Primary Cardiovascular Prevention: 2019 ACC/AHA Guideline Update
Eighty percent of all cardiovascular events are preventable. The ACC/AHA 2019 guidelines are a single source of best practices to help achieve that goal. Review them here, at-a-glance.
“More than 80 percent of all cardiovascular events are preventable through lifestyle changes, yet we often fall short in terms of implementing these strategies and controlling other risk factors.” --Roger S. Blumenthal, MD, co-chair of the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease.
Gaps in Primary Prevention of CVD. Only 17% of US adults are at ideal levels of ≥5 of the American Heart Association's 7 metrics for ideal cardiovascular health: No smoking, healthy weight, adequate exercise/healthy diet, at target for LDL-C, BP, A1c. The 2019 ACC/AHA primary prevention guidelines summarize for all clinicians in an accessible manner past guidelines and consensus statements and new evidence on lifestyle modifications that serve as the cornerstone of CVD prevention.
"ABCDEs" of Primary Prevention.
A = Assess Risk
ASCVD Risk Enhancers.
A = Aspirin Therapy.
B = Blood Pressure.
C = Cholesterol.
C = Cholesterol, continued.
C = Cigarette Smoking.
FDA-approved Smoking Cessation Medications.
D = Diabetes.
D = Diet and Weight.
E = Exercise.
E = Economic and Social Factors.
In a commentary on the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease, guideline co-chair Roger Blumenthal, MD and colleagues emphasize 3 “overarching central recommendations” that apply to all ASCVD prevention efforts: Adopting a team-based approach; engaging patients in shared decision making; and, addressing social determinants of health to inform optimal treatment. The guideline framework is simple but adherence to the recommendations can have far-reaching effects on US morbidity and mortality. Each of the slides below offers a snapshot of one key prevention principle. Â
