Highlights of the American Heart Association's revised 2002 guidelines for doctors to help them screen patients for cardiovascular disease and stroke:
SMOKING: Ask about tobacco use status at every visit. Advise every tobacco user to quit in a clear, strong and personalized manner. Assess the tobacco user's willingness to quit. Assist by counseling and developing a plan for quitting. Urge avoidance of exposure to secondhand smoke at work or home. Goal: Complete cessation, no exposure to environmental tobacco smoke.
BLOOD PRESSURE: Promote healthy lifestyle modification. Advocate weight reduction; reduction of sodium intake; consumption of fruits, vegetables and lowfat dairy products; moderation of alcohol intake; and physical activity in persons with blood pressure of 180 systolic, 80 diastolic. Goal: 140 systolic, 90 diastolic.
DIETARY INTAKE: Advocate consumption of a variety of fruits, vegetables, grains, lowfat or nonfat dairy products, fish, legumes, poultry, and lean meats. Match energy intake with energy needs and make appropriate changes to achieve weight loss when indicated. Goal: An overall healthy eating pattern.
ASPIRIN: Do not recommend for patients with aspirin intolerance. Low-dose aspirin increases risk for gastrointestinal bleeding and hemorrhage stroke. Do not use in people at increased risk for these diseases. Benefits of cardiovascular risk reduction outweigh these risks in most patients at higher coronary risk. Goal: Low-dose aspirin in people at higher coronary heart disease risk.
BLOOD LIPID MANAGEMENT: If artery-clogging LDL, or bad cholesterol, is above goal range, initiate additional therapeutic lifestyle changes consisting of dietary modifications. Goal: A lower LDL cholesterol level.
PHYSICAL ACTIVITY: If cardiovascular, respiratory, metabolic, orthopedic, or neurological disorders are suspected, or if patient is middle-aged or older and is sedentary, consult physician before initiating vigorous exercise program. Goal: At least 30 minutes of moderate-intensity physical activity on most (and preferably all) days of the week.
WEIGHT MANAGEMENT: Initiate weight-management program through caloric restriction and increased caloric expenditure as appropriate. For overweight/obese persons, reduce body weight by 10 percent in first year of therapy. Goal: Achieve and maintain desirable weight. Waist circumference should be equal to or less than 40 inches in men and 35 inches in women.
CHRONIC ATRIAL FIBRILLATION: Irregular pulse should be verified by an electrocardiogram. Goals: Normal sinus rhythm or, if chronic atrial fibrillation is present, use anti blood-clogging medicine.
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