Introduction to the information for preventing and managing cardiovascular diseases such as ischemic heart disease, hypertension, and heart failure.
2013 prevention guidelines on obesity, cholesterol, risk assessment and lifestyle: obesity requires long-term professional management; lower overall heart attack and stroke risk, not just cholesterol; assessing risk of heart attack and stroke in more people; lifestyle recommendations for dietary patterns and exercise.
Life’s Simple 7: Avoiding being overweight or obese, eating a healthy diet, not smoking, being physically active, and keeping total cholesterol, blood pressure, and fasting glucose at goal level.
Eighth Joint National Committee (JNC 8) guideline for the management of high blood pressure (BP) in adults: There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; the panel recommends a BP of less than 140/90 mm Hg for other groups based on expert opinion. The same thresholds and goals are recommended for hypertensive adults with diabetes or nondiabetic chronic kidney disease (CKD) as for the general hypertensive population younger than 60 years.
Intestinal microbiota may contribute to the well-established link between high levels of red meat consumption and cardiovascular disease risk.
Meta-analysis of prospective cohort studies concluded: It is unlikely that caffeine consumption causes or contributes to atrial fibrillation. Habitual caffeine consumption may reduce atrial fibrillation risk.
ESC Exercise, Sports Guidelines for CVD: The European Society of Cardiology (ESC) has issued the first guidelines for exercise and sports participation in individuals with cardiovascular (CV) disease (CVD). Key messages: CV screening before participation in recreational and competitive sports is aimed at the detection of disorders associated with sudden cardiac death and has the potential to lower CV risk through disease-specific and individualized patient management. CV screening in adult and senior athletes should target the higher prevalence of atherosclerotic coronary artery disease (CAD) including an assessment of CVD risk factors and exercise stress test. Coronary artery calcium scoring may be performed in asymptomatic athletes with a moderate atherosclerotic risk profile. Healthy adults of all ages and individuals with known cardiac disease should exercise on most days, totaling at least 150 min/week of moderate-intensity exercise. Individuals with CAD, at low risk for exercise-induced adverse events, should be considered eligible for competitive or leisure sports activities, with few exceptions. Competitive sports are not recommended in individuals with CAD, at high risk of exercise-induced adverse events or those with residual ischemia, with the exception for individually low-intensity skill sports. Exercise programs in heart failure (HF) improve exercise tolerance and quality of life and have a modest effect on all-cause and HF-specific mortality, and all-cause hospitalization and HF-specific hospitalization. Asymptomatic individuals with mild valvular heart disease may participate in all sporting activities including competitive sports. A select group of asymptomatic individuals with moderate valve disease who have good functional capacity and no evidence of myocardial ischemia, complex arrhythmias, or hemodynamic compromise on a maximal exercise stress test may be considered for competitive sports after careful discussion with an expert cardiologist. Implementation of healthy lifestyle behaviors including sports participation decreases the risk of CV events and mortality in individuals with aortopathies. Individuals with acute myocarditis or pericarditis should abstain from all sports while active inflammation is present. Individuals with cardiomyopathy or resolved myocarditis or pericarditis, who wish to participate in regular sports, should undergo comprehensive evaluation, including an exercise test, to assess the risk of exercise-induced arrhythmias. Individuals who are genotype positive/phenotype negative or have a mild cardiomyopathy phenotype and absence of symptoms or any risk factors, may be able to participate in competitive sports. A notable exception is arrhythmogenic cardiomyopathy where high-intensity exercise and competitive sports should be discouraged. Managing sports participation in individuals with arrhythmogenic conditions is guided by three principles: (i) preventing life-threatening arrhythmias during exercise; (ii) symptom management to allow sports; and (iii) preventing sports-induced progression of the arrhythmogenic condition. In each case, these three basic questions need to be addressed. Pre-excitation should be excluded in all athletes with paroxysmal supraventricular tachycardia, and ablation of the accessory pathway is recommended if present. In individuals with premature ventricular contraction who want to engage in sports, underlying structural or familial arrhythmogenic conditions must be excluded, since sports activity may trigger more malignant arrhythmias if those underlying conditions are present. Athletes with electrical abnormalities of genetic origin, such as the inherited ion channelopathies, require assessment and shared decision making in which cardiogeneticists are involved, given the complex interplay of genotype, phenotype, potential modifiers, and exercise. Individuals with pacemakers should not be discouraged from participation in sport because of the device but need to tailor their sports participation according to the underlying disease. Participation in leisure-time and competitive sport in patients with an implantable cardioverter defibrillator may be considered, but requires shared and individualized decision making, based on a higher likelihood of appropriate and inappropriate shocks during sports, and the potential consequences of short episodes of loss of consciousness. Patients with congenital heart disease should be encouraged to exercise and should be given a personalized exercise prescription. Source: https://academic.oup.com/eurheartj/