heart disease

Heart Disease And Stroke Prevention Guidelines

The American Heart Association (AHA) and the American College of Cardiology have set forth updated recommendations for heart dis­ease and stroke prevention. These guidelines focus on cholesterol, heart disease, lifestyle, obesity, and risk assessment. In terms of cholesterol, the shift is away from focusing on numeric targets, but rather toward a healthy diet pattern like the Mediterranean or the Dietary Approach to Stop Hypertension (DASH) diets. The emphasis is now on statin (drug) therapy for people who are deemed to be at high risk for cardiovascular disease (CVD)or heart disease. The LDL cholesterol number is no longer the main consideration in treatment. Some experts, however, strongly disagree with these heart disease guidelines. They feel that the recommendations will increase the number of people on statin medications and will not be more effective than the previous tar­get-based guidelines. The current recommendations specifically target four high-risk groups for whom statin drugs are recommended:

1). People with preexisting CVD or heart disease (those who have suffered angina, a heart attack, stroke, a transient ischemic attack or mini stroke, and anyone who has had a cardiovascular procedure such as angioplasty to widen arteries)

2). Type 2 diabetics between 40 and 75 years of age

3). People with very high LDL cholesterol (l 90 mg/di or above)

4). People between 40 and 75 without CVD or diabetes who have a 30-year risk of CVD of at least 7.5 percent based on an online risk calculator (see risk assessment in the next column).

Lowering LDL cholesterol, however, is still important. The current guidelines encourage people to consume no more than 5 to 6 percent of total daily calories from saturated fat and less than I percent from trans fats.

The healthy lifestyle guidelines incorporate adequate physical activity, weight management, and dietary patterns that empha­size vegetables, fruits, whole grains, low-fat dairy products, fish, poultry, and nuts. People should limit red meat, processed foods, saturated and trans fats, sodium, and sugary foods

and beverages. Physical activity performed on a regular basis, 40 minutes of exercise 3 to 4 days a week. is also encouraged in the guidelines.