Viet Le, DMSc, PA-C, is a preventive cardiology PA at Intermountain Health and the former president of the Academy of Physician Associates in Cardiology.

Viet Le, DMSc, PA-C

Breaking Down 2025 ACC/AHA Hypertension Guidelines, with Viet Le, PA-C, DMSc

On August 14, 2025, the American Heart Association (AHA) and the American College of Cardiology (ACC) published a revised set of clinical guidelines for the detection and management of 

, based on decisions from the ACC/AHA Joint Committee on Clinical Practice Guidelines. Titled the “2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults”, the new document replaces the 2017 guidelines.

Aiming to collate all current knowledge in the field of high blood pressure to provide primary care and specialty clinicians with a comprehensive guide to managing hypertension, the document included detailed recommendations describing the processes of screening, treatment, and prevention of the condition.

 sat down with Viet Le, DMSc, PA-C, a preventive cardiology PA at Intermountain Health and the former president of the Academy of Physician Associates in Cardiology, to discuss the implications of these new guidelines and the impact they may have on the treatment landscape as hypertension becomes a greater burden for the public.

“The necessity of bringing 2025 forward in time was to reiterate that yes, stage 1 is 130-80, stage 2 is 140-90, and then we have elevated blood pressure regions,” Le told 

. “But most importantly, we all agree that the goal is less than 130 systolic, the goal is less than 80 diastolic.”

The revised document includes a table detailing new recommendations, including improved and increased screening for primary aldosteronism, avoiding atenolol, ARB, ACEi, nitroprusside, MRA, or direct renin inhibitors in pregnant patients with hypertension, and suggestions to prevent cognitive impairment and 

Another significant change made in the new guidelines was a recommendation that health care professionals utilize the Predicting Risk of CVD EVENTs (PREVENT) risk calculator, which was derived from data including a more diverse sample of racial and ethnic groups. Additionally, PREVENT expands the investigatory scope to total CVD risk, including 

Le also went on to discuss the broader implications of these guidelines. He expressed concern as to the practical ability of the US healthcare system to manage the burden of hypertension proactively.

"I think health systems need to rise up to this because, hey, I’m one person, but I work within the confines of a healthcare system that either supports me being able to do public health practice or not,” Le said. “And so, if we’re just happy with fee-for-service and sick care, we’ll never get to proactive value-based care and actually deliver health care. I would say that the US healthcare system in particular is not ready for that burden because we’re incentivized the wrong way.”

Editor’s Note: Relevant disclosures for Le include Novartis, Pfizer, Amgen, and Janssen.

Jones DW, Ferdinand KC, Taler SJ, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online August 14, 2025. 

Jones, D, Ferdinand, K, Taler, S. et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. JACC. null2025, 0 (0). 

https://doi.org/10.1016/j.jacc.2025.05.007

Videos

Le discusses the implications of these new guidelines and whether the US healthcare system can manage the increasing public burden of hypertension.

The Future of Cardiology 2025 with Viet Le, DMSc, PA-C

 field has been rapidly expanding over the past few years, with breakthroughs that would take decades in any other specialty cropping up just days apart from one another.

This immense progress was highlighted this year at the 

American College of Cardiology (ACC) 2025 Annual Scientific Sessions

 for over 4,750 abstracts, with 1,300 expert faculty and 300 sessions, covering 53 different late-breaking clinical trials.

A leading expert in the field, Viet Le, DMSc, PA-C, a preventive cardiology PA at Intermountain Health and the former president of the Academy of Physician Associates in Cardiology, spoke with the editorial team of 

 about upcoming studies and anticipated breakthroughs for the rest of 2025.

: What are you looking forward to in cardiology for the rest of 2025?

: As a researcher, I look forward to all the ongoing trials in this space. Lipoprotein(a) [Lp(a)] is starting to take front and center stage as we get into these final moments of follow-up for at least one of the four studies that are out there. I'm involved with the HORIZON study with pelacarsen, and I am so excited to see where that reports out. I'm hoping that we'll see some type of result, maybe the end of this year, or maybe the first quarter of 2026. I look forward to that, and we have a couple of trials coming from Intermountain [Health]. There's the Target-D trial, where we're looking at vitamin D levels in an acute coronary syndrome (ACS) population. And then, of course, we have our CorCal trial, where we're looking at coronary artery calcium scoring versus the Pooled Cohort Equation in terms of statin eligibility and uptake in statin use, as well as the lowering of LDL-C. We're all asking, is this the appropriate thing to do? Stay tuned, those are things I'm excited about. Of course, there are SGLT inhibitors and GLP-1 trials that are coming, so it's an exciting time for cardiovascular medicine.

Relevant disclosures for Le include Novartis, Pfizer, Amgen, and Janssen.

Le discusses his anticipation for the results of upcoming cardiology trials in 2025, including HORIZON and Target-D.

Latest in Lipids and Trials to Watch in 2025, with Viet Le, DMSc, PA-C

Updates and Top Trials in Cardiology at ACC.25, with Viet Le, PA-C, DMSc

Several major cardiovascular trials presented at the 

 highlighted the expanding role of glucagon-like peptide 1 (GLP-1) receptor agonists and sodium glucose cotransporter 2 (SGLT2) inhibitors in cardiovascular and metabolic health.

This year’s meeting in Chicago featured more than 4,750 accepted abstracts, with 1,300 expert faculty and 300 sessions, encompassing 53 late-breaking clinical trials.

In an interview at ACC.25, Viet Le, DMSc, PA-C, an associate professor of research and a preventive cardiology PA at Intermountain Health, talks about key updates he felt were most pertinent for practicing clinicians to be aware of from the first 2 days of the meeting

Le highlighted the STRIDE trial examining the effects of semaglutide (1 mg injectable) in patients with peripheral artery disease (PAD) but without diabetes. The investigative team, led by Marc Bonaca, MD, CPC Clinical Research, identified significant cardiovascular benefits for this population, reinforcing findings from the SELECT trial. Based on these results, Le suggested that GLP-1 RAs should be considered cardiovascular drugs, rather than solely for weight management or glucose control. Le indicated the benefits observed in STRIDE were not driven by weight loss, raising further questions about the underlying mechanisms of metabolic dysfunction.

The SOUL trial investigated oral semaglutide and confirmed cardiovascular benefits similar to its injectable counterpart. Le noted that before this trial, there was uncertainty regarding whether the oral formulation would provide the same protective effects. Oral semaglutide was linked to a 14% reduction in major adverse cardiovascular events (MACE) at an average follow-up of four years in high-risk type 2 diabetes (T2D). Le indicated these findings provide reassurance that patients who prefer oral semaglutide due to needle aversion can still achieve cardiovascular benefits.

In the transcatheter aortic valve replacement (TAVR) space, the DapaTAVI trial, conducted across 39 centers in Spain with approximately 1,200 patients, assessed the use of dapagliflozin (10 mg) versus placebo in patients with heart failure aged ≥75 years undergoing TAVR. Le noted the results showed a significant reduction in mortality and improved quality-of-life outcomes, suggesting that SGLT2 inhibitors provide meaningful benefits even in older, frail patients.

Watch the video above to gain more insights from our conversation with Le.

Campbell P. STRIDE: Semaglutide improves functional outcomes in peripheral artery disease. HCP Live. March 29, 2025. Accessed April 2, 2025. 

https://www.hcplive.com/view/semaglutide-improves-functional-outcomes-in-peripheral-artery-disease

Iapoce C. Soul: Oral Semaglutide Cuts Mace by 14% in people with type 2 diabetes. HCP Live. March 29, 2025. Accessed April 2, 2025. 

https://www.hcplive.com/view/soul-oral-semaglutide-cuts-mace-by-14-in-people-with-type-2-diabetes

Iapoce C. Dapagliflozin improves outcomes in heart failure after Tavi Procedure. HCP Live. March 30, 2025. Accessed April 2, 2025. 

https://www.hcplive.com/view/dapagliflozin-improves-outcomes-in-heart-failure-after-tavi-procedure

Le examines the STRIDE, SOUL, and DapaTAVI trials presented at this year’s ACC Scientific Sessions. 

Updates and Top Trials at ACC.25, with Viet Le, DMSc, PA-C

HCPLive Viet Le AHA 2024

American Heart Association (AHA) Annual Scientific Sessions 2024

 community welcomed several new trials and updates across the spectrum of cardiovascular disease, from arrhythmias to heart failure to hypertension and everything in between.

As part of our on-site coverage of AHA 24, the editorial team of HCPLive Cardiology caught up with advisory board Viet Le, PA-C, DMSc, an associate professor of research and a preventive cardiology PA at Intermountain Health. In the video above, Le, who is also the immediate past president of the Academy of Physician Associates in Cardiology (APAC), talks about 5 key updates he felt were most pertinent for practicing clinicians to be aware of from the first 2 days of the meeting.

First, Le highlights the BPROAD trial, which reaffirmed the need for intensive blood pressure targets, particularly in patients with diabetes. Results from this Chinese population study demonstrated lowering systolic blood pressure to <120 mmHg significantly reduced cardiovascular events without increasing hypotension risk relative to a target of <150 mmHg.

Next, he highlights the OPTION trial, which compared LAAC with the WATCHMAN FLX device against DOACs. Results of the trial found the device was noninferior for stroke prevention while reducing bleeding risk, offering a valuable alternative for patients intolerant to anticoagulants.

Le calls particular attention to the VANISH2 trial, which found use of catheter ablation in ventricular tachycardia (VT) reduced VT events and shocks—something Le expects could have a profound impact on the quality of life for patients.

Lastly, Le calls attention to a pair of updates related to the use of artificial intelligence (AI) in care. At the meeting, AI's utility in echocardiography was explored through studies demonstrating its ability to enhance diagnostic workflows. While Le cautions this technology may not be ready for autonomous use, these advancements highlight its potential to streamline processes and enhance precision in cardiovascular imaging.

Relevant disclosures for Le include Novartis, Pfizer, Amgen, and Janssen. 

Ning G, Wang W, He J, Bi Y, et al. Effects of Intensive Blood Pressure Control in Patients with Type 2 Diabetes. Presented at the American Heart Association (AHA) Scientific Sessions 2024. Chicago, Illinois. November 16-18, 2024.

Wazni OM. Randomized Comparison of Left Atrial Appendage Closure with Oral Anticoagulation after Catheter Ablation for Atrial Fibrillation. Paper presented at: American Heart Association Scientific Sessions 2024; November 15 - 18; Chicago, Il. Accessed November 16, 2024.

Sapp JL, Tang ASL, Stevenson WG, et al. Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia. The New England Journal of Medicine. Published November 16, 2024. Accessed November 16, 2024.

The American Heart Association Annual Scientific Sessions 2024 presented significant updates in cardiovascular disease management. Key highlights include the BPROAD trial, which supports intensive blood pressure control in diabetic patients to reduce cardiovascular events. The OPTION trial demonstrated the noninferiority of the WATCHMAN FLX device compared to DOACs for stroke prevention, with reduced bleeding risk. The VANISH2 trial showed catheter ablation's effectiveness in reducing ventricular tachycardia events. Additionally, advancements in AI for echocardiography were discussed, emphasizing its potential to improve diagnostic workflows.

Viet Le, PA-C, DMSc, breaks down new data and updates from AHA 24, spotlighting 3 specific trials and the applicability of artificial intelligence in care.

Viet Le, DMSc, PA-C

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