Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update: Difference between revisions
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==2011 AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease<ref name=Secondary-Prevention-Athero>AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update http://ac.els-cdn.com/S0735109711043567/1-s2.0-S0735109711043567-main.pdf?_tid=49947b56-9d3e-11e6-a5c0-00000aab0f6c&acdnat=1477680333_bca68af215739ff9481a8a528bdd9554 Accessed on October 28, 2016</ref>== | ==2011 AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease<ref name=Secondary-Prevention-Athero>AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update http://ac.els-cdn.com/S0735109711043567/1-s2.0-S0735109711043567-main.pdf?_tid=49947b56-9d3e-11e6-a5c0-00000aab0f6c&acdnat=1477680333_bca68af215739ff9481a8a528bdd9554 Accessed on October 28, 2016</ref>== | ||
===Smoking=== | ===Smoking=== | ||
{|class="wikitable" width="80%" | |||
|- | |||
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1. '''Patients should be asked about tobacco use status at every office visit ''([[ACC AHA guidelines classification scheme#Classification of Recommendations|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2. '''Every tobacco user should be advised at every visit to quit ''([[ACC AHA guidelines classification scheme#Classification of Recommendations|Level of Evidence: A]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3. '''The tobacco user’s willingness to quit should be assessed at every visit ''([[ACC AHA guidelines classification scheme#Classification of Recommendations|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''4. '''Patients should be assisted by counseling and by development of a plan for quitting that may include pharmacotherapy and/or referral to a smoking cessation program ''([[ACC AHA guidelines classification scheme#Classification of Recommendations|Level of Evidence: A]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''5. '''Arrangement for follow up is recommended. ''([[ACC AHA guidelines classification scheme#Classification of Recommendations|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''6. '''All patients should be advised at every office visit to avoid exposure to environmental tobacco smoke at work, home, and public places ''([[ACC AHA guidelines classification scheme#Classification of Recommendations|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|} | |||
===Blood pressure control=== | |||
{|class="wikitable" width="80%" | |||
|- | |||
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1. '''All patients should be counseled regarding the need for lifestyle modification: weight control; increased physical activity; alcohol moderation; sodium reduction; and emphasis on increased consumption of fresh fruits, vegetables, and low-fat dairy products ''([[ACC AHA guidelines classification scheme#Classification of Recommendations|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2. '''Patients with blood pressure �140/90 mm Hg should be treated, as tolerated, with blood pressure medication, treating initially with -blockers and/or ACE inhibitors, with addition of other drugs as needed to achieve goal blood pressure ''([[ACC AHA guidelines classification scheme#Classification of Recommendations|Level of Evidence: A]])''<nowiki>"</nowiki> | |||
===Lipid management=== | |||
===Physical activity=== | |||
Goal: At least 30 minutes, 7 days per week (minimum 5 days per week) | |||
{|class="wikitable" width="80%" | {|class="wikitable" width="80%" | ||
|- | |- | ||
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| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1. '''It is reasonable for the clinician to recommend complementary resistance training at least 2 days per week. ''([[ACC AHA guidelines classification scheme#Classification of Recommendations|''Level of Evidence: C'']])''<nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1. '''It is reasonable for the clinician to recommend complementary resistance training at least 2 days per week. ''([[ACC AHA guidelines classification scheme#Classification of Recommendations|''Level of Evidence: C'']])''<nowiki>"</nowiki> | ||
|} | |} | ||
===Weight management=== | ===Weight management=== | ||
Goals: Body mass index: 18.5 to 24.9 kg/m2 Waist circumference: women <35 inches (<89 cm), men 40 inches (<102 cm) | Goals: Body mass index: 18.5 to 24.9 kg/m2 Waist circumference: women <35 inches (<89 cm), men 40 inches (<102 cm) |
Revision as of 19:08, 28 October 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
2011 AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease[1]
Smoking
Class I |
"1. Patients should be asked about tobacco use status at every office visit (Level of Evidence: B)" |
"2. Every tobacco user should be advised at every visit to quit (Level of Evidence: A)" |
"3. The tobacco user’s willingness to quit should be assessed at every visit (Level of Evidence: C)" |
"4. Patients should be assisted by counseling and by development of a plan for quitting that may include pharmacotherapy and/or referral to a smoking cessation program (Level of Evidence: A)" |
"5. Arrangement for follow up is recommended. (Level of Evidence: C)" |
"6. All patients should be advised at every office visit to avoid exposure to environmental tobacco smoke at work, home, and public places (Level of Evidence: B)" |
Blood pressure control
Class I | ||||||
"1. All patients should be counseled regarding the need for lifestyle modification: weight control; increased physical activity; alcohol moderation; sodium reduction; and emphasis on increased consumption of fresh fruits, vegetables, and low-fat dairy products (Level of Evidence: B)" | ||||||
"2. Patients with blood pressure �140/90 mm Hg should be treated, as tolerated, with blood pressure medication, treating initially with -blockers and/or ACE inhibitors, with addition of other drugs as needed to achieve goal blood pressure (Level of Evidence: A)"
Lipid managementPhysical activityGoal: At least 30 minutes, 7 days per week (minimum 5 days per week)
Weight managementGoals: Body mass index: 18.5 to 24.9 kg/m2 Waist circumference: women <35 inches (<89 cm), men 40 inches (<102 cm) Type 2 diabetes mellitus managementAntiplatelet agents/anticoagulantsAntiplatelet agents/anticoagulants cont’dRenin-angiotensin-aldosterone system blockersBlockersBlockers cont’dInfluenza vaccinationDepressionCardiac rehabilitation |
- ↑ AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update http://ac.els-cdn.com/S0735109711043567/1-s2.0-S0735109711043567-main.pdf?_tid=49947b56-9d3e-11e6-a5c0-00000aab0f6c&acdnat=1477680333_bca68af215739ff9481a8a528bdd9554 Accessed on October 28, 2016