Heart Disease News:

New Recommendations Issued to Help Patients Prevent Second Heart Attacks or Strokes

The two leading U.S. heart organizations on May 15th jointly issued new recommendations for intensive treatment designed to help patients prevent second heart attacks or strokes.

The new recommendations:

• lower target levels for low-density lipoprotein (LDL or ‘bad’) cholesterol;
• expand use of established therapies; and,
• for the first time, recommend flu shots for patients with chronic cardiovascular disease.

The revised guidelines were published by the American Heart Association (AHA) and the American College of Cardiology (ACC), and endorsed by the National Heart, Lung, and Blood Institute.

The guidelines recommend goals for six major cardiac risk factors:

1. Smoking: complete cessation; no exposure to environmental tobacco smoke.
2. Blood pressure less than 140/90 millimeters of mercury (mm Hg) or less than 130/80 mm Hg if the patient has diabetes or chronic kidney disease.
3. Lipid management: LDL (bad) cholesterol less than 100 milligrams per deciliter (mg/dL), with a goal of a level less than 70 mg/dL.
4. Physical activity: 30-60 minutes seven days per week (minimum five days per week);
5. Weight management: body mass index (BMI) 18.5 to 24.9; waist circumference: men less than 40 inches, women less than 35 inches.
6. Diabetes management:  HbA1c (a test to measure the average amount of sugar in your blood over the past two to three months) levels less than 7 percent.

The guidelines also recommend dropping daily doses of aspirin taken for prevention to between 75 milligrams a day (a baby aspirin) and 162 milligrams (half of a regular aspirin), except in patients who have had bypass surgery.

The authors of the new guidelines said that in the nine years since the recommendations were first published, the “graying” of the population has increased the number of cardiovascular patients who might benefit from these therapies.

Dr. Sidney C. Smith, chairman of the group that prepared the updated guidelines, said they could affect as many as 26 million Americans who have survived heart attacks and strokes, or have chronic coronary heart disease.

“It is important that physicians and patients alike understand the benefit and be certain that therapies are implemented as recommended if we are to make progress in reducing the toll of the nation’s No. 1 killer," Smith said.

Source: Medical Week Staff week of May 15, 2006