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

Abstract

A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Geriatrics Society, the American Society of Preventive Cardiology, and the Preventive Cardiovascular Nurses Association

Keywords: ACC/AHA Clinical Practice Guidelines; LDL-cholesterol; antihypertensive agents; aspirin; atherosclerosis; atherosclerotic cardiovascular disease; atrial fibrillation; behavior modification; behavior therapy; blood cholesterol; blood pressure; body mass index; cardiovascular; cardiovascular disease; cardiovascular team-based care; cholesterol; chronic kidney disease; coronary artery calcium score; coronary disease; coronary heart disease; cost; diabetes mellitus; diet; dietary fats; dietary patterns; dietary sodium; dyslipidemia; e-cigarettes; exercise; guidelines; health services accessibility; healthcare disparities; heart failure; hypertension; lifestyle; lipids; measurement; myocardial infarction; nicotine; nonpharmacological treatment; nutrition; physical activity; prejudice; primary prevention; psychosocial deprivation; public health; quality indicators; quality measurement; risk assessment; risk factors; risk reduction; risk reduction discussion; risk treatment discussion; risk-enhancing factors; secondhand smoke; sleep; smoking; smoking cessation; social determinants of health; socioeconomic factors; statin therapy; systems of care; tobacco; tobacco smoke pollution; treatment adherence; treatment outcomes; type 2 diabetes mellitus; waist circumference; weight loss.

Figures

FIGURE 1. Hours Per Day Spent in Various States of Activity

U.S. adults spend >7 h/d on average in sedentary activities. Replacing sedentary time with other physical activity involves increasing either moderate- to vigorous-intensity physical activity or light-intensity physical activity. Data modified from Young et al. (S3.2-12).

FIGURE 2. Treatment of T2DM for Primary Prevention of Cardiovascular Disease

CVD indicates cardiovascular disease; GLP-1R, glucagon-like peptide-1 receptor; HbA1c, hemoglobin A1c; SGLT-2, sodium-glucose cotransporter 2; and T2DM, type 2 diabetes mellitus.

FIGURE 3. Primary Prevention

Colors correspond to Class of Recommendation in Table 1. ABI indicates ankle-brachial index; apoB, apolipoprotein B; ASCVD, atherosclerotic cardiovascular disease; CAC, coronary artery calcium; CHD, coronary heart disease; HIV, human immunodeficiency virus; hs-CRP, high-sensitivity C-reactive protein; LDL-C, low-density lipoprotein cholesterol; and Lp(a), lipoprotein (a). Reproduced with permission from Grundy et al. (S4.3-1). Copyright © 2018, American Heart Association, Inc., and American College of Cardiology Foundation.

FIGURE 4. BP Thresholds and Recommendations for Treatment

Colors correspond to Class of Recommendation in Table 1. BP indicates blood pressure; and CVD, cardiovascular disease. Adapted with permission from Whelton et al. (S4.4-1). Copyright © 2017, American College of Cardiology Foundation and the American Heart Association, Inc.