Neha Pagidipati, MD, MPH, is an assistant professor of medicine and cardiovascular disease prevention specialist at Duke University School of Medicine.

Neha Pagidipati, MD, MPH

Counting down the biggest news from major medical meetings, it's the HCPLive Five!

HCPLive Five at Heart in Diabetes 2025

 is a medical conference bringing together world-renowned clinical leaders in 

. Designed to evaluate state-of-the-art clinical data and research while focusing on the management of the heart and 

 in diabetes, the meeting’s goal is to align cardiologists, endocrinologists, diabetologists, 

, nephrologists, and all other interested clinicians in their understanding and development of appropriate comprehensive clinical management plans for high-risk patients.

’s on-site coverage, the editorial team conducted expert interviews and reported on timely topics across implementation science, cardiometabolic health, combination therapy, and more. In this edition of the HCPLive Five, the team highlights key conversations on barriers to evidence-based cardiometabolic care, recognizing 

 as a chronic disease, data on cardiovascular disease trends, the CONFIDENCE trial of combined finerenone plus empagliflozin in patients with both 

 and type 2 diabetes, and data accessibility issues in an era of unprecedented technological innovation.

Improving Evidence-Based Cardiometabolic Care, with Neha Pagidipati, MD, MPH

While innovation in cardiovascular, kidney, and metabolic care often centers around emerging therapies, the underuse of established, evidence-based treatments in clinical practice remains a major and under-discussed challenge. In this interview with 

 at HiD, Neha Pagidipati, MD, MPH, an assistant professor of medicine and cardiovascular disease prevention specialist at Duke University School of Medicine, reviews different barriers to implementing guideline-directed medical therapy as well as facilitators and potential avenues for improvement moving forward.

Classifying Obesity as a Chronic Disease with W. Timothy Garvey, MD

Given the limitations surrounding BMI measurement of obesity, a recent Lancet Commission aimed to better define obesity as a condition of illness that comes as a direct result of excess adiposity and its effect on the function of tissues and organs. In this interview with 

 at HiD, Timothy Garvey, MD, breaks down some of the key points from the paper and how they will influence the treatment of obesity and its complications moving forward.

Moving the Needle on Cardiovascular Disease, with Seth Martin, MD, MHS

Despite decades of progress and innovation in cardiovascular care, recent data from the American Heart Association (AHA) suggest that the momentum has stalled—and in some cases, reversed. At HiD, Seth Martin, MD, MHS, a professor of medicine in the division of cardiology at Johns Hopkins Hospital and co-founder at Corrie Health, offered a data-driven overview of the current state of cardiovascular disease (CVD) in the United States and globally, based on the AHA’s 2024 statistical update. In this interview with 

, he reviews key trends and calls for urgent action to improve implementation of prevention and treatment strategies at scale.

Don’t Miss a Beat: CONFIDENCE Trial and Combination T2D, CKD Therapy at Heart in Diabetes 2025

, hosts Muthiah Vaduganathan, MD, MPH, a cardiologist and codirector of the Center for Cardiometabolic Implementation Science at Brigham and Women’s Hospital, and Steve Greene, MD, an advanced heart failure specialist at Duke University School of Medicine, review key findings and clinical implications of the CONFIDENCE trial. The data, which were also presented at the 

62nd European Renal Association (ERA 2025) Congress

 in Vienna, Austria, suggest the potential benefits of combination initial therapy with finerenone plus empagliflozin in patients with both CKD and type 2 diabetes.

Confronting Cardiology's Data Accessibility Problem, with Robert Califf, MD

, Robert Califf, MD, an instructor of medicine at Duke University School of Medicine and former commissioner of the US Food and Drug Administration, provided his perspective on the ongoing difficulties in implementation of digital technologies and preventative measures for cardiovascular diseases and diabetes. He points to shortcomings of the cardiology field and the medical industry at large in adapting technological advances to practical, clinical usability, citing the high number of new programs and mechanisms for tracking individual risk factors and their failure to collate this data meaningfully for patients.

These 5 represent only some of the data the 

 team covered at this year's meeting! Check out more KOL insight and our full conference coverage on our 

Videos

From barriers to implementing evidence-based care to innovations in combination therapy, here are 5 key updates from the annual meeting.

, and metabolic care often centers around emerging therapies, the underuse of established, evidence-based treatments in clinical practice remains a major and under-discussed challenge.

 in Philadelphia, Pennsylvania, Neha Pagidipati, MD, MPH, an assistant professor of medicine and cardiovascular disease prevention specialist at Duke University School of Medicine, reviewed different barriers to implementing guideline-directed medical therapy as well as facilitators and potential avenues for improvement moving forward.

“It's really exciting to talk about the next new therapy, but I would say it's equally as important to talk about how we get therapies that are already available used appropriately,” Pagidipati explained to 

, highlighting current shortcomings of care for patients with cardiometabolic diseases and potential reasons behind them.

Despite the availability of highly effective, low-cost treatments like high-intensity statins, ACE inhibitors/ARBs, and SGLT2 inhibitors or GLP-1 receptor agonists, Pagidipati notes that their uptake remains alarmingly low. She cites data showing fewer than 2.7% of patients with both diabetes and atherosclerotic cardiovascular disease are on all 3 therapies, stressing the urgency of addressing this implementation gap.

“I think the reasons for lack of evidence-based care are incredibly diverse and complicated, and that's why it's not easy to fix,” Pagidipati said, describing the combination of patient-, clinician, and system-level factors that contribute to this issue.

Looking ahead to what can be done to improve implementation of guideline-directed medical therapy, Pagidipati cites the importance of addressing issues at all levels, emphasizing that all it takes to make a difference locally is for somebody to care. As an example, she references findings from the COORDINATE-Diabetes trial demonstrating better rates of appropriate medical therapy implementation among sites where somebody stepped up as a “champion,” most commonly a nurse, a medical assistant, a pharmacist, or an advanced practice clinician.

Pagidipati also describes national initiatives, including the CardioHealth Alliance and 2 new programs: test to treat, aimed at improving LDL cholesterol testing and follow-up care post–cardiac events, and IRIS CKD, which seeks to boost chronic kidney disease screening and treatment in patients with type 2 diabetes.

“I hope that what people took away is that, yes, we have a problem, we have to recognize that evidence-based therapies are not being used, even when they are inexpensive and widely available. We have to understand why that's happening, importantly on a local level, but also on a health system level,” Pagidipati concluded. “I hope people came away with some amount of optimism that we are trying to address this.”

Editors’ note: Pagidipati has relevant disclosures with Alnylam, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, CRISPR Therapeutics, Eggland’s Best, Eli Lilly, Esperion, Novartis, Novo Nordisk, Merck, and Miga Health.

Tannu M, Kaltenbach L, Pagidipati NJ, et al. Effects of an Intervention to Improve Evidence-Based Care for People With Diabetes and Cardiovascular Disease Across Sex, Race, and Ethnicity Subgroups: Insights From the COORDINATE-Diabetes Trial. Circulation. 2024 Jul 16;150(3):180-189. doi:10.1161/CIRCULATIONAHA.124.068962

Pagidipati describes barriers to implementing guideline-directed medical therapy in patients with cardiometabolic diseases and steps needed to overcome them.

Neha Pagidipati, MD, MPH

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