Heart attack, stroke guidelines updated

September 1, 2002

Pharmaceutical Representative

Physicians should routinely assess patients' general risk of cardiovascular disease beginning at age 20, according to new recommendations from the Dallas-based American Heart Association.

Physicians should routinely assess patients' general risk of cardiovascular disease beginning at age 20, according to new recommendations from the Dallas-based American Heart Association.

The guidelines, published in the journal Circulation (vol. 106, no. 3), also recommend that physicians calculate the risk of developing cardiovascular disease in the next 10 years for people age 40 and older or for anyone who has multiple risk factors.

The use of low-dose aspirin is also advised for people who have an increased risk for coronary heart disease, and blood-thinning drugs are recommended to reduce stroke risk in people who have atrial fibrillation.

"The U.S. Preventive Services Task Force has always recommended aspirin for secondary prevention in people who already have heart disease, but now recommends low-dose aspirin for primary prevention, as well," said Thomas Pearson, who chaired the panel that worked on the update. "Aspirin can cause gastrointestinal bleeding and may increase the risk of hemorrhagic stroke (bleeding into the brain). But if a person has a 10-year risk of heart disease that exceeds 10%, the benefits of aspirin therapy greatly outweigh the risks."

Other preventive recommendations:


•Â No exposure to tobacco smoke.


•Â Blood pressure maintained below 140/90 mm Hg; below 130/85 mm Hg for people with kidney damage or heart failure; and below 130/80 mm Hg for people with diabetes.


•Â An overall healthy eating pattern.


•Â Cholesterol lowered to appropriate level based on individual risk.


•Â At least 30 minutes of moderate-intensity physical activity on most (preferably all) days of the week.


•Â Achievement and maintenance of desirable weight (body mass index 18.5 to 24.9 kg/m2).


•Â Normal fasting blood glucose (below 110 mg/dL).

"Healthcare providers should be asking about smoking and measuring blood pressure and cholesterol levels," said Pearson. "The public should be encouraged to ask their physicians and other healthcare providers about these important issues in disease prevention." PR

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