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New Orleans, LA (March 17, 2019) – The choices we make every day can have a lasting effect on our heart and vascular health. Adopting a heart-healthy diet, doing more exercise, avoiding smoking and managing known risk factors are some of the key recommendations of the 2019 directive on the primary prevention of cardiovascular disease in the American College of Cardiology (ACC) and the American Heart Association (AHA). In addition, it is recommended to use aspirin only rarely to help prevent heart attacks and strokes in people without known cardiovascular disease.
The guideline, presented today at the CAC's 68th Annual Scientific Session, provides comprehensive but practical recommendations for preventing cardiovascular disease, which remains the leading cause of death for both men and women in the United States. In the United States, nearly one in three deaths is due to cardiovascular disease.
"The most important way to prevent cardiovascular disease, that it is an accumulation of plaque in the arteries, a heart attack, a stroke." , from heart failure or problems related to how the heart contracts and pumps blood to the rest of the body, is to adopt Roger S. Blumenthal, MD, co-chair of the 2019 directive of the 39; ACC / AHA on Primary Prevention of Cardiovascular Disease and Professor Kenneth Jay Pollin of Cardiology at Johns Hopkins Medicine. "More than 80% of all cardiovascular events can be prevented through lifestyle changes, but we do not often fail to implement these strategies and control other risk factors. "
The new prevention guideline, he said, aims to provide a road map of strategies that can be used and adapted to help people without a history of heart disease stay in good heart condition and, more importantly, to emphasize the need to identify and remove personal or social barriers to health. do this (for example, income and education levels, cost issues, lack of health insurance, access to healthy food or safe places to exercise, stressors of life).
Risk badessment
According to the guideline, any effort to prevent a first case of cardiovascular disease (called primary prevention) should ideally begin with a thorough badessment of its risk – that is, estimate the risk of developing blockages in arteries and having a heart attack or stroke or die as a result. All patients should discuss openly with their health care team their health habits and personal risks of cardiovascular disease and together determine the best way to prevent them based on available evidence and personal preferences.
"We now have good evidence on how to identify these high-risk individuals with a physical exam and a good history.For people at marginal risk, other factors can help us determine who is the more at risk and who should, for example, take a drug like a statin earlier to prevent a cardiovascular event, "Blumenthal said. "In the past, many people may have had a fatalistic attitude to developing heart problems sooner or later, but in reality most cardiovascular events can be avoided."
The paper synthesizes the best data and proven interventions to improve diet and exercise, stopping smoking and optimally controlling other factors that affect the likelihood of heart problems and problems. Strokes (eg, obesity, diabetes, high cholesterol and high blood pressure). The paper also addresses issues that may prevent people from incorporating better lifestyle habits.
Lifestyle change recommendations
The guideline emphasizes that healthy lifestyle changes are the cornerstone of heart disease prevention and goes a step further by providing practical advice based on the latest research.
"We can all do better with our eating and exercise habits, and it's very important when we think we want to live longer and healthier, whether to see our grandchildren grow up or to stay." as active as possible at an advanced age, "said Blumenthal. I said.
Some of the key lifestyle recommendations include:
Eat better for the heart – choose more vegetables, fruits, legumes, nuts, whole grains and fish, and limit salt, saturated fats, fried foods, processed meats and sugary drinks; specific dietary plans such as Mediterranean, DASH and vegetarian diets are reviewed.
Exercise regularly – experts advise to aim weekly for at least 150 minutes of moderate intensity exercise, such as brisk walking, swimming, dancing or cycling. For people who are inactive, some activities are better than no activities and small periods of activity of 10 minutes throughout the day can be very helpful for people with busy schedules. Currently, only half of American adults exercise enough and long periods of sitting can thwart the benefits of exercise.
Aim for and maintain a healthy weight – for overweight or obese people, losing only 5 to 10% of their weight (which is 10 to 20 pounds for a person weighing 200 pounds) can significantly reduce the risk of heart disease, stroke brain and other health problems.
Avoid smoking by avoiding smoking, breathing or breathing in the smoke – 1 in 3 deaths due to heart disease is attributable to smoking or exposure to second-hand smoke; each individual.
Use of aspirin
For people who have had a heart attack, stroke, open heart surgery or stents placed to open clogged arteries, aspirin can save lives. But the regular use of aspirin to prevent heart attacks and strokes in healthy people is not as clear.
In this guideline, ACC / AHA experts propose scientific recommendations that aspirin should only rarely be used to help prevent heart attacks and strokes in people without cardiovascular disease known. Recent research suggests that the risk of bleeding, given the anticoagulant effect of aspirin, may be too high and that the evidence of benefit – the number of heart attacks or strokes – may increase. Really prevented strokes – is not enough to make a daily aspirin to take for most adults in this setting.
"Clinicians should be very selective in prescribing aspirin to people not suffering from known cardiovascular disease," said Blumenthal. "It's much more important to optimize lifestyle and control blood pressure and cholesterol than to recommend aspirin." Aspirin should be limited to people at higher risk of disease cardiovascular and a very low risk of hemorrhage. "
Based on a simplified summary of the latest recommendation for ACC / AHA cholesterol, statins should be routinely recommended to modify lifestyle to prevent cardiovascular disease in people with high levels of low lipoprotein cholesterol. density (LDL) (approximately 190 mg / dl), Type 2 Diabetes and anyone deemed very likely to have a stroke or heart attack after reviewing their medical history and risk factors and discussing it in detail with his clinician.
Diabetes
For people with type 2 diabetes, which is one of the most important risk factors for cardiovascular disease, new data indicate that two clbades of diabetes medications, which help lower blood sugar levels, can also reduce the risk of heart attack, stroke, and related diseases. deaths.
The 2019 ACC / AHA guideline on the primary prevention of cardiovascular disease will be published simultaneously in the Journal of the American College of Cardiology and in the Journal of the American Heart Association circulation.
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About the American College of Cardiology
The American College of Cardiology envisions a world where innovation and knowledge optimize care and cardiovascular outcomes. As a professional home for the entire cardiovascular care team, the College and its 52,000 members are dedicated to transforming cardiovascular care and improving heart health. The CAC confers its competencies on cardiovascular health professionals who meet stringent qualifications and plays a leading role in the development of health policies, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned journals, JACC, manages national registries to measure and improve care, and provides cardiovascular accreditation to hospitals and institutions. For more, visit acc.org.
About the American Heart Association
The American Heart Association is a major force for a world of longer and healthier lives. With nearly a century of life-saving work, the Dallas-based organization works to ensure equitable health for all. We are a reliable source for people to improve their heart health, their cerebral health and their well-being. We work with many organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share life-saving resources and information. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.
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