ACC/AHA 2019 guidelines highlight patient collaboration in CVD prevention

  • Arnett DK & al.
  • Circulation
  • 17 Mar 2019

  • International Clinical Digest
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  • Editorial: Patient-centered treatment paradigm of these guidelines is “paramount,” with its emphasis on shared decision-making, team-based care, and social determinants of health.
  • Guidelines published by the American College of Cardiology (ACC), American Heart Association (AHA), and presented at their annual meeting.

Why this matters

  • The new cardiovascular disease (CVD) primary prevention guidelines fill gaps in 9 topic areas, with a focus on how social determinants of health affect implementation.

Key highlights

  • 10-year risk calculation for atherosclerotic CVD remains “the foundation of primary prevention.”
  • Clinicians can also screen for social determinants of health; a tool is available from Centers for Medicare & Medicaid Services.
  • Bleeding, CVD risk should be considered when deciding on prophylactic aspirin use.
  • With more than a third of men still using tobacco, guidelines recommend assessing for use, offering “firm advice” to quit, and maximizing success with combined medical/behavioral intervention.
  • Cholesterol: adapted from the 2018 Clinical Practice Guidelines.
  • Hypertension: adapted from the 2017 Clinical Practice Guidelines.
  • Diet recommendations offer the usual emphasis on vegetables and whole grains but also note that health disparities can make implementation complicated.
  • Exercise guidelines note existing recommendation for physical activity and need to encourage sedentary patients toward even short bursts of activity.
  • Guidelines emphasize diet and weight loss in diabetes prevention and team-based care for treatment.

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