronary Syndromes Guideline
- 2025 AHA/ACC High Blood Pressure Guideline
- ADA Standards of Care in Diabetes—2026: Cardiovascular Disease and Risk Management
- 2021 AHA/ACC Chest Pain Guideline—Executive Summary
- 2019 ACC/AHA Primary Prevention Guideline—aspirin and lifestyle guidance
*For lipid management and risk estimation, use the 2026 dyslipidemia guideline rather than the older lipid recommendations in the 2019 prevention guideline.
Additional guidance & clinical tools
- 2026 Dyslipidemia Guideline-at-a-Glance—implementation summary
- 2026 ACC Antiplatelet Therapy Scientific Statement
- 2025 ESC/EAS Focused Update on Dyslipidaemias
- 2025 AACE Dyslipidemia Consensus Algorithm
- AHA PREVENT calculator
- Vasculearn Network Lp(a) Clinician Toolkit
- ACC Lipid Manager
- JACC Chest Pain Interactive Tool—evaluation and testing pathways
- 2022 ACC Acute Chest Pain Decision Pathway—emergency department evaluation and disposition
- ADA 2026 Pharmacologic Treatment Tables—agent-specific cardiovascular and kidney benefits
- AHA scientific statement on implementing prevention to eliminate health care inequities
References
1. Blumenthal RS, Morris PB, Gaudino M, et al. J Am Coll Cardiol. 2026;87(19):2624-2757. doi:10.1016/j.jacc.2025.11.016
2. Virani SS, Newby LK, Arnold SV, et al. J Am Coll Cardiol. 2023;82(9):833-955. doi:10.1016/j.jacc.2023.04.003
3. Rao SV, O’Donoghue ML, Ruel M, et al. J Am Coll Cardiol. 2025;85(22):2135-2237. doi:10.1016/j.jacc.2024.11.009
4. Gulati M, Levy PD, Mukherjee D, et al. J Am Coll Cardiol. 2021;78(22):2218-2261. doi:10.1016/j.jacc.2021.07.052
5. Mach F, Koskinas KC, Roeters van Lennep JE, et al. Eur Heart J. 2025;46(42):4359-4378. doi:10.1093/eurheartj/ehaf190
6. Patel SB, Belalcazar LM, Afreen S, et al. Endocr Pract. 2025;31(10):1207-1238. doi:10.1016/j.eprac.2025.07.014
7. Wiggins BS, Barac A, Benziger CP, et al. J Am Coll Cardiol. 2026;87(19):2617-2623. doi:10.1016/j.jacc.2026.02.4872
8. Lee YJ, Lee SJ, Kim JW, et al. N Engl J Med. 2026;394(14):1365-1375. doi:10.1056/NEJMoa2600283
9. Kumbhani DJ, Gibson CM, Kinlay S, et al. J Am Coll Cardiol. 2026;88(11):1284-1313. doi:10.1016/j.jacc.2026.05.037
10. Jones DW, Ferdinand KC, Taler SJ, et al. J Am Coll Cardiol. 2025;86(18):1567-1678. doi:10.1016/j.jacc.2025.05.007
11. Arnett DK, Blumenthal RS, Albert MA, et al. J Am Coll Cardiol. 2019;74(10):e177-e232. doi:10.1016/j.jacc.2019.03.010
12. American Diabetes Association Professional Practice Committee for Diabetes. Diabetes Care. 2026;49(suppl 1):S216-S245. doi:10.2337/dc26-S010
13. Agarwala A, Patel J, Stephens J, et al. Circulation. 2023;148(15):1183-1193. doi:10.1161/CIR.0000000000001171
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