Closing the Access Gaps in Cardiovascular Treatment: AHA 2025

There are major translational challenges in moving medical findings to equitable clinical practice, according to experts who presented at the 2025 American Heart Association Scientific Sessions.

Vallerie McLaughlin, MD, the Kim A. Eagle M.D. Endowed Professor of Cardiovascular Medicine and professor of internal medicine at the University of Michigan Medical School, highlighted the need for early detection and specialist access for rare diseases like pulmonary arterial hypertension (PAH).

Martha Gulati, MD, MS, FACC, FAHA, FASPC, FESC, cardiologist at the Cedars-Sinai Medical Center Schmidt Heart Institute, professor of cardiology and associate director of the Barbra Streisand Women’s Heart Center, and director of cardiovascular disease prevention, emphasized using implementation science to close the persistent gaps in care for women with cardiovascular conditions.

Stephen Nicholls, MBBS, PhD, MBA, professor of cardiology at Monash University, program director of the Victorian Heart Hospital at Monash Health, and director of the Monash Victorian Heart Institute in Melbourne, Australia, identified patient access to effective new drugs, like glucagon-like peptide-1 (GLP-1) receptor agonists, as the biggest hurdle

This transcript has been lightly edited; captions were auto-generated.

Transcript

What is the single biggest translational challenge you see in moving the latest findings to routine, equitable clinical practice?

McLaughlin: Taking care of PAH patients is challenging in many ways, and there are many inequities that exist in our current health care system. It's a rare disease and is not often recognized, and sometimes just identifying the patients and getting them to a specialist is a challenge. I would say early detection [is the biggest translation challenge]. I would say being seen in a center by a team that has experience with a treatment of PAH is something that I would like to see done more equitably in our patients.

Gulati: For me, the biggest challenge in cardiovascular disease is that we continue to talk for over 2 decades, perhaps 3 decades, about gaps in care for women. We continue to say that it's important to diagnose women because they continue to be undertreated, underdiagnosed, underrepresented, underresearched, all of these things. We need implementation science, though, to start moving these numbers.

It's not good enough to just say, “Here's the data, and here's how badly we're doing,” because we are always doing badly when it comes to women. We need to, instead, change the narrative: what would be a nice trial to see if we can improve the care of women, and if it fails, okay, well, then we know that doesn't work. But then let's try something else. We need implementation science, and that should be the next step for our cardiology community. Enough talking and more action.

Nicholls: The single biggest challenge we have in the clinic translating these results is access. And there's not a country in the world where access to any of these agents [GLP-1s] is easy. There are a lot of patients who stand to benefit. I know that all the payers are trying to work out how best to focus the therapies to those who need them the most, but our ability to be able to make these more available in a much quicker timeframe will allow us to be able to reduce a whole range of end-organ complications.

It's one thing to develop the agents. It's another thing to show that they work. But now we need to get them in the hands of the clinic and clinicians, and hopefully not think that we're going to be waiting 10 [to] 15 years to be able to do that. I'm pretty confident that we're going to see that access start to move quickly. I think that one of the things that may drive that is actually more agents coming into the space. I think that competition will be important in terms of driving the market and how the payers then respond to that.