This past year the American College of Cardiology, the American Heart Association and the National Heart Lung and Blood Institute released guidelines dealing with prevention of cardiovascular disease, and for managing lifestyle choices, cholesterol and weight. Prevention of heart attack and stroke is the overall goal.
These guidelines include a calculator (available as an app on a smartphone) developed to estimate an individual’s risk of a heart attack or stroke over the next 10 years. Also, lifetime risk for those less than 59 years old can also be calculated. The calculator uses age, sex, race, total and HDL cholesterol, blood pressure treatment, diabetes and smoking to determine risk, and will allow the physician better identify people who will benefit from lifestyle changes and medical therapies.
Lifestyle management emphasizes the importance of a healthy diet and exercise regimen. Three major recommendations are made:
Treatment of blood cholesterol to reduce the risk of heart attack and stroke emphasizes the intensity of treatment for a particular patient instead of targeting a specific LDL cholesterol number. Statin therapy rather than other cholesterol lowering drugs are considered the best. Four groups of patients are felt to benefit from statin therapy:
If possible high intensity statin therapy (atorvastatin 80 mg - Lipitor, or rosuvastatin 20- 40 mg - Crestor) should be used for the first two groups to achieve at least a 50% reduction in LDL cholesterol. Moderate or high intensity statin therapy can be used for the last two groups. These new guidelines help the physician guide patients to a healthier and hopefully longer life.
Guideline on the Assessment of Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
Guideline on Lifestyle Management to Reduce Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society.
Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.