Preventive Cardiology Research Updates

This review summarizes advances in pulmonary arterial hypertension (PAH) over four decades, noting shifts in epidemiology toward older patients with comorbidities and ongoing delays in diagnosis. It highlights pathobiologic insights (including dysregulation of the activin/TGF-β axis), evolving management with upfront oral combination therapy and sotatercept as the first antiremodeling therapy shown in randomized trials to improve hemodynamics, right heart function, and clinical outcomes, while gaps remain in early detection, personalized therapy, and treatments targeting right ventricular failure.

This American Heart Association scientific statement reviews exercise training across multiple high‑risk populations (including frailty, stroke, spinal cord injury, rheumatologic disease, genetic cardiomyopathies, and recipients of advanced heart failure therapies or cardiac devices), summarizing required modifications and responses to training. Common findings are increased barriers to participation, low baseline cardiorespiratory fitness creating heightened need for interventions, frequent need to emphasize strength, balance, and flexibility with enhanced supervision or equipment, and evidence of functional and quality‑of‑life gains from appropriately adapted programs; the statement highlights gaps and priorities for future research on patient‑centered, scalable delivery.

This 2026 American College of Cardiology Scientific Statement reviews evidence and implementation issues for direct oral anticoagulants (DOACs) across primary and secondary prevention of thrombotic events, noting DOACs have become preferred agents for most atrial fibrillation and venous thromboembolism patients but remain underutilized or inappropriately dosed in some populations. The statement synthesizes data on indications, special populations (chronic kidney disease, liver dysfunction, cancer, obesity, frailty, prior bleeding, valvular disease), periprocedural management, and practical considerations (drug selection, dosing, bleeding management, interactions, adherence, cost) to support individualized care.