AHA/ACC updates Guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update

The American Heart Association and the American College of Cardiology on Monday issued updated guidelines designed to ensure optimal treatment of patients with a variety of cardiovascular conditions, including heart disease, acute coronary syndromes, heart attack, and peripheral arterial disease, USA Today reports. The revised recommendations, which are endorsed by the National Heart, Lung, and Blood Institute, were created in light of results from the clinical trials that have been completed since the last recommendations were issued five years ago. For instance, the guidelines suggest that the daily aspirin dose for patients with heart disease or other blood vessel disorders be lowered to between 75 mg and 162 mg per day after a series of clinical trials showed that lower aspirin doses were “just as effective” as higher doses at preventing future heart attacks; however, the guidelines continue to advise that bypass patients receive between 100 mg and 300 mg of aspirin per day for up to one year. In addition, the guidelines for the first time suggest that all patients with chronic heart disease receive a flu vaccination. The guidelines also call for increased use of statins to reduce LDL levels, which now are recommended to be kept under 100 mg per deciliter in all heart disease patients. Other measures included in the revised guidelines “simply highlight tried-and-true means of reining in risk,” such as encouraging heart disease patients to get 30 to 60 minutes of moderate exercise at least five to seven days per week. The guidelines also recommend that a patient’s body mass index remain between 18.5 and 24.8, with waist circumference measuring no more than 40 inches in men and 35 inches in women. For diabetes management, the guidelines suggest that patients receive blood sugar level tests three to four times per year and recommend that the level stay below 7%. According to the report authors, the “aggressive, comprehensive risk-factor management” outlined in the guidelines has been shown in multiple studies to increase survival and prevent complications among heart patients. HealthDay notes that both groups plan to launch a campaign to inform cardiologists and other physicians of the new guidelines (Sternberg, USA Today, 5/15; HealthDay/Yahoo! News, 5/15).