ACC/AHA Issues Guidelines for Heart Health

Officials with the American College of Cardiology (ACC) and the American Heart Association (AHA) issued key recommendations in the 2019 Primary Prevention of Cardiovascular Disease at its 68^th Annual Scientific Session in New Orleans, Louisiana that emphasize adopting a heart healthy diet, engaging in exercise, avoiding tobacco, using aspirin sparingly, and managing known risk factors are among the recommendations.

The guideline is meant to provide strategies that can be used and tailored for those without a history of cardiovascular disease to stay heart healthy. It also emphasizes the need to identify and address personal or social barriers for doing so, such as income and education levels; cost concerns, lack of health insurance, access to healthy foods or safe places to exercise, and life stressors.

“The most important way to prevent cardiovascular disease, whether it’s a build-up of plaque in the arteries, heart attack, stroke, heart failure or issues with how the heart contracts and pumps blood to the rest of the body, is by adopting heart healthy habits and to do so over one’s lifetime,” Roger S. Blumenthal, MD, co-chair of the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease, expained in a prepared statement about the recommendations. “More than 80% of all cardiovascular events are preventable through lifestyle changes, yet we often fall short in terms of implementing these strategies and controlling other risk factors.”

According to the guidelines, the first step to prevent cardiovascular disease is to assess one’s risk through communication with a practitioner or care team. The document synthesizes data and proven interventions to improve diet, exercise and other factors, and also discusses the challenges that may interfere with individuals’ ability to incorporate better lifestyle habits.

Some of the key lifestyle recommendations include:

• Eating heart healthier to include more fruits, vegetables, legumes, nuts, whole grains, and fish, and limiting salt, saturated fats, fried foods, processed meat, and sweetened beverages.
• Engaging in regular exercise for at least 150 minutes of moderate-intensity exercises such as brisk walking, swimming, dancing, or cycling each week. For people who are inactive, some activity is better than none and small, 10-minute bursts of activity throughout the day can add up for those with hectic schedules.
• Aiming for and keeping a healthy weight for people who are overweight or obese, losing just 5% to 10% of their body weight (that would be 10-20 pounds for someone who weighs 200 pounds) can markedly cut their risk of heart disease, stroke and other health issues.
• Avoiding tobacco by not smoking, vaping or breathing in smoke — 1 in 3 deaths from heart disease is attributable to smoking or exposure to secondhand smoke, so every effort to try to quit through counseling and/or approved cessation medications should be supported and tailored to each individual.
• Limited aspirin use for healthy people. The guidelines recommend that aspirin should only rarely be used to help prevent heart attacks and stroke without known cardiovascular disease. Recent research suggests that the chance of bleeding, given the blood-thinning effect of aspirin, may be too high and the evidence of benefit—the number of heart attacks or strokes that are actually prevented—is not sufficient enough to make a daily aspirin worth taking for most adults in this setting.

For people with type 2 diabetes, which is one of the strongest risk factors for cardiovascular disease, there are new data that 2 classes of diabetes medications, which work to lower blood sugar levels, can also cut the risk of heart attack, stroke and related deaths.

The 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease will simultaneously publish in the Journal of the American College of Cardiology and the American Heart Association’s journal Circulation.

Reference

ACC/AHA Guidance for Preventing Heart Disease Stroke Released [news release]. New Orleans, Louisiana. Published March 17, 2019. https://www.acc.org/about-acc/press-releases/2019/03/17/09/49/acc-aha-guidance-for-preventing-heart-disease-stroke-released. Accessed March 18, 2019.