Emphasis on quitting smoking, medication, exercise, weight loss, cardiac rehab, new drugs
FRIDAY, Nov. 4 (HealthDay News) -- For patients with coronary heart disease (CHD), and atherosclerotic vascular disease, health care practitioners should implement appropriate treatment based on evidence-based guidelines and assess their success, according to a scientific statement published online Nov. 3 in Circulation.
Sidney C. Smith Jr., M.D., from the University of North Carolina at Chapel Hill, and colleagues reviewed available literature to update the 2006 American College of Cardiology Foundation and the American Heart Association guidelines on secondary prevention and risk reduction therapy for patients with CHD, and atherosclerotic vascular disease.
The authors reported that health practitioners should exercise judgment before implementing these recommendations after an acute event. Patients should stop smoking and avoid tobacco smoke; use statin therapy to achieve a low-density lipoprotein-cholesterol level of less than 100 mg/dL; exercise for at least 30 minutes, five to seven days a week; reduce weight, if overweight or obese; reduce waist circumference; get an annual flu vaccination; take daily low-dose aspirin; and take antiplatelet agents/anticoagulants. All patients with CHD and atherosclerotic disease should be referred for a cardiac rehabilitation program. Heart disease patients should be screened for depression. Patients receiving coronary stents can now be treated with new drugs (prasugrel and ticagrelor) instead of clopidogrel and aspirin. The 2006 recommendations for blood pressure control were not updated in this report. Therapeutic application of these guidelines should be based on evidence. In addition to implementing therapies, the health care provider should assess their success.
"It is important not only that the health care provider implement these recommendations in appropriate patients but also that health care systems support this implementation to maximize the benefit to the patient," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.