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Effective Strategies for Managing Atherosclerotic Cardiovascular Disease

Tom Poole
Written by
Tom Poole
Effective Strategies for Managing Atherosclerotic Cardiovascular Disease

Table of Contents

The Importance of Shared Decision-Making in Cardiovascular Care

Shared decision-making (SDM) is a collaborative approach where healthcare professionals (HCPs) and patients work together to make informed decisions about treatment options. This method is particularly beneficial in managing ASCVD, where treatment protocols can be complex and varied. According to Wexelman et al. (2025), SDM fosters a partnership that respects patients’ values and preferences, ultimately leading to improved adherence to treatment plans and better health outcomes.

Benefits of Shared Decision-Making

The benefits of SDM in cardiovascular care include:

  1. Increased Trust: Patients are more likely to trust their HCPs when involved in the decision-making process.
  2. Enhanced Adherence: Personalized treatment plans that align with patients’ values lead to greater adherence to medication and lifestyle recommendations.
  3. Reduced Decisional Conflict: Patients report feeling more satisfied with their care when they participate in the decision-making process, reducing anxiety and confusion about their health choices (Wexelman et al., 2025).

Implementing SDM in clinical practice requires the establishment of a supportive environment where patients feel empowered to express their concerns and preferences. This may involve training HCPs to communicate effectively and provide educational resources that are easy to understand.

Enhancing Lipid Management: Overcoming Barriers in Clinical Practice

Lipid management is a critical component of ASCVD prevention, particularly in controlling low-density lipoprotein cholesterol (LDL-C) levels. Despite the availability of effective lipid-lowering therapies (LLTs), data indicate that many patients do not achieve the recommended LDL-C targets. According to Cannon et al. (2021), only one in three patients with ASCVD reached the LDL-C goal of less than 70 mg/dL.

Common Barriers to Optimal Lipid Management

  1. Physician Inertia: Many healthcare providers hesitate to initiate or escalate lipid-lowering therapy, often due to outdated beliefs about acceptable lipid levels.
  2. Patient Adherence: Adherence to prescribed therapies is often suboptimal, further compounding the challenge of achieving lipid targets (Virani et al., 2018).
  3. Statin Intolerance: Some patients report adverse effects from statin therapy, leading to discontinuation or avoidance of these essential medications (Cheeley et al., 2022).

Strategies to Improve Lipid Management

  1. Education and Training: Continuous education for HCPs on current lipid management guidelines and effective communication strategies can enhance treatment initiation and adherence.
  2. Patient Engagement: Implementing shared decision-making can help patients understand the importance of lipid management and encourage adherence to prescribed therapies (Wexelman et al., 2025).
  3. Utilizing Technology: Tools such as electronic health records can help track patient progress and facilitate timely interventions for patients not meeting lipid targets.

Benefits of Lipid-Lowering Therapies for Heart Health

Lipid-lowering therapies, particularly statins, are essential in reducing cardiovascular events and improving overall heart health. Statins have been shown to decrease the risk of heart attacks, strokes, and the need for coronary interventions. Research by Navar et al. (2017) indicates that patients on high-intensity statin therapy significantly reduced their cardiovascular risk.

Additional benefits include:

  • Reduction in Inflammation: Statins not only lower cholesterol levels but also exhibit anti-inflammatory properties, contributing to vascular health (Ference et al., 2018).
  • Improved Endothelial Function: By enhancing endothelial function, statins help maintain the integrity of blood vessels, reducing the risk of atherosclerosis (Mach et al., 2020).

Table 1: Overview of Common Lipid-Lowering Therapies

Therapy Type Mechanism of Action Common Side Effects
Statins Inhibit HMG-CoA reductase Muscle pain, liver enzyme increase
Ezetimibe Decrease intestinal cholesterol absorption Abdominal pain, diarrhea
PCSK9 Inhibitors Enhance LDL receptor recycling Injection site reactions, flu-like symptoms
Fibrates Increase lipoprotein lipase activity Gastrointestinal upset, myopathy

Role of Continuous Glucose Monitoring in Diabetes Management

Continuous glucose monitoring (CGM) is an innovative approach that plays a vital role in managing diabetes, particularly for patients with type 2 diabetes who are at risk for cardiovascular diseases. CGM provides real-time feedback on glucose levels, allowing for timely adjustments in diet and medication, ultimately leading to better glycemic control and reduced cardiovascular risk (Welford et al., 2025).

Benefits of Continuous Glucose Monitoring

  1. Real-Time Data: CGM provides continuous data that helps patients and providers make informed decisions about insulin dosing and dietary changes.
  2. Reduction in Hypoglycemia: By monitoring glucose levels closely, CGM can prevent episodes of severe hypoglycemia, which is particularly dangerous for older adults (Seidu et al., 2022).
  3. Improved Quality of Life: Patients using CGM report feeling more empowered and confident in managing their diabetes, leading to enhanced overall well-being (Pratley et al., 2020).

Implementing CGM in Clinical Practice

To optimize the use of CGM, healthcare providers should focus on:

  • Training Patients: Educating patients on how to interpret CGM data and integrate it into their daily management plans.
  • Addressing Barriers: Identifying and mitigating barriers to the adoption of CGM, such as cost and access to technology.

Innovations in Hyperbaric Oxygen Therapy for Ulcerative Colitis

Hyperbaric oxygen therapy (HBOT) has emerged as a promising treatment for patients with ulcerative colitis (UC) experiencing moderate to severe flares. HBOT involves breathing 100% oxygen in a pressurized environment, enhancing tissue oxygenation and reducing inflammation (Bonner et al., 2025).

Potential Benefits of Hyperbaric Oxygen Therapy

  1. Anti-Inflammatory Effects: HBOT may reduce local and systemic inflammation, providing relief from UC symptoms.
  2. Tissue Healing: Increased oxygen levels can promote healing of damaged intestinal tissues, potentially leading to remission (Dulai et al., 2018).
  3. Improved Quality of Life: By alleviating symptoms and preventing complications, HBOT can significantly enhance patients’ quality of life.

Future Directions for HBOT in UC Management

Further research is essential to establish the long-term efficacy and safety of HBOT in UC. Ongoing trials will provide critical insights into its role in standard care practices for UC management, potentially transforming treatment paradigms (Bonner et al., 2025).

Conclusion

Managing Atherosclerotic Cardiovascular Disease requires a multi-faceted approach that includes shared decision-making, effective lipid management, diabetes care through continuous glucose monitoring, and innovative therapies like hyperbaric oxygen therapy. By fostering collaboration between healthcare professionals and patients, addressing barriers to treatment, and utilizing cutting-edge therapies, we can significantly improve health outcomes for individuals affected by ASCVD.

FAQ

What is Atherosclerotic Cardiovascular Disease?
Atherosclerotic Cardiovascular Disease (ASCVD) refers to a range of conditions caused by the build-up of plaque in the arteries, leading to reduced blood flow and increased risk of heart attacks and strokes.

How does shared decision-making improve cardiovascular care?
Shared decision-making enhances patient engagement, increases adherence to treatment, and builds trust between patients and healthcare professionals, leading to better health outcomes.

What are the benefits of lipid-lowering therapies?
Lipid-lowering therapies help reduce LDL cholesterol levels, lower the risk of cardiovascular events, and improve overall heart health by reducing inflammation and enhancing endothelial function.

How does continuous glucose monitoring work?
Continuous glucose monitoring provides real-time data on glucose levels through a small sensor inserted under the skin, allowing for timely adjustments to insulin and dietary management.

What is hyperbaric oxygen therapy and how does it help ulcerative colitis?
Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized environment, which can reduce inflammation and promote healing in patients with ulcerative colitis during severe flares.

References

  1. Wexelman, W. J., Ciffone, N., & Shah, N. P. (2025). Shared Decision-Making for Restoring Trust in the Management of Atherosclerotic Cardiovascular Disease in the Post-pandemic Era. Advances in Therapy, 1-17. Link

  2. Cannon, C. P., de Lemos, J. A., & Rosenson, R. S. (2021). Use of lipid-lowering therapies over 2 years in GOULD, a registry of patients with atherosclerotic cardiovascular disease in the US. JAMA Cardiology, 6(10), 1060-1068

  3. Virani, S. S., Kennedy, K. F., & Akeroyd, J. M. (2018). Variation in lipid-lowering therapy use in patients with low-density lipoprotein cholesterol ≥190 mg/dL: insights from the National Cardiovascular Data Registry-practice innovation and clinical excellence registry. Circ Cardiovasc Qual Outcomes, 11(2), e004652

  4. Cheeley, M. K., Saseen, J. J., & Agarwala, A. (2022). A scientific statement on statin intolerance: a new definition and key considerations for ASCVD risk reduction in the statin intolerant patient. Journal of Clinical Lipidology, 16(3), 361-375. Link

  5. Welford, A. E., Ridgeway, J., & Gillies, C. (2025). Continuous Glucose Monitoring in the Management of Medication in Care Home Residents with Type 2 Diabetes (eDMED): A Protocol for a Feasibility Study. Diabetes Therapy, 1-19. Link

  6. Bonner, L. B., Sadler, C., & Lindholm, P. (2025). Hyperbaric oxygen therapy for ulcerative colitis patients hospitalized for moderate to severe flares (HBOT-UC): study protocol for a multi-center, randomized, double-blind, sham-controlled trial. BMJ Open, 1-10. Link

  7. Dulai, P. S., Buckey, J. C., & Raffals, L. E. (2018). Hyperbaric oxygen therapy is well tolerated and effective for ulcerative colitis patients hospitalized for moderate-severe flares: a phase 2A pilot multi-center, randomized, double-blind, sham-controlled trial. Am J Gastroenterol, 113(1), 516-523

  8. Mach, F., Baigent, C., & Catapano, A. (2020). 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk—the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Eur Heart J, 41(1), 111-188

  9. Ference, B. A., Graham, I., Tokgozoglu, L., & Catapano, A. (2018). Impact of lipids on cardiovascular health: JACC health promotion series. J Am Coll Cardiol, 72(10), 1141-1156. Link

  10. Pratley, R. E., Kanapka, L. G., & Rickels, M. R. (2020). Effect of continuous glucose monitoring on hypoglycemia in older adults with type 1 diabetes: a randomized clinical trial. JAMA, 323(23), 2397-2406

  11. Seidu, S., Khunti, K., & Davies, M. J. (2022). Continuous glucose monitoring in older people with diabetes and memory problems: a mixed-methods feasibility study in the UK. BMJ Open, 9(11), e032037. Link

  12. Thom, S. R. (2011). Hyperbaric oxygen: its mechanisms and efficacy. Plast Reconstr Surg, 127(Suppl 1), 131s-141s

  13. Dulai, P. S., Raffals, L. E., & Hudesman, D. (2020). A phase 2B randomised trial of hyperbaric oxygen therapy for ulcerative colitis patients hospitalized for moderate to severe flares. Aliment Pharmacol Ther, 52(955-963)

  14. Wexelman, W. J., Ciffone, N., & Shah, N. P. (2025). Shared Decision-Making for Restoring Trust in the Management of Atherosclerotic Cardiovascular Disease in the Post-pandemic Era. Advances in Therapy, 12182467. Link

  15. Cannon, C. P., de Lemos, J. A., & Rosenson, R. S. (2021). Use of lipid-lowering therapies over 2 years in GOULD, a registry of patients with atherosclerotic cardiovascular disease in the US. JAMA Cardiology, 6(10), 1060-1068

  16. Virani, S. S., Kennedy, K. F., & Akeroyd, J. M. (2018). Variation in lipid-lowering therapy use in patients with low-density lipoprotein cholesterol ≥190 mg/dL: insights from the National Cardiovascular Data Registry-practice innovation and clinical excellence registry. Circ Cardiovasc Qual Outcomes, 11(2), e004652

  17. Cheeley, M. K., Saseen, J. J., & Agarwala, A. (2022). A scientific statement on statin intolerance: a new definition and key considerations for ASCVD risk reduction in the statin intolerant patient. Journal of Clinical Lipidology, 16(3), 361-375. Link

  18. Welford, A. E., Ridgeway, J., & Gillies, C. (2025). Continuous Glucose Monitoring in the Management of Medication in Care Home Residents with Type 2 Diabetes (eDMED): A Protocol for a Feasibility Study. Diabetes Therapy, 12182526. Link

  19. Bonner, L. B., Sadler, C., & Lindholm, P. (2025). Hyperbaric oxygen therapy for ulcerative colitis patients hospitalized for moderate to severe flares (HBOT-UC): study protocol for a multi-center, randomized, double-blind, sham-controlled trial. BMJ Open, 12182182. Link

  20. Dulai, P. S., Buckey, J. C., & Raffals, L. E. (2018). Hyperbaric oxygen therapy is well tolerated and effective for ulcerative colitis patients hospitalized for moderate-severe flares: a phase 2A pilot multi-center, randomized, double-blind, sham-controlled trial. Am J Gastroenterol, 113(1), 516-523

  21. Mach, F., Baigent, C., & Catapano, A. (2020). 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk—the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Eur Heart J, 41(1), 111-188

  22. Ference, B. A., Graham, I., Tokgozoglu, L., & Catapano, A. (2018). Impact of lipids on cardiovascular health: JACC health promotion series. J Am Coll Cardiol, 72(10), 1141-1156. Link

  23. Pratley, R. E., Kanapka, L. G., & Rickels, M. R. (2020). Effect of continuous glucose monitoring on hypoglycemia in older adults with type 1 diabetes: a randomized clinical trial. JAMA, 323(23), 2397-2406

  24. Seidu, S., Khunti, K., & Davies, M. J. (2022). Continuous glucose monitoring in older people with diabetes and memory problems: a mixed-methods feasibility study in the UK. BMJ Open, 9(11), e032037. Link

  25. Thom, S. R. (2011). Hyperbaric oxygen: its mechanisms and efficacy. Plast Reconstr Surg, 127(Suppl 1), 131s-141s

  26. Dulai, P. S., Raffals, L. E., & Hudesman, D. (2020). A phase 2B randomised trial of hyperbaric oxygen therapy for ulcerative colitis patients hospitalized for moderate to severe flares. Aliment Pharmacol Ther, 52(955-963)

  27. Wexelman, W. J., Ciffone, N., & Shah, N. P. (2025). Shared Decision-Making for Restoring Trust in the Management of Atherosclerotic Cardiovascular Disease in the Post-pandemic Era. Advances in Therapy, 12182467. Link

  28. Cannon, C. P., de Lemos, J. A., & Rosenson, R. S. (2021). Use of lipid-lowering therapies over 2 years in GOULD, a registry of patients with atherosclerotic cardiovascular disease in the US. JAMA Cardiology, 6(10), 1060-1068

  29. Virani, S. S., Kennedy, K. F., & Akeroyd, J. M. (2018). Variation in lipid-lowering therapy use in patients with low-density lipoprotein cholesterol ≥190 mg/dL: insights from the National Cardiovascular Data Registry-practice innovation and clinical excellence registry. Circ Cardiovasc Qual Outcomes, 11(2), e004652

  30. Cheeley, M. K., Saseen, J. J., & Agarwala, A. (2022). A scientific statement on statin intolerance: a new definition and key considerations for ASCVD risk reduction in the statin intolerant patient. Journal of Clinical Lipidology, 16(3), 361-375. Link

  31. Welford, A. E., Ridgeway, J., & Gillies, C. (2025). Continuous Glucose Monitoring in the Management of Medication in Care Home Residents with Type 2 Diabetes (eDMED): A Protocol for a Feasibility Study. Diabetes Therapy, 12182526. Link

  32. Bonner, L. B., Sadler, C., & Lindholm, P. (2025). Hyperbaric oxygen therapy for ulcerative colitis patients hospitalized for moderate to severe flares (HBOT-UC): study protocol for a multi-center, randomized, double-blind, sham-controlled trial. BMJ Open, 12182182. Link

  33. Dulai, P. S., Buckey, J. C., & Raffals, L. E. (2018). Hyperbaric oxygen therapy is well tolerated and effective for ulcerative colitis patients hospitalized for moderate-severe flares: a phase 2A pilot multi-center, randomized, double-blind, sham-controlled trial. Am J Gastroenterol, 113(1), 516-523

  34. Mach, F., Baigent, C., & Catapano, A. (2020). 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk—the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Eur Heart J, 41(1), 111-188

  35. Ference, B. A., Graham, I., Tokgozoglu, L., & Catapano, A. (2018). Impact of lipids on cardiovascular health: JACC health promotion series. J Am Coll Cardiol, 72(10), 1141-1156. Link

  36. Pratley, R. E., Kanapka, L. G., & Rickels, M. R. (2020). Effect of continuous glucose monitoring on hypoglycemia in older adults with type 1 diabetes: a randomized clinical trial. JAMA, 323(23), 2397-2406

  37. Seidu, S., Khunti, K., & Davies, M. J. (2022). Continuous glucose monitoring in older people with diabetes and memory problems: a mixed-methods feasibility study in the UK. BMJ Open, 9(11), e032037. Link

  38. Thom, S. R. (2011). Hyperbaric oxygen: its mechanisms and efficacy. Plast Reconstr Surg, 127(Suppl 1), 131s-141s

  39. Dulai, P. S., Raffals, L. E., & Hudesman, D. (2020). A phase 2B randomised trial of hyperbaric oxygen therapy for ulcerative colitis patients hospitalized for moderate to severe flares. Aliment Pharmacol Ther, 52(955-963)

  40. Wexelman, W. J., Ciffone, N., & Shah, N. P. (2025). Shared Decision-Making for Restoring Trust in the Management of Atherosclerotic Cardiovascular Disease in the Post-pandemic Era. Advances in Therapy, 12182467. Link

  41. Cannon, C. P., de Lemos, J. A., & Rosenson, R. S. (2021). Use of lipid-lowering therapies over 2 years in GOULD, a registry of patients with atherosclerotic cardiovascular disease in the US. JAMA Cardiology, 6(10), 1060-1068

  42. Virani, S. S., Kennedy, K. F., & Akeroyd, J. M. (2018). Variation in lipid-lowering therapy use in patients with low-density lipoprotein cholesterol ≥190 mg/dL: insights from the National Cardiovascular Data Registry-practice innovation and clinical excellence registry. Circ Cardiovasc Qual Outcomes, 11(2), e004652

  43. Cheeley, M. K., Saseen, J. J., & Agarwala, A. (2022). A scientific statement on statin intolerance: a new definition and key considerations for ASCVD risk reduction in the statin intolerant patient. Journal of Clinical Lipidology, 16(3), 361-375. Link

  44. Welford, A. E., Ridgeway, J., & Gillies, C. (2025). Continuous Glucose Monitoring in the Management of Medication in Care Home Residents with Type 2 Diabetes (eDMED): A Protocol for a Feasibility Study. Diabetes Therapy, 12182526. Link

  45. Bonner, L. B., Sadler, C., & Lindholm, P. (2025). Hyperbaric oxygen therapy for ulcerative colitis patients hospitalized for moderate to severe flares (HBOT-UC): study protocol for a multi-center, randomized, double-blind, sham-controlled trial. BMJ Open, 12182182. Link

  46. Dulai, P. S., Buckey, J. C., & Raffals, L. E. (2018). Hyperbaric oxygen therapy is well tolerated and effective for ulcerative colitis patients hospitalized for moderate-severe flares: a phase 2A pilot multi-center, randomized, double-blind, sham-controlled trial. Am J Gastroenterol, 113(1), 516-523

  47. Mach, F., Baigent, C., & Catapano, A. (2020). 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk—the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Eur Heart J, 41(1), 111-188

  48. Ference, B. A., Graham, I., Tokgozoglu, L., & Catapano, A. (2018). Impact of lipids on cardiovascular health: JACC health promotion series. J Am Coll Cardiol, 72(10), 1141-1156. Link

  49. Pratley, R. E., Kanapka, L. G., & Rickels, M. R. (2020). Effect of continuous glucose monitoring on hypoglycemia in older adults with type 1 diabetes: a randomized clinical trial. JAMA, 323(23), 2397-2406

  50. Seidu, S., Khunti, K., & Davies, M. J. (2022). Continuous glucose monitoring in older people with diabetes and memory problems: a mixed-methods feasibility study in the UK. BMJ Open, 9(11), e032037. Link

Tom Poole
Written by
Tom Poole

Tom is passionate about technology and its impact on health. With experience in the tech industry, he enjoys providing practical tips and strategies for improving mental health with technology. In his free time, Tom is an avid gamer and enjoys coding new projects.