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
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| "1. Patients should be asked about tobacco use status at every office visit (Level of Evidence: B)"
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| "2. Every tobacco user should be advised at every visit to quit (Level of Evidence: A)"
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| "3. The tobacco user’s willingness to quit should be assessed at every visit (Level of Evidence: C)"
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| "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)"
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| "5. Arrangement for follow up is recommended. (Level of Evidence: C)"
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| "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)"
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Blood pressure control
| Class I
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| "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)"
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"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 management
Physical activity
Goal: At least 30 minutes, 7 days per week (minimum 5 days per week)
| Class I
|
| "1. 1. For all patients, the clinician should encourage 30 to 60 minutes of moderate-intensity aerobic activity, such as brisk walking, at least 5 days and preferably 7 days per week, supplemented by an increase in daily lifestyle activities (eg, walking breaks at work, gardening, household work) to improve cardiorespiratory fitness and move patients out of the least fit, least active high-risk cohort (Level of Evidence: B)"
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| "2. For all patients, risk assessment with a physical activity history and/or an exercise test is recommended to guide prognosis and prescription. (Level of Evidence: B)"
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| "3. The clinician should counsel patients to report and be evaluated for symptoms related to exercise.(Level of Evidence: C)"
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| Class IIa
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| "1. It is reasonable for the clinician to recommend complementary resistance training at least 2 days per week. (Level of Evidence: C)"
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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)
Type 2 diabetes mellitus management
Antiplatelet agents/anticoagulants
Antiplatelet agents/anticoagulants cont’d
Renin-angiotensin-aldosterone system blockers
Blockers
Blockers cont’d
Influenza vaccination
Depression
Cardiac rehabilitation
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