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  • Heart Month: New Heart Disease and Stroke Prevention Guidelines

    by Glenn Bean

    The American College of Cardiology and the American Heart Association recently released new clinical practice guidelines covering four important areas that impact heart health: lifestyle, cholesterol, obesity and risk assessment. These revised guidelines are designed to help primary health care providers better identify adults who may be at high risk for heart disease.

    The guidelines — which were last updated in 2004 — take a very different approach from the past, offering a new formula for estimating risk, and are aimed at preventing strokes as well, not just heart attacks.

    Heart disease is the no. 1 killer of men and women. But there's a lot you can do to prevent it — like scheduling a Heart Check screening at MultiCare today.

    The guidelines’ new risk assessment formula focuses more broadly on a person’s overall disease risk by using a range of factors — including age, gender, race and smoking history — instead of focusing solely on specific targets, such as cholesterol levels.

    Part of this new approach includes cholesterol treatment guidelines that set a lower threshold for prescribing cholesterol medicines, called statins. The guidelines also identify the four groups of people that would benefit the most from this medicine:
    • People who already have heart disease
    • Those with an LDL (“bad” cholesterol) level of 190 or higher, usually because of genetic risk
    • People ages 40 to 75 with Type 2 diabetes
    • People ages 40 to 75 with an estimated 10-year risk of heart attack or stroke at 7.5 percent or higher (meaning, for every 100 people with a similar risk profile, seven or eight of those people would have a heart attack or stroke within 10 years).
    Under the new guidelines, up to one-third of US adults — 44 percent of men and 22 percent of women — now meet the threshold to consider taking medicine to lower their cholesterol. Previously, statins were recommended for only about 15 percent of adults. However, physicians say the new approach will actually limit how many people are put on statins based only on their cholesterol level, and will help to ensure that patients who will benefit the most will receive medication.

    The guidelines also recommend:
    • Adults ages 40 to 79 should have a risk evaluation done every four to six years using the new formula to estimate their chances of suffering a heart attack or stroke.
    • Adults ages 20 to 59 should be evaluated using traditional factors such as cholesterol and blood pressure to estimate their lifetime risk of a heart attack or stroke, and, if necessary, encourage them to make healthier lifestyle choices.
    • To fight obesity, health care providers should support an individualized weight loss plan for overweight or obese patients, and the guidelines recommend programs that offer two or three in-person meetings a month for at least six months.
    • Everyone should get at least 40 minutes of moderate to vigorous exercise three or four times a week.
    • Everyone should eat a diet that focuses on vegetables, fruits and whole grains. It should include low-fat dairy products, poultry, fish, beans and healthy oils and nuts. The diet should also limit sweets, sweet drinks, red meat, saturated fat and salt.
    The new guidelines were based on rigorous, comprehensive, and systematic evidence reviews sponsored by the National Heart, Lung, and Blood institute and endorsed by the American College of Cardiology and the American Heart Association.

    The best way to evaluate your own risk and the need for preventive treatment is to consult with your primary care health provider.

    For more information on the new guidelines and ways to keep your heart healthy, visit the American Heart Association's website.

    Posted on Feb 19, 2014 in Cardiac, Stroke & Neurosciences, Healthy Living