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New Guidelines for Old

Late in 2013 new guidelines were published for health care professionals to manage people at risk of cardiac or vascular (stroke) disease. The guidelines were written because the old guidelines did not 1) address the risk of stroke, 2) consider younger patients with risk factors but normal cholesterol numbers, and 3) make recommendations in the area of lifestyle and obesity concerns. The old guidelines focused on cholesterol numbers. The new guidelines focus on the patient.

Patient focus

The guidelines written by the American Academy of Cardiology and the American Heart Association address four specific areas:

  1. An assessment to estimate a patient’s risk of having a cardiac or stroke event in the next ten years, based on more than cholesterol numbers; namely sex, age, cholesterol, blood pressure, blood pressure treatment, diabetes, and smoking.
  2. Guideline for managing blood cholesterol numbers based on an increasing intensity of treatment for increasing risk, using medications, specific lifestyle interventions, and specific weight management interventions.
  3. Guideline for recommending active and specific interventions in dietary patterns and physical activity patterns. Specifically, diets rich in fruits, vegetables, whole grains, low-fat dairy, legumes, fish, poultry, and nuts and low in red meat, sweets, saturated and trans fats, and salt. Health care professionals are encouraged to do more than say “eat right.” They are to arrange for dietary counseling for their patients.
  4. Guideline for determining the level of body weight, arranging for proactive intervention by a weight management professional and encouraging steady progress toward goals.

Statins are known to be the most effective drug in lowering cholesterol. But what intervention is most effective in achieving a healthy patient who is at decreased risk for heart or stroke events? Modified dietary intake, physical activity, and weight control are easily the most effective in lowering risk AND lowering cholesterol numbers.

If you are one of those people who have a higher risk of heart or stroke disease, do not be side-tracked or discouraged by the recent flurry of press coverage of the arguments over who should or should not take statins. Concentrate on those interventions that have proven most effective in lowering risk – dietary modification, physical exercise, and weight control.

Only after these three interventions have done their job should medications be considered. These three interventions can establish a lifestyle pattern with fabulous overflow effects in cancer prevention, auto-immune prevention, arthritis prevention – and they have almost no side-effects.

Don’t pass up a good deal.