stroke

Heart disease and strokes are the number one and number four leading causes of death in the United States. About one-third of American adults have elevated levels of bad cholesterol and nearly two-thirds have high blood pressure or pre-hypertension. Approximately 610,000 Americans endure a first stroke every year and another 525,000 have a first heart attack. To help reduce these statistics, new heart disease and stroke prevention guidelines were released by the American Heart Association and American College of Cardiology in 2013.

The guidelines are recommendations about the best approaches to managing heart disease and stroke; they were created by a team of experts who poured over hundreds of clinical research studies to reach their conclusions. The new guidelines include advice aimed at improving the clinical decisions that doctors make with their patients who suffer from obesity, high cholesterol and other lifestyle risk factors for heart disease and stroke.

Obesity equals disease

Obesity should be managed and treated like a disease. People should eat fewer calories than the body needs, exercise more and eliminate unhealthy behaviors such as smoking.

Healthcare providers are advised to place emphasis on overall healthy diets, rather than focusing on an occasional indulgence. The overall diet should include a broad range of whole grains, lean proteins, vegetables and legumes. Limiting processed foods and drinks high in sugar and sodium is also important; sodium intake should be kept to no more than 2,400 mg per day.

Research has found that patients are more likely to stay on a healthy track when guided by a trained professional in a healthcare setting. As a result, healthcare providers are now being urged to actively help patients achieve and maintain a healthier body weight. Obesity screening through calculation of the Body Mass Index (BMI) at the yearly well check and prescribing behavioral counseling to help change behaviors around food and physical activity are tools that a doctor can use to help their patients maintain a healthy weight.

Statins should be more widely used

The new cholesterol guideline states that cholesterol-lowering statin drugs, which are used to lower the amount of cholesterol circulating in the blood, could be prescribed to an estimated 33 million Americans without cardiovascular disease who have a 7.5 percent or higher risk for a heart attack or stroke within the next decade. This is a big shift from the 2002 federal cholesterol guideline, which recommended that people should only take a statin if their 10 year risk level was greater than 20 percent. The reason for the changes is that the old guideline only considered a person’s risk for heart disease and did not consider the person’s risk for stroke. Often people who are at a 7.5 percent risk or higher have three or more risk factors such as age, poor lifestyle and high blood pressure or ethnicity, age and high blood pressure.

For the first time doctors have access to heart health risk equations for African-Americans who have increased risk for heart disease. Previously they had been relying on risk equations gathered from research on a white population.

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