Thursday 30 Oct 2014

Information and opinions presented here do not always represent the views of the American Heart Association.

Doctors’ advice on the latest prevention guidelines

Published: 2:44 pm CDT, November 14, 2013

The new prevention guidelines released by the American Heart Association and American College of Cardiology provide the best practices for your healthcare providers.

What’s the most important thing for you to know about these guidelines as a patient, and what should you be asking your doctor? Here’s some advice from medical professionals who volunteer for the American Heart Association:

Elliott Antman, M.D., President-Elect of the American Heart Association, Professor of Medicine and Associate Dean for Clinical/Translational Research at Harvard Medical School and a senior physician in the Cardiovascular Division of the Brigham and Women’s Hospital in Boston:  

I think what’s important for patients to recognize is that the AHA has teams of experts always looking at the latest data. You can rest assured that with the guidelines your doctors are provided the very latest scientific information and recommendations for the best way to prevent and treat heart disease.

It’s also important to recognize that there is no one magical treatment for all patients to prevent heart disease. This suite of guidelines emphasizes a comprehensive approach to cardiovascular health: eating a healthy diet, being physically active and avoiding unhealthy behaviors such as smoking. If you have diabetes or high cholesterol we have specific recommendations for treating those conditions.

As you consider your overall health, you should know that the American Heart Association has tools that will allow you to quickly and easily take ownership of your cardiovascular health. You’ll have the very latest recommendations and learn information you can discuss with your doctor.

I recommend reviewing the American Heart Association’s Life’s Simple 7 to learn about your cardiovascular health in a patient-friendly format. You can go through the Life’s Simple 7 assessments and bring those numbers, as well as your questions, to your doctor.

Just recently a patient with a family history of heart disease asked, “Am I doing everything I can to avoid developing coronary heart disease as I get older?” We looked at the computer in my office together for an introduction to Life’s Simple 7.

I also explained how to sign up on the AHA’s Heart360 website, where you can enter and track personal cardiovascular health information (such as blood pressure, weight, glucose and cholesterol measurements, and medications). It was easy. And within less than 15 minutes we were linked up on Heart360, which patients and doctors can use to communicate online — quickly and securely — about a patient’s health.

Mariell Jessup M.D., FAHA, President of the American Heart Association, Professor of Medicine, University of Pennsylvania Heart and Vascular Center

The guidelines have been updated with the very best scientific research, all focused on preventing cardiovascular disease and stroke. At the foundation of the guidelines is an emphasis on healthy lifestyle, e.g., Life’s Simple 7 and the advice to “know your numbers.” The recommendations in the guidelines make sense:

1. Try to prevent cardiovascular disease.
2. If cardiovascular disease has already occurred, the guidelines are about prolonging a healthy recovery and preventing recurrence.

When you visit your doctor, always have a list of your medical problems in chronological order, including any surgeries and allergies. Make sure you have a good family history, especially about cardiovascular disease. And know your numbers, e.g., your most recent cholesterol, blood sugar, weight and blood pressure.

Clyde W. Yancy, M.D., Past President of the American Heart Association and Chief of the  Division of Cardiology at Northwestern University’s Feinberg School of Medicine: 

The new guidelines are refreshing. We have more information now than ever before and we have a much better idea of who benefits most from efforts to reduce the risk for heart disease. Regardless of who you are, a heart-healthy lifestyle is a good idea; don’t smoke, lose weight, increase your physical activity and follow a healthy diet.

If you are in a group at higher risk for heart disease we recommend statin drugs. These are safe drugs that are proven to be effective. Here are the groups at risk:

  • Someone with already known heart disease
  • A person with a very high LDL (or “bad”) cholesterol
  • A patient with diabetes between the ages of 40-75
  • Anyone who is found to have a 10-year risk of heart disease based on our risk calculator

If you don’t fall into the high-risk groups, we might consider looking at your longer-term risk for heart disease and we might also consider using a test for the presence of calcium in your heart blood vessels. The big-picture takeaway is that we can reduce your risk for heart disease and now have even better methods to identify who needs risk reduction most and how best to get there.

These guidelines are all about lifestyle change. Focus most on diet; the data are pretty clear. A diet rich in fruits and vegetables, low-fat dairy, nuts and fish and low in sweets and red meat works. Think about the Mediterranean diet. That’s a great place to start. Avoid trans fats especially and keep saturated fat consumption at the lowest possible levels. Sodium restriction is a good idea, particularly if high blood pressure is a consideration. Physical activity is important and if you are healthy enough to be more active, target 40 minutes a day, 3-4 days a week.

Being well-informed helps. Don’t hesitate to ask questions, especially if you are in a higher risk group. If you don’t already know your numbers ask; you should know your blood pressure, cholesterol and blood sugar numbers. Think of those numbers as your body’s phone number.