(Circulation. 1997;95:2329-2331.)
© 1997 American Heart Association, Inc.
Articles |
Guide to Primary Prevention of Cardiovascular Diseases
A Statement for Healthcare Professionals From the Task Force on Risk Reduction
Key Words: AHA Medical/Scientific Statements • prevention • cardiovascular diseases • risk factors
 |
Introduction |
|---|
The clinical and public health approaches to primary prevention are complementary. Primary prevention refers to guidance given to persons with no known cardiovascular disease. Physicians can contribute to the public health approach through patient education. The first goal of prevention is to prevent the development of risk factors. Physicians should instruct all patients about adopting healthy life habits that will prevent intensification of risk factors. Patient education should be family oriented. Ideally, risk factor prevention begins in childhood. Preventing cigarette smoking by children and adolescents is a prime goal. Another major goal is prevention of overweight and obesity in children and weight gain in adults; overweight lies at the heart of several risk factors. Encouraging life habits that incorporate regular physical activity, especially walking, and active recreational sports likewise will decrease intensity of risk factors. Patients and their families should be encouraged to reduce their intake of cholesterol and saturated fats by using unsaturated vegetable oils instead of animal-based saturated fats and adopting the habit of eating smaller portions. Evaluation of the family history may reveal that other family members need intervention to avoid developing cardiovascular disease. Adoption of healthy life habits and early intervention will mitigate the severity of risk factors that are the result of aging and genetic factors.
In addition to complementing public health efforts, a clinical
approach is needed to detect the presence of established risk factors
and to effectively modify them. The physician should regularly check
for established risk factors: smoking, physical inactivity, elevated
lipid
This article has been cited by other articles:
 |
|
 |
|
  H Noda, H Iso, H Toyoshima, C Date, A Yamamoto, S Kikuchi, A Koizumi, T Kondo, Y Watanabe, Y Wada, et al. Smoking status, sports participation and mortality from coronary heart disease Heart, April 1, 2008; 94(4): 471 - 475. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M A Smith, E D Cox, and J M Bartell Overprescribing of lipid lowering agents. Qual. Saf. Health Care, August 1, 2006; 15(4): 251 - 257. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Hur, L. S Simon, and G S. Gazelle Analysis of Aspirin-Associated Risks in Healthy Individuals Ann. Pharmacother., January 1, 2005; 39(1): 51 - 57. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Hur, N. S. Nishioka, and G. S. Gazelle Cost-Effectiveness of Aspirin Chemoprevention for Barrett's Esophagus J Natl Cancer Inst, February 18, 2004; 96(4): 316 - 325. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Madjid, M. Naghavi, S. Litovsky, and S. W. Casscells Influenza and Cardiovascular Disease: A New Opportunity for Prevention and the Need for Further Studies Circulation, December 2, 2003; 108(22): 2730 - 2736. [Full Text] [PDF]
|
|
|
|
 |
|
 E. J. Benjamin, S. C. Smith Jr, R. S. Cooper, M. N. Hill, and R. V. Luepker Task Force #1--magnitude of the prevention problem: opportunities and challenges J. Am. Coll. Cardiol., August 21, 2002; 40(4): 588 - 603. [Full Text] [PDF]
|
|
|
|
|
|
P. A. Ades, T. E. Kottke, N. Houston Miller, J. C. McGrath, N. B. Record, and S. S. Record Task Force #3--getting results: who, where, and how? J. Am. Coll. Cardiol., August 21, 2002; 40(4): 615 - 630. [Full Text] [PDF]
|
|
|
|
|
|
C. N. B. Merz, G. A. Mensah, V. Fuster, P. Greenland, and P. D. Thompson Task Force #5--the role of cardiovascular specialists as leaders in prevention: from training to champion J. Am. Coll. Cardiol., August 21, 2002; 40(4): 641 - 649. [Full Text] [PDF]
|
|
|
|
|
|
T. A. Pearson, S. N. Blair, S. R. Daniels, R. H. Eckel, J. M. Fair, S. P. Fortmann, B. A. Franklin, L. B. Goldstein, P. Greenland, S. M. Grundy, et al. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases Circulation, July 16, 2002; 106(3): 388 - 391. [Full Text] [PDF]
|
|
|
|
 |
|
 B. Franklin, K. Bonzheim, J. Warren, S. Haapaniemi, N. Byl, and N. Gordon Effects of a Contemporary, Exercise-Based Rehabilitation and Cardiovascular Risk-Reduction Program on Coronary Patients With Abnormal Baseline Risk Factors* Chest, July 1, 2002; 122(1): 338 - 343. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Lauer Aspirin for Primary Prevention of Coronary Events N. Engl. J. Med., May 9, 2002; 346(19): 1468 - 1474. [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, W. E. Mitch, R. W. Nesto, P. T. O'Gara, R. C. Becker, L. T. Clark, S. Hunt, I. Jialal, S. E. Lipshultz, and E. Loh Prevention Conference VI: Diabetes and Cardiovascular Disease: Writing Group V: Management of Cardiovascular-Renal Complications Circulation, May 7, 2002; 105 (18): e159 - e164. [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Koffman, T. Bazzarre, L. Mosca, R. Redberg, T. Schmid, and W. A. Wattigney An Evaluation of Choose to Move 1999: An American Heart Association Physical Activity Program for Women Arch Intern Med, October 8, 2001; 161(18): 2193 - 2199. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. R. Warnick, M. Nauck, and N. Rifai Evolution of Methods for Measurement of HDL-Cholesterol: From Ultracentrifugation to Homogeneous Assays Clin. Chem., September 1, 2001; 47(9): 1579 - 1596. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Hengstenberg, S.R Holmer, B Mayer, S Engel, A Schneider, H Lowel, G.A.J Riegger, and H Schunkert Siblings of myocardial infarction patients are overlooked in primary prevention of cardiovascular disease Eur. Heart J., June 1, 2001; 22(11): 926 - 933. [Abstract] [PDF]
|
|
|
|
|
|
S.N Willich, J Muller-Nordhorn, M Kulig, S Binting, H Gohlke, H Hahmann, K Bestehorn, K Krobot, and H Voller Cardiac risk factors, medication, and recurrent clinical events after acute coronary disease. A prospective cohort study Eur. Heart J., February 2, 2001; 22(4): 307 - 313. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Angerer, S. Stork, W. Kothny, P. Schmitt, and C. von Schacky Effect of Oral Postmenopausal Hormone Replacement on Progression of Atherosclerosis : A Randomized, Controlled Trial Arterioscler Thromb Vasc Biol, February 1, 2001; 21(2): 262 - 268. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Higashi, M. Sanada, S. Sasaki, K. Nakagawa, C. Goto, H. Matsuura, K. Ohama, K. Chayama, and T. Oshima Effect of Estrogen Replacement Therapy on Endothelial Function in Peripheral Resistance Arteries in Normotensive and Hypertensive Postmenopausal Women Hypertension, February 1, 2001; 37(2): 651 - 657. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G.F.H Diercks, A.J van Boven, H.L Hillege, W.M.T Janssen, J.A Kors, P.E de Jong, D.E Grobbee, H.J.G.M Crijns, and W.H van Gilst Microalbuminuria is independently associated with ischaemic electrocardiographic abnormalities in a large non-diabetic population. The PREVEND (Prevention of REnal and Vascular ENdstage Disease) study Eur. Heart J., December 1, 2000; 21(23): 1922 - 1927. [Abstract] [PDF]
|
|
|
|
|
|
P. Angerer, W. Kothny, S. Stork, and C. von Schacky Hormone replacement therapy and distensibility of carotid arteries in postmenopausal women: a randomized, controlled trial J. Am. Coll. Cardiol., November 15, 2000; 36(6): 1789 - 1796. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. T. Katzmarzyk, N. Gledhill, and R. J. Shephard The economic burden of physical inactivity in Canada Can. Med. Assoc. J., November 1, 2000; 163(11): 1435 - 1440. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Herrington, D. M. Reboussin, K. B. Brosnihan, P. C. Sharp, S. A. Shumaker, T. E. Snyder, C. D. Furberg, G. J. Kowalchuk, T. D. Stuckey, W. J. Rogers, et al. Effects of Estrogen Replacement on the Progression of Coronary-Artery Atherosclerosis N. Engl. J. Med., August 24, 2000; 343(8): 522 - 529. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Fodor, J. J. Frohlich, J. J.G. Genest Jr., P. R. McPherson, and for the Working Group on Hypercholesterolemia and Recommendations for the management and treatment of dyslipidemia: Report of the Working Group on Hypercholesterolemia and Other Dyslipidemias Can. Med. Assoc. J., May 16, 2000; 162(10): 1441 - 1447. [Full Text] [PDF]
|
|
|
|
|
|
A. J. Taylor, A. P. Burke, P. G. O’Malley, A. Farb, G. T. Malcom, J. Smialek, and R. Virmani A Comparison of the Framingham Risk Index, Coronary Artery Calcification, and Culprit Plaque Morphology in Sudden Cardiac Death Circulation, March 21, 2000; 101(11): 1243 - 1248. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A. Smaha From Bench to Bedside: The Future Is Now : Presented at the 72nd Scientific Sessions of the American Heart AssociationAtlanta, Georgia Circulation, March 7, 2000; 101(9): 942 - 945. [Full Text] [PDF]
|
|
|
|
|
|
S. M. Grundy, R. Pasternak, P. Greenland, S. Smith Jr, and V. Fuster Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: A statement for healthcare professionals from the American Heart Association and the American College of Cardiology J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1348 - 1359. [Full Text] [PDF]
|
|
|
|
|
|
S. M. Grundy, R. Pasternak, P. Greenland, S. Smith Jr, and V. Fuster Assessment of Cardiovascular Risk by Use of Multiple-Risk-Factor Assessment Equations : A Statement for Healthcare Professionals From the American Heart Association and the American College of Cardiology Circulation, September 28, 1999; 100(13): 1481 - 1492. [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Herrington The HERS Trial Results: Paradigms Lost? Ann Intern Med, September 21, 1999; 131(6): 463 - 466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Grundy Primary Prevention of Coronary Heart Disease : Integrating Risk Assessment With Intervention Circulation, August 31, 1999; 100(9): 988 - 998. [Full Text] [PDF]
|
|
|
|
|
|
M. Haim, M. Benderly, D. Brunner, S. Behar, E. Graff, H. Reicher-Reiss, and U. Goldbourt Elevated Serum Triglyceride Levels and Long-Term Mortality in Patients With Coronary Heart Disease : The Bezafibrate Infarction Prevention (BIP) Registry Circulation, August 3, 1999; 100(5): 475 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Herrington, B. L. Werbel, W. A. Riley, B. E. Pusser, and T. M. Morgan Individual and combined effects of estrogen/progestin therapy and lovastatin on lipids and flow-mediated vasodilation in postmenopausal women with coronary artery disease J. Am. Coll. Cardiol., June 1, 1999; 33(7): 2030 - 2037. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. R. Harper and T. A. Jacobson New Perspectives on the Management of Low Levels of High-Density Lipoprotein Cholesterol Arch Intern Med, May 24, 1999; 159(10): 1049 - 1057. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Mosca, S. M. Grundy, D. Judelson, K. King, M. Limacher, S. Oparil, R. Pasternak, T. A. Pearson, R. F. Redberg, S. C. Smith Jr, et al. Guide to Preventive Cardiology for Women Circulation, May 11, 1999; 99(18): 2480 - 2484. [Full Text] [PDF]
|
|
|
|
|
|
S. M. Grundy, G. J. Balady, M. H. Criqui, G. Fletcher, P. Greenland, L. F. Hiratzka, N. Houston-Miller, P. Kris-Etherton, H. M. Krumholz, J. LaRosa, et al. Primary Prevention of Coronary Heart Disease: Guidance From Framingham : A Statement for Healthcare Professionals From the AHA Task Force on Risk Reduction Circulation, May 19, 1998; 97(18): 1876 - 1887. [Full Text] [PDF]
|
|
|
|
|
|
M. N. Hill New Targeted AHA Research Program : Cardiovascular Care and Outcomes Circulation, April 7, 1998; 97(13): 1221 - 1222. [Full Text] [PDF]
|
|
|
|
 |
|
 Missed Opportunities in Preventive Counseling for Cardiovascular Disease--United States, 1995 JAMA, March 11, 1998; 279(10): 741 - 742. [Full Text] [PDF]
|
|
|
|
|
|
M. N. Hill Behavior and Biology: The Basic Sciences for AHA Action : Presented at the 70th Scientific Sessions of the American Heart Association November 9, 1997 Orlando, Florida Circulation, March 3, 1998; 97(8): 807 - 810. [Full Text] [PDF]
|
|
|
|
 |
|
 M. N. Hill Behavior and Biology: The Basic Sciences for AHA Action : Presented at the 70th Scientific Sessions of the American Heart Association November 9, 1997 Orlando, Florida Stroke, March 1, 1998; 29(3): 739 - 742. [Full Text] [PDF]
|
|
|
|
 |
|
 Lowering Cholesterol in Patients Without Coronary Disease Journal Watch Dermatology, July 1, 1997; 1997(701): 17 - 17. [Full Text]
|
|
|
|
 |
|
 LOWERING CHOLESTEROL IN PATIENTS WITHOUT CORONARY DISEASE Journal Watch (General), May 20, 1997; 1997(520): 1 - 1. [Full Text]
|
|