Heart Attack, Stroke Prevention Guidelines Updated

American Heart Association Issues New Recommendations

To avert a first heart attack or stroke, physicians should routinely assess patients' general risk of cardiovascular disease beginning at age 20, according to new American Heart Association recommendations published in Circulation: Journal of the American Heart Association.

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The "AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update" also recommends 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 imperative to prevent the first episode of coronary disease or stroke remains strong because many first-ever heart attacks or strokes are fatal or disabling," says Dr. Thomas Pearson, who chaired the consensus panel that worked on the update.

The updated guidelines incorporate new findings and expert opinion that have emerged since the American Heart Association published the recommendations in 1997. They reflect recent data on the degree of risk imposed by specific risk factors and the new efforts to categorize people more specifically according to their number and types of risk factors.

"Risk factor screening" includes having blood pressure, body mass index, waist circumference and pulse recorded at least every two years and cholesterol profile and glucose testing at least every five years beginning at age 20.

"Global risk estimation" combines information from all existing risk factors to determine a person's percentage risk for developing cardiovascular disease in the next 10 years. Multiple areas of slight risk can be more important than one area of very high risk. This estimation is recommended every five years for people age 40 or older or for anyone with two or more risk factors.

"The challenge for healthcare professionals is to begin comprehensive risk reduction for more patients at an earlier stage of their disease," says Pearson.

The update integrates recommendations from other clinical guidelines and consensus statements developed over the past five years -- for example, the American Diabetes Association recommendation for managing high blood pressure and high cholesterol levels in diabetic patients and the U.S. Preventive Services Task Force recommendations for routine health care examinations. Consolidating these various guidelines means that health care providers and patients can use a single source of information to evaluate individual risk for heart disease and stroke and to obtain the latest information about disease prevention.

For a listing of the new guidelines, click here.

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