New Cholesterol Guidelines
The American College of Cardiology and American Heart Association released new guidelines in 2013 for cholesterol management. The previous guidelines from ATP III (Adult Treatment Panel 3) focused on hard coronary disease outcomes. The new guidelines are more encompassing of fatal/nonfatal myocardial infarctions and fatal/nonfatal stroke. Here is the summary of the new guidelines:
Focus on risk of cardiac events
Used Framingham risk score to determine 10-year risk of CV events
Institute therapy to achieve specific LDL goals (LDL is “bad” cholesterol)
Add other classes of cholesterol lowering drugs to statins
Focus on risk of a range of CV events, including cardiac events and stroke
Used Pooled Cohort Equations to determine 10-year risk of stroke and CV events
Institute therapy based on CV events, rather than LDL goals
Use only statins
You should see your primary care physician to get a fasting cholesterol and blood pressure reading. Then you will be ready to use the Pooled Cohort Equation (PCE). The Pooled Cohort Equation is below to see if you are at high risk for CV and stroke events:
New Guidelines for Blood Pressure Management
The new guidelines by the JNC-8 (Joint National Commission-8) have relaxed the criteria for the diagnosis of hypertension.
BP goals for adults > 60 years is < 140/90
BP goals for patients with diabetes of chronic kidney disease is < 130/80
No racial or ethnic differences in initial antihypertensive drug therapy
BP goal for adults > 60 years is < 150/90
BP goals for adults with diabetes or chronic kidney disease is < 140/90
Initial treatment of African American adults with hypertension should be a thiazide diuretic or calcium channel blocker.
Diet and exercise recommendations for hypertension and cholesterol
On the basis of strong evidence by the ACC, the DASH (Dietary Approaches to Stop Hypertension) diet has shown to decrease blood pressure and cholesterol. The DASH diet is high in fresh fruits, vegetables, low-fat dairy products, nuts, whole grains, poultry, and fish, and low in red meats, sugar, and sugar-sweetened beverages.
In addition, the committee found moderate evidence that limiting sodium intake to less that 2,400 mg/day resulted in lower blood pressure and that further blood pressure benefits could be expected from lowering sodium intake of 1,500 mg/day.
The 2013 AHA/ACC lifestyle committee also found strong evidence that regular aerobic exercise reduces SBP by 2 to 5 mm Hg and DBP by 1 to 4 mm Hg. Therefore, the guidelines recommend that all adults engage in moderate to intense aerobic activity for 3 to 4 sessions/week, with each session lasting 40 minutes.