Dispense As Written

Four episodes. One guideline. One honest answer to the question nobody asks at the end of a guideline review: what do we actually do now? This finale recaps the four key takeaways from the 2026 ACC/AHA Dyslipidemia series, addresses the non-statin evidence gap, and closes with the argument that matters most — the one about the patient sitting across from you. 📊 Four Takeaways: • COR 1 + LOE C-EO...

The new 2026 cholesterol guideline just replaced the national heart risk calculator — and 17 million Americans no longer qualify for a statin because of it. 4.1 million of them are currently taking one. Here's what makes this worth examining closely: ↳ The new PREVENT calculator cuts mean 10-year ASCVD risk nearly in half nationally (8.0% → 4.3%) ↳ Black adults saw the largest drop: 10.9% → 5....

The new 2026 ACC/AHA Dyslipidemia Guideline issued a Class 1 Recommendation for every adult in the US to get their Lipoprotein(a) measured once in a lifetime. But here is the catch: if you find it elevated, the guideline’s core recommendation is simply to optimize modifiable risk factors—the exact same care we should already be providing. With no completed outcomes trials yet proving that lowering...

The 2026 ACC/AHA Dyslipidemia Guideline sets LDL targets of less than 70 mg/dL for high-risk patients and less than 55 mg/dL for very high-risk patients. Those numbers will drive prescribing decisions for the next decade. Has anyone ever run a randomized trial where one group was treated to a target of 70 and another to 55, and compared what happened? When the guideline was published on March 13,...

The newly released 2026 ACC/AHA Dyslipidemia Guideline represents a massive collaborative effort across eleven co-signing societies, introducing critical updates like new LDL targets and universal Lp(a) screening. It is a vital playbook for primary care. However, implementing these updates effectively requires us to look closely at how recommendations are categorized. As clinicians, it is easy to...

Nearly 20 years after HPV vaccines were introduced, fewer than one in three eligible adolescent girls worldwide has ever been vaccinated. The barrier isn’t the science — it’s supply, access, and multi-dose schedules. If a single shot delivers the same protection as two, the public health implications are enormous. The ESCUDDO trial (Kreimer et al., NEJM 2025) enrolled over 20,000 girls across Cost...

Should I stop drinking coffee? For years, we’ve said yes — or at least probably. But that advice was built on zero randomized evidence. Observational data had been leaning the other way for years. Nobody actually ran the trial. Until now. The DECAF trial — Does Eliminating Coffee Avoid Fibrillation? — is the first randomized clinical trial to directly test caffeine in AFib patients after cardiover...

Your patient is still not at blood pressure goal after 1–3 months on a medication. Do you double the current dose — or add a second drug? Most clinicians double the dose. A 2025 Lancet meta-analysis of 484 double-blind, placebo-controlled randomized controlled trials has a definitive answer. And the math is not close. Doubling the dose buys you ~1.5 mmHg on average. Beta-blockers? Half a millimete...

Title: Tirzepatide vs Semaglutide: Which GLP-1 Wins? | SURMOUNT-5 TrialDescription:Head-to-head comparison: tirzepatide 15mg vs semaglutide 2.4mg for weight loss. SURMOUNT-5 trial breakdown in under 5 minutes. Evidence-based medicine, no fluff.📊 KEY FINDINGS:Tirzepatide: -20.2% weight loss at 72 weeksSemaglutide: -13.7% weight loss at 72 weeks48.4% vs 27.3% achieving ≥20% weight lossSimilar toler...