NEW ORLEANS — The American College of Cardiology (ACC) and American Heart Association (AHA) have released a new evidence-based guideline detailing the primary prevention of cardiovascular disease (CVD), including recommendations on patient-centered care, aspirin use, nutrition and body weight, smoking cessation, as well as diabetes management. The guideline was presented and discussed at the 2019 American College of Cardiology annual meeting held in New Orleans, March 16-18.
Strategies for CVD Prevention
According to the ACC/AHA, the majority of CVD burden and mortality are linked to smoking, poor diet, sedentary lifestyle, elevated body mass index (adverse health behaviors) as well as hypercholesterolemia, hypertension, and diabetes (major risk factors).
The ACC/AHA guidelines reflect the current consensus that targeting lifestyle, behavioral, and underlying medical conditions that contribute to heart disease is the cornerstone of disease prevention.
The guideline emphasizes the importance of a team-based care coordinated by professionals from multiple disciplines. Multidisciplinary care should channel its efforts into a shared-decision making approach which involves the patient as well as the patient’s family. A team-based approach can be facilitated in an outpatient setting to further help reduce disease risk among previously hospitalized patients at risk for heart disease.
Screening patient for social determinants of health, including food and housing insecurity and poor health literacy, can also be implemented in patient-centered care to identify health-related barriers.
Based on the level of current data, the guideline recommends against aspirin use among patients aged >70 years as well as adults who are at risk of bleeding. The use of prophylactic aspirin in middle-aged adults is now considered a Class IIb recommendation, the guideline states. “The complexity of assessing risk and benefit related to prophylactic aspirin use in individual patients mandates thorough assessment of cardiovascular risk and bleeding risk and re-emphasizes the importance of shared decision making,” the researchers wrote.
Although the use of cigarettes in the US have declined in recent years, tobacco use is still somewhat prevalent among men (34.8%) and women (20.8%). Clinicians are asked to reaffirm the importance of tobacco assessment during clinic visits, and tobacco cessation continues to be recommended.
Behavioral intervention combined with pharmacotherapy can optimize cessation rates, the guideline wrote. The guideline also advises clinicians to urge patients to reduce e-cigarette use.
This article originally appeared on The Cardiology Advisor