An updated guideline for the primary prevention of cardiovascular disease has been released jointly by the American Heart Association (AHA) and the American College of Cardiology. Among the major changes is a recommendation against the broad use of aspirin in primary prevention, after recently reported results of the ARRIVE, ASCEND, and ASPREE trials cast doubt on the balance of risk and benefit with treatment in a variety of populations.
The 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease was published online in the Journal of the American College of Cardiology to coincide with its presentation at the American College of Cardiology 68th Annual Scientific Session 2019 (ACC.19).
The document emphasises healthy lifestyle, in which nutrition and diet play an important role. According to the guideline, "All adults should consume a healthy diet that emphasises the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimises the intake of trans fats, red meat and processed red meats, refined carbohydrates, and sweetened beverages."
An addendum to the guideline provides clarity on the definition of processed meat, stating that "Processed meats are any meat preserved by smoking, curing, or salting, or additional chemical preservatives.” (S3.1-28a)
The AHA/ACC guideline is endorsed the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Society of Preventive Cardiology, the American Geriatrics Society, and the Preventive Cardiovascular Nurses Association.
During the ACC.19 meeting, Richard Kovacs, MD, professor of clinical medicine and clinical director of the Krannert Institute of Cardiology, Indiana University School of Medicine, and concurrently vice president of the American College of Cardiology, congratulated the writing committee for completing this task in one year, through 33 peer reviews.
"This is going to be a comprehensive resource for both clinical and public health practices in terms of the prevention of cardiovascular disease, and it dovetails quite nicely with other guidelines," Kovacs said, updating the 2013 CV Risk and 2013 Lifestyle guidelines, and the 2013 overweight and obesity guidelines, but also "includes and replicates" portions of the 2017 blood pressure guidelines and the 2018 cholesterol guideline.
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