Top 10 Take-Home Messages for the Primary Prevention of Cardiovascular Disease

1. The most important way to prevent all heart disease is to promote a healthy lifestyle throughout life. 

2. A team-based care approach is an effective strategy for the prevention of cardiovascular disease. Clinicians should evaluate the social determinants of health that affect individuals to inform treatment decisions. 

3. Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should have a risk assessment every ten years to determine if they need to start taking certain medications such as high blood pressure tablets, a statin, or aspirin. In addition, they should undergo coronary artery calcium scanning. 

4. All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, red meat and processed red meats, refined carbohydrates, and sweetened beverages. For adults with overweight and obesity, counselling and caloric restriction are recommended for achieving and maintaining weight loss. 

5. Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity. 

6. For adults with type 2 diabetes, lifestyle changes, such as improving dietary habits and achieving exercise recommendations, are crucial. If medication is indicated, metformin is first choice. 

7. All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit. 

8. Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit. 

9. Statin therapy is recommended for those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion. 

10. Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg.

Adapted from 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Top 10 Take-Home Messages for the Primary Prevention of Cardiovascular Disease