The ACC HeartPAC is excited to announce a brand-new challenge – HeartPAC March Mayhem! Chapters will compete with one another to see who can get the most members to contribute to HeartPAC! The winner will take home the title of 2023 March Mayhem Champion, along with other special prizes. It is vitally important that we each support the HeartPAC. No amount is too small. To make your 2023 contribution, please visit HeartPAC.org or text HeartPAC to 41444. Let's make sure that the Ohio-ACC has a good showing!

If you will be at ACC.23, there will be some special HeartPAC events! 2023 donors who contribute $250+ ($25 for FITs, $50 for CV team members and Chapter Executives) will receive exclusive access to the HeartPAC Donor Lounge, serving complimentary breakfast, lunch, coffee, and snacks. This year’s lounge will also include exciting programming from advocacy roundtable discussions to mentor opportunities to learn more about ACC’s health policy initiatives! More details are included below.

Friday, March 3 | 5:30 PM – 7:30 PM CST

Bar Marilou, 544 Carondelet St

*Open to ACC members who have contributed to HeartPAC in 2023

Please RSVP to rmoore@acc.org by Monday, February 27.

Saturday, March 4 – Monday, March 6 | 7 AM – 5 PM

Lounge & Learn Pavilion, Ernest N. Morial Convention Center

You are cordially invited to join the Ohio-ACC for a special legislative day in Columbus, on May 9th with a kick-off dinner on May 8th. This will be a day of visiting your Ohio representatives and senators to introduce them to cardiology issues facing you and your patients. Building relationships with your state lawmakers will help ensure that the Ohio General Assembly remains informed of issues facing clinicians and patients. There is no charge for the event, and appointments with your lawmakers will be made for you. Parking will be validated. Get complete details here.

Issues that we have advocated for in the past that have become law include: raising the age to purchase cigarettes, other tobacco products, and alternative nicotine products such as e-cigarettes and vaping products from 18 to 21; Lindsay's Law which informs and educates students and youth athletes participating in or desiring to participate in athletic activity, their parents, and their coaches about the nature and warning signs of sudden cardiac arrest; and vital telehealth legislation. Your participation makes a difference!

A limited number of Ohio-ACC Legislative Day travel stipends are available on a first-come, first-served basis, which includes overnight accommodations for May 8 and parking. Contact ohioacc@gmail.com for this opportunity.

If Gwen Goldfarb, our chapter executive, or I can be of assistance to you, please let us know.

Please take a moment to subscribe to the Ohio-ACC CardiOhio Podcast. Simply copy and paste this URL into the podcast app of your choice, or click here to view in Apple podcasts. These 30-minute audio podcasts are designed to provide practical management tips for our providers. We really hope that you will find this information useful for your practice.

Guest: Philip Barger, MD

Guest: Sagar Kalahasti, MD, FACC

The Ohio-ACC FIT council continues the successful Fellow Grand Rounds Series which presents a noon session approximately every two months to highlight the extraordinary work being done to mitigate disparities in cardiology. Each session rotates between different Ohio fellowship programs. The goal of the grand rounds is to bring a better understanding of the root cause of disparities in cardiology and how our speakers have dedicated their careers to the topic. Participants will learn more about the given topic, the speaker’s career journey, and her/his niche in the field.

February 22, 2023 - OSU/Kettering/Doctors Hospital - Dr. Lauren Lastinger will highlight Cardio-Obstetrics. Register here.

If you missed a session, you can see it here!

Thiazide and thiazide-like diuretics have been a cornerstone in the treatment of hypertension for decades. In ALLHAT, a randomized, double-blind controlled trial of 33,357 patients with hypertension randomized to receive chlorthalidone, amlodipine, or lisinopril.¹ The thiazide-like diuretic, chlorthalidone, was superior to amlodipine in the risk of developing heart failure (HF) (RR 1.38; 95% CI, 1.25-1.52) and rates of HF hospitalization (RR 1.35; 95% CI, 1.21-1.50) as well as superior to lisinopril in the prevention of the composite of coronary heart disease death, nonfatal myocardial infarction (MI), stroke, coronary revascularization, hospitalized or treated angina, hospitalized or treated HF, and peripheral arterial disease (RR 1.10; 95% CI, 1.05-1.15). Additionally, chlorthalidone’s half-life of 40 to 60 hours provides more consistent blood pressure control over a 24-hour period compared to hydrochlorothiazide’s 5-to-15-hour half-life.^2,3 There has been concern that hydrochlorothiazide may have a wearing-off effect given its pharmacokinetics. As a result, the 2017 ACC/AHA Hypertension guidelines recommend chlorthalidone as the preferred thiazide diuretic given proven reduction in cardiovascular outcomes and pharmacokinetic properties.⁴

Two recent studies sought to determine the comparative effectiveness and safety of these two agents. In 2020, Hripcsak and colleagues conducted a cohort study analyzing 730,225 patients newly initiated on antihypertensive treatment with chlorthalidone or hydrochlorothiazide.⁵ Of note, the vast majority of participants were receiving hydrochlorothiazide (~95%). Overall, there was no difference in the risk of acute MI, HF hospitalization, stroke, or composite cardiovascular disease with the use of chlorthalidone compared to hydrochlorothiazide. The use of chlorthalidone was, however, associated with an increased risk of hypokalemia (HR 2.72; 95% CI, 2.38-3.12), hyponatremia (HR 1.31; 95% CI, 1.16-1.47), and acute renal failure (HR 1.37; 95% CI, 1.15-1.63).

In 2022, an open-label, randomized controlled trial investigated the use of chlorthalidone versus hydrochlorothiazide in 13,523 patients 65 years or older with hypertension randomized to hydrochlorothiazide (25-50 mg/day) or chlorthalidone (12.5-25 mg/day).⁶ At a median follow-up of 2.4 years, there was no difference in the primary composite outcome of nonfatal MI, stroke, HF hospitalization, urgent coronary revascularization for unstable angina, and non-cancer-related death between the two groups (p=0.45). There was also no difference observed in the rates of the components of the primary outcome. With respect to tolerability, the chlorthalidone group experienced more hypokalemia with a potassium level <3.1 mmol/L (5% vs 3.6%, p<0.0001). The median average daily dose was equipotent at 12.3 mg in the chlorthalidone group and 23 mg in the hydrochlorothiazide group; however, it should be noted that these doses are lower than those that previously demonstrated cardiovascular benefit (≥ 50 mg of hydrochlorothiazide and ≥ 25 mg of chlorthalidone).

1.      The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288(23):2981–2997.

2.      Thalitone (chlorthalidone) [package insert]. East Brunswick, NJ: Casper Pharma LLC; 2018.

3.      Hydrochlorothiazide [package insert]. Morgantown, WV: Myland Pharmaceuticals Inc; 2011.

4.      Whelton PK, Carey RM, AronowWS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA 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 Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018;71:e127-e248.

5.      Hripcsak G, Suchard MA, Shea S, et al. Comparison of cardiovascular safety and outcomes of chlorthalidone vs hydrochlorothiazide to treat hypertension. JAMA Intern Med. 2020;180(4):542-551.

6.      Ishani A, Cushman WC, Leatherman SM, et al. Chlorthalidone vs. hydrochlorothiazide for hypertension-cardiovascular events. N Engl J Med. 2022;387:2401-2410.

Studies show advice from a healthcare provider to quit nicotine use is an important motivator to making a cessation attempt, as well as overall patient satisfaction with their healthcare provider.^[1],[2] While there has been some success in reducing nicotine and nicotine use, new products and challenges still result in nicotine use being the number one preventable cause of death. The Ohio Tobacco Quit Line (OTQL) is available to all Ohioans, regardless of insurance status, to provide telephonic coaching and nicotine replacement therapy cost-free to enrollees.

Eligible Applicants: Any Ohio provider of medical, pharmaceutical, oral health, or other treatment services may apply. These provider types include, but are not limited to: dentist, cardiologists, pulmonologists, obstetricians, gynecologists, orthopedists, podiatrists, psychiatrists, chiropractors.

Project Details: For additional information on the project, please see the following resources.

·    BHIW Tobacco Cessation Provider QI Agreement - Final

·    Sample Contract

2.   If you are an entity that wishes to engage in this project, you will need to apply for an OH/ID – Supplier ID number at https://supplier.ohio.gov before beginning your application to allow for processing time. Contact Ohio Shared Services at 1-877-644-6771 for assistance. (If you are already a vendor, please use the same link above to ensure your Supplier ID is active. If it is not active, be sure to reactivate before proceeding.)

3.   Once you receive your Supplier ID number, send an email to Amy.Gorenflo@odh.ohio.gov with the number and state your intentions to receive a contract for the AAR Quality Improvement Project.

[1] Toll BA, Rojewski AM, Duncan LR, et al. "Quitting smoking will benefit your health": the evolution of clinician messaging to encourage tobacco cessation. Clin Cancer Res. 2014;20(2):301-309. doi:10.1158/1078-0432.CCR-13-2261

[2] Solberg LI, Boyle RG, Davidson G, Magnan SJ, Carlson CL. Patient satisfaction and discussion of smoking cessation during clinical visits. Mayo Clin Proc. 2001 Feb;76(2):138-43. doi: 10.1016/S0025-6196(11)63119-4. PMID: 11213301.

With more than 6 million Americans with heart failure, patient education is key in managing and living with this condition. To help patients better understand and manage heart failure, ACC’s CardioSmart team has developed a package of tools and resources including a new Action Plan for Heart Failure With Preserved Ejection Fraction (HFpEF). The package also includes infographics, decision aids, and updated tools teaching patients how to make the most of their follow-up visits, use checklists, daily trackers, and more. Download the tools for free.

Hot off the press: Don’t miss this month’s issue of Cardiology magazine, focused on the global burden of cardiovascular disease and opportunities for clinicians from around the world to come together to deliver tangible change. Read the full issue at ACC.org/Cardiology.  

CardioSmart is the ACC’s dedicated home for patient tools and resources, including infographics, shared decision-making aids, and more. Find information on specific clinical conditions, health lifestyle choices and more at CardioSmart.org.

The recent Global Burden of Cardiovascular Disease special issue of JACC looks at data addressing 18 specific cardiovascular conditions and five risk factors from 204 countries and territories. It highlights the leading global modifiable cardiovascular risk factors, their contribution to disease burden and recent prevention advancements. Read the full almanac-style issue.

The ACC’s NCD Academy equips global health care providers with high quality continuing education available anytime, anywhere, and free of charge on skills to mitigate non-communicable diseases (NCDs). Current courses address topics like cardiovascular disease, diabetes, cancer, mental health and advocacy. Learn more at ACC.org/NCDAcademy.