Guidelines to prevent Cardiovascular Diseases

Cardiovascular diseases once affected those in their 60s and 70s, are now not uncommon among people who are in their 40s or even 30s. In fact, it’s so prevalent that sometimes it snatches away the lives of people who are in their 20s.

What’s the reason? Why cases of Cardiovascular diseases are steadily increasing? If there’s a one-word answer to the question, it’s ‘lifestyle’.

Is there a way out? Indeed, yes. In March 2019, the American College of Cardiology (ACC) and American Heart Association (AHA) published a new set of guidelines for the prevention of Cardiovascular disease. While briefing the press about the new guidelines, the presidents of both the ACC and AHA opined thus: “What we are here to talk about today is the fact that through lifestyle choices and modifications, nearly 80% of all Cardiovascular diseases can be treated.”

Let’s delve deep into the new set of guidelines and understand how, with lifestyle modifications, we can keep ourselves away from the dangers of Cardiovascular diseases.

Who is it for?

Intended for the use of all who have not had a Cardiovascular disease so far, these guidelines strive to attain the prevention of Coronary heart diseases including Heart failure and Atrial fibrillation and Strokes.

The diet recommendations

The diet recommendations strongly argue for the inclusion of fruits, vegetables, legumes, nuts, fish and whole grains. It also recommends limiting the intake of red meat, processed meats, sodium, and cholesterol.

Physical activity recommendations

While recommending physical activities, the new guidelines adopt a moderate approach. At no point, it excludes those who have an aversion towards intense physical activities. The recommendations are as follows:

• 150 minutes of moderate exercise per week – a brisk walk, for instance.
• 75 minutes of vigorous activities such as Swimming or Jogging

It’s important to note that the guidelines do not demand an individual to join a gym or do intense physical activities. All it suggests is some kind of activity on an individual’s part. If someone finds it difficult to meet the 150 or 75 minutes of recommended activities, they should do ‘something’. The reason is simple: every little bit of movement that keeps one away from the couch is beneficial.

With all these lifestyle modifications, a person with no history of Cardiovascular diseases can effectively prevent it at the primary level.

Drug therapy

But when it comes to drug therapy, it’s important to estimate an individual’s risk. But how to assess it? The pooled cohort equations help in predicting the 10-year risk of developing Atherosclerotic Vascular disease. The guidelines strongly recommend it in order to maximize the anticipated benefit of any drug therapy while minimizing harmful overtreatment. The 10-year risk of cholesterol is calculated using Atherosclerotic Vascular disease.

The risk assessment is not required for individuals who fall into the following category:

• Diabetics > 40 years of age
• Low-density Lipoprotein (LDL) cholesterol level > 190 mg/dL

They, instead, are advised to get treated with statins. But then, how about individuals who are at borderline or intermediate risk (5% to 20%), i.e. when risk is not certain? It’s when risk-enhancing factors come to the rescue. Statin therapy is ruled out in those with a calcium score of zero and highly recommended in cases where calcium score is > 100.

As the new guidelines clearly indicate, with lifestyle modifications including diet and exercise, individuals can ward off their risk of getting Cardiovascular diseases and lead a happy and healthy life.

Dr. Vivekanand Gajapati, Consultant Cardiology, SDM Narayana Heart Centre, Dharwad