Brief Review of ACC/AHA Primary Prevention Guidelines 2019 Take Away Points— Arnett 2019

In the article 2019 ACC AHA Guideline on Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the ACC/AHA Task Force on Clinical Practice Guidelines published, 2019 by Arnett and Colleagues, The outcomes and key points are as noted: Ten Take-away Points Re-adopted form the 2019 ACC/AHA Primary Cardiac Prevention Executive Summary:

1. The most critical prevention of cardiovascular disease is to endorse a healthy lifestyle throughout life.

2. A multidisciplinary and team-based care approach is an effective strategy for the prevention of cardiovascular disease. Clinicians should evaluate the social determinants of health that influence individuals to inform treatment decisions.

3. Patients ages 40 to 75 years old should undergo 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation for cardiovascular prevention and have a clinician–patient risk discussion before starting on pharmacological therapy, such as antihypertensive therapy, a statin, or aspirin. Evaluating other risk factors and considering coronary artery calcium scores in select patients may further refine options for management.

4. Adult diets should include vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, red meat and processed red meats, refined carbohydrates, and sweetened beverages. Overweight and obesity counseling should be done with caloric restriction recommended.

5. Adults should exercise at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes weekly of vigorous-intensity physical activity.

6. For adults with diabetes mellitus type 2 , lifestyle modifications, such as improving dietary habits and exercise recommendations are critical. If medication is indicated, first-line therapy is with metformin, after which a sodium-glucose cotransporter 2 inhibitor or a glucagon-like peptide-1 receptor agonist may be considered.

7. Adults should be screened for tobacco use, and tobacco users are strongly advised to quit.

8. Aspirin for primary prevention of cardiovascular disease lacks net benefit and therefore should be used seldom in the routine primary prevention.

9. Statin therapy is first-line therapy for primary prevention of atherosclerotic cardiovascular disease in the following patient/criteria groups: elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion.

10. Non Pharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring drug therapy, the target blood pressure should generally be <130/80 mm Hg.

Donna K. Arnett, et al., 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, 17 Mar 2019 https://doi.org/10.1161/CIR.0000000000000678 Circulation