Nurse Practitioner Chronicles

New ACC Guidance on Obesity and Cardiovascular Disease: What Every NP Needs to Know If you're a nurse practitioner in primary care, family practice, or cardiology, you already know that the obesity conversation has fundamentally changed. We're no longer in the era of "eat less, move more" as the sole clinical recommendation. The American College of Cardiology dropped two major guidance documents in August 2025 that every NP managing cardiovascular risk needs to have on their radar — and if you missed them, consider this your clinical catch-up. Let's break down what matters for your practice. Two Documents, One Clear Message The ACC released a Concise Clinical Guidance (CCG) on the medical management of obesity and a Scientific Statement focused specifically on treating obesity in adults with heart failure. Both documents signal a seismic shift in how we should be thinking about weight management as a core component of cardiovascular care — not a side conv...

Lipid Panel: Beyond Total Cholesterol—Non-HDL, ApoB, Lp(a), and Secondary Causes LDL-C is calculated, not measured. Non-HDL may be better. And nobody's checking Lp(a) yet even though they should be. The lipid panel is ordered on nearly every adult in primary care, yet most providers look at the LDL-C, compare it to a target, and stop. The panel actually contains much more information—and the advanced markers that are increasingly recommended (non-HDL, apoB, Lp(a)) are the ones that predict cardiovascular events better than LDL alone. The Standard Panel Total cholesterol : LDL + HDL + VLDL. Largely supplanted by its components for clinical decisions. LDL-C : Usually  calculated  by the Friedewald equation (TC − HDL − TG/5). Inaccurate when triglycerides >400 (equation breaks down) or when LDL is very low. Direct LDL measurement is available but not standard. HDL-C : Higher is generally protective. Very low HDL (<40 men, <50 women) increases cardiovascular risk. Pharmac...