1st March 2007
American Heart Association
Summary,

Source: National Guidelines Clearinghouse

GUIDELINE OBJECTIVE(S)

To present the most current evidence-based clinical recommendations for the prevention of cardiovascular disease (CVD) in women >20 years of age with a broad range of cardiovascular risk

TARGET POPULATION

Adult women 20 years and older with a broad range of cardiovascular risk

INTERVENTIONS AND PRACTICES CONSIDERED

1. Assessment and stratification of cardiovascular risk (medical and family history, physical examination, laboratory tests, and Framingham risk assessment)
2. Lifestyle interventions
   • Avoidance of cigarette smoking and exposure to environmental tobacco, counseling and nicotine replacement if indicated
   • Physical activity and exercise
   • Cardiovascular or stroke rehabilitation if indicated
   • Heart-healthy diet
   • Weight maintenance/reduction through diet, exercise, and behavioral programs
   • Omega 3 fatty acid supplementation
   • Psychosocial factors (screening and treatment for depression when indicated)
3. Major risk factor interventions
   • Management of blood pressure through lifestyle approaches (weight management, diet, activity, moderation of alcohol) and drugs, such as thiazide diuretics
   • Management of lipids through lifestyle, diet therapy, and pharmacotherapy (low-density lipoprotein cholesterol [LDL-C]–lowering therapy (statin), niacin or fibrate)
   • Management of diabetes (glycemic control) with lifestyle and pharmacotherapy
4. Preventive drug interventions
   • Antiplatelet therapy (aspirin, or clopidogrel, or other antiplatelet)
   • Beta-blockers
   • Angiotensin-converting enzyme (ACE) inhibitors
   • Angiotensin-receptor blockers (ARBs)
   • Aldosterone blockade

*Guideline developers considered but recommended against the following interventions for prevention of cardiovascular disease: hormone therapy and selective estrogen-receptor modulators (SERMs) in postmenopausal women, antioxidant supplements in general populations of women, folic acid with or without B6 and B12 supplementation, and routine use of aspirin in healthy women <65 years of age.

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• Cardiovascular disease (CVD) risk, including lifetime risk and short-term absolute risk, defined by Framingham Point Score Estimates of 10-year risk for coronary heart disease (CHD) in women, based on age, total cholesterol, smoking status, high-density lipoprotein (HDL) levels, systolic blood pressure
• Major cardiovascular disease (CVD) clinical end points (death, myocardial infarction, stroke, revascularization procedure, congestive heart failure, or a composite cardiovascular disease end point)