Drug Information
Health Information
Health Links
|
|
|
|
Health Topics > Primary Prevention
|
What is primary prevention? - Educating people about risk factors and lifestyle changes to reduce risk.
- Identifying and altering risk factors to prevent the onset of cardiovascular disease leading to heart attack or stroke.
Atherosclerosis is the underlying process that causes most heart disease. It begins in young adulthood, but it may be decades before clinical disease shows up. That's why more effort should be focused on prevention. We don't fully understand all the causes of heart disease, but large epidemiological studies have identified risk factors and strategies to reduce the risk. The risk factors we can change, treat or modify include: - cigarette and tobacco smoke
- high blood cholesterol
- high blood pressure
- physical inactivity
- obesity and overweight
- diabetes mellitus
AHA RecommendationThe decline in death rates from cardiovascular disease in the United States is due largely to the public's adopting a more healthful lifestyle. This underscores why it is important for the medical profession to advocate prevention strategies.
Guide to primary prevention of cardiovascular diseasesSmoking Goal: Complete cessation Recommendations: - Ask about smoking status as part of routine evaluation. Reinforce nonsmoking status.
- Strongly encourage patient and family to stop smoking.
- Provide counseling, nicotine replacement and formal cessation programs as appropriate.
Blood pressure controlGoal: 140/90 mm Hg or less Recommendations: - Measure blood pressure in all adults at least every 2½ years.
- Promote lifestyle modification: weight control, physical activity, moderation in alcohol intake, moderate sodium restriction.
- If blood pressure 140/90 mm Hg or greater after 3 months of life habit modification or if initial blood pressure is greater than 160/100 mm Hg: Add blood pressure medication; individualize therapy to patient's other requirements and characteristics.
Cholesterol management Primary goal: LDL less than 160 mg/dL if no more than 1 risk factor or LDL less than 130 mg/dL if 2 or more risk factors Secondary goals : HDL greater than 35 mg/dL Triglycerides less than 200 mg/dL Risk factors: - Age (men 45 years or older; women 55 years or older, or postmenopausal)
- Hypertension (blood pressure 140/90 mm Hg or greater)
- Diabetes
- Smoking
- HDL less than 35 mg/dL
- Family history of coronary heart disease in first-degree relatives (male relatives under age 55; female relatives under age 65)
- If HDL is 60 mg/dL or greater, subtract 1 risk factor from the number of positive risk factors.
Recommendations: - Ask about dietary habits as part of routine evaluation.
- Measure total and HDL cholesterol in all adults 20 years and older, and assess positive and negative risk factors at least every 5 years.
- For all persons: Promote the AHA Step I Diet: no more than 30% of calories as fat, 8 to 10% of calories as saturated fat, and less than 300 mg/dL of dietary cholesterol per day. Also promote weight control and physical activity.
- Measure LDL (low-density lipoprotein) if total cholesterol is 240 mg/dL or greater, or 200 mg/dL or greater with 2 or more risk factors, or if HDL (high-density lipoprotein) is less than 35 mg/dL.
- If HDL is less than 35 mg/dL, emphasize weight management and physical activity, avoidance of cigarette smoking. Niacin raises HDL. Consider niacin if patient has 2 or more risk factors and high LDL (except patients with diabetes).
- If LDL is 160 mg/dL or greater with no more than 1 risk factor, or is 130 mg/dL or greater on 2 occasions with 2 or more risk factors, then start the AHA Step II Diet — no more than 30 percent of calories as fat, less than 7 per
|
|
|
|
|
|
