The American Heart Association (AHA...

The American Heart Association (AHA) has released of the present day guidelines on the prevention of heart disease and hardship based on a woman's individual cardiovascular health. "Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women" appears in the February 10 2004 issue of Circulation and is available online at: http://circ.ahajournals.org/cgi/content/full/109/5/672.

The guidelines describe cardiovascular disease (CVD) as a condition that disentangles over time and that should be viewed as a continuum, rather than a have-or-have-not condition. According to the of recent origin recommendations, the aggressiveness of treatment should be linked to whether a woman has gentle intermediate, or high risk of having a myocardial infarction in the nearest 10 years, based on a standardized scoring order developed by the Framingham Heart investigation Low risk means a woman has a les than 10 percent chance of having a myocardial infarction in the nearest 10 years, intermediate risk is a 10 to 20 percent chance, and high risk is a greater than 20 percent chance.

Aspirin therapy guidelines illustrate by what mode recommended therapy varies across the three flushs of risk. For all high-risk women and for those who have documented cardiovascular disease, aspirin therapy is praiseed but it is not commended for low-risk women. Among intermediate-risk women aspirin therapy can be considered as drawn out as blood pressure is controll and the benefit is likely to outweigh the risk of side issues (e.g., gastrointestinal bleeding or hemorrhagic stroke)

Lifestyle interventions like as smoking cessation, regular physical activity, heart-healthy diet, and weight maintenance were given a efficient priority in all women, not solely because of their potential to bring to existing CVD, but also because heart-healthy lifestyles may thwart major risk factors from developing.

Angiotensin-converting enzyme inhibitors and beta blocker are commited for all high-risk women.

The guidelines also include a tough recommendation that high-risk women, level those with low-density lipoprotein cholesterol flushs below 100 mg per dL (259 mmol through L), receive cholesterol-lowering drugs, preferably statins. Routine statin therapy has not previously been approveed for these women, but late studies have shown a benefit in this subgroup The use of niacin and fibrates, other cholesterol-lowering put drugs intos of particular benefit in specific cases, also is discussed.

For pat prevention, warfarin is recommended for women who have atrial fibrillation and are at intermediate or high risk of embolic reverse If the use of warfarin is contraindicated in a woman, or if a woman is at cheap risk for stroke, aspirin therapy should be considered.

Prevention measures in the guidelines, as well-as; not only-but also; not only-but; not alone-but lifestyle and medical, are divided into classes based onward the strength of the recommendation for each even of risk. Class I is the greatest in quantity strongly recommended intervention, followed according to Class IIa and IIb. The guidelines also provide information in succession what not to do, with certain interventions labeled Class III--indicating that an intervention is not useful or may be harmful, or the two (e.g., hormone therapy, antioxidant supplements)

Another example is aspirin use, which is Class III for low-risk women because the side results may outweigh the benefits. According to the AHA, until more research is available, it is thrifty to wait before recommending aspirin therapy in this assemblage of women.

COPYRIGHT 2004 American Academy of Family Physicians

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