What’s New With the Old Heart Guidelines?

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If you’re like most American women, you don’t believe heart disease is your greatest health threat. But it is—greater than breast cancer. In fact, greater than all cancers combined. With more than 90 percent of women having at least one risk factor for cardiovascular disease, it’s important to know how to keep your heart healthy.

In the last two years, there have been changes in two important areas: Who should take statin therapy and when blood pressure should be treated.

Statin Therapy

The new guidelines say some people should take statin drugs regardless of what their cholesterol numbers are. These include:

  • Anyone already diagnosed with cardiovascular disease. The goal is to prevent another event, such as a heart attack or the need for a coronary artery bypass.
  • Anyone who doesn’t have heart disease but whose risk of a heart attack or stroke in the next 10 years is at least 7.5%, as determined by factors such as blood pressure, age, cholesterol levels, and diabetes.

Therapy under the old guidelines was designed to reach target cholesterol levels. But we’ve learned that there’s a lack of evidence to support this approach and strong evidence that the appropriate intensity of statin therapy is a better way to reduce cardiovascular risk. We’ll still measure cholesterol levels to be sure patients are taking their medications.

Blood Pressure

The new guidelines represent a significant change from the traditional blood pressure reading of “120 over 80.”

Now, two heart groups say you don’t need to be treated for high blood pressure if you’re older than age 60 unless your reading is greater than 150 over 90. And if you’re younger or have diabetes or chronic kidney disease, medication therapy should begin if your reading is greater than 140 over 90.

What do These Numbers Mean?

The top number, systolic blood pressure, is the pressure on your blood vessels when your heart contracts. The bottom number, diastolic blood pressure, is the pressure on your blood vessels when your heart relaxes between beats.

Previous guidelines, followed for more than 30 years, told us to strive for blood pressures below 140 over 90. Basically, the groups found there was not strong evidence to support the stricter guidelines and that medications used to lower blood pressure have risks.

There are many ways to lower blood pressure without medication, and you’ve probably heard them before. They include: losing weight; eating more fruits, vegetables, low-fat dairy products, and reducing your intake of saturated fats; engaging in regular physical activity; and limiting alcohol consumption.

author name

Dana M. Weinstein, DO

Dana M. Weinstein, DO, is a cardiologist with The Heart Group of Lancaster General Health.

Education: A graduate of Franklin & Marshall College and the Philadelphia College of Osteopathic Medicine, Dr. Weinstein has special interest in heart disease in women, and risk reduction. During her cardiovascular fellowship at Baystate Medical Center, Dr. Weinstein was active in a community educational program on healthy living, nutrition, exercise, and stress reduction.

Call: 717-544-8300

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