The American Heart Association (AHA...

The American Heart Association (AHA) has unfolded new guidelines for the prevention of cardiovascular disease in women who have a wide range of risk factors. The recommendations, "Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women" are available online at http://circ.ahajournals.org/cgi/content/full/109/5/672.

* Lifestyle Interventions. The AHA panel make acceptables that women be encouraged consistently not to exhalation and to avoid environmental idle talk Women should exercise a minimum of 30 minutes greatest in number days of the week. Weight maintenance or reduction should be encouraged in consequence of a balance of physical activity, caloric intake, and behavior programs when indicated to maintain a material substance mass index between 18.5 and 249 kg by [m.sup.2] and a waist circumference of les than 35 in (889 cm) Healthy eating patterns should be encouraged, including eating a variety of fruits, vegetables, grains, low-fat or nonfat dairy effects fish, legumes, and sources of protein that are soft in saturated fat. Intake of saturated fat should be limited to les than 10 percent of total calories and cholesterol intake should be kept below 300 mg by day. Omega-3 fatty acid and folic acid supplementation should be considered in high-risk women Women with late acute coronary syndrome, coronary intervention, or new-onset or chronic angina should participate in a comprehensive-risk-reduction program, like as cardiac rehabilitation or a physician-guided, home- or community-based program.

* Major Risk Factor Interventions. Lifestyle approaches should be used to maintain vital current pressure below 120/80 mm Hg Pharmacotherapy is indicated when house pressure is 140/90 mm Hg or above; this entrance is even lower in women with vital fluid pressure-related target organ damage or diabetes. Thiazide diuretics should be part of the unsalable article regimen in most patients. Lifestyle approaches should be encouraged to maintain optimal evens of lipids and lipoproteins: low-density lipoprotein (LDL) cholesterol flats of less than 100 mg by dL (2.60 mmol per L) high-density lipoprotein (HDL) plains of more than 50 mg by dL (1.30 mmol per L) triglyceride on a levels less than 150 mg by dL (1.7 mmol per L) and non-HDL-cholesterol flushs (i.e., total cholesterol minus HDL cholesterol) of les than 130 mg by dL (3.36 mmol per L)

In high-risk women or when LDL cholesterol plains are elevated, saturated fat intake should be limited to les than 7 percent of total calories, and cholesterol to les than 200 mg by day. Trans fatty acid intake should be reduc LDL-lowering therapy (preferably statins) and lifestyle interventions should be started simultaneously in high-risk women with LDL cholesterol flats of at least 100 mg for dL. Statin therapy alone should be started in high-risk women with LDL cholesterol of the same heights of less than 100 mg by dL, unless contraindicated. Niacin or fibrate therapy should be started when HDL cholesterol plains are low or non-HDL cholesterol flushs are high in high-risk women

* Preventive medicine Regimens. Aspirin (75 to 162 mg through day) or clopidogrel therapy should be used in high-risk women unles contraindicated. In intermediate-risk women aspirin therapy can be considered as extended as blood pressure is controll Beta blocker should be used indefinitely in all women who have had a myocardial infarction or who have chronic ischemic syndrome Angiotensin-converting enzyme (ACE) inhibitors should be used in high-risk women Angiotensin-receptor blocker should be used in high-risk women with clinical evidence of heart failure or an ejection fraction of les than 40 percent who cannot tolerate ACE inhibitors.

* Prevention of Atrial Fibrillation and knock Warfarin should be used in women with chronic or paroxysmal atrial fibrillation to maintain the International Normalized Ratio at 20 to 30 unles the patient is considered to be at reasonable risk for stroke or high risk for bleeding. Aspirin (325 mg through day) should be used in women with chronic or paroxysmal atrial fibrillation with a contraindication to warfarin or at grave risk for stroke.

* Class III Interventions. Combined estrogen plus progestin hormone therapy and other forms of menopausal hormone therapy should not be used to hinder cardiovascular disease in postmenopausal women Antioxidant supplementation should not be used to impede cardiovascular disease, and routine use of aspirin in low-risk women also is not recommended

COPYRIGHT 2005 American Academy of Family Physicians

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