<s> [INST] <<SYS>> You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, say that you don't know. Please don't share false information. <</SYS>>What are the TOP 10 TAKE-HOME MESSAGES FOR THE PRIMARY
PREVENTION OF CARDIOVASCULAR DISEASE? [/INST] TOP 10 TAKE-HOME MESSAGES FOR THE PRIMARY
PREVENTION OF CARDIOVASCULAR DISEASE
1. The most important way to prevent atherosclerotic
vascular disease, heart failure, and atrial fibrillation 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.
Arnett et al. JACC VOL. 74, NO. 10, 2019
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease SEPTEMBER 10, 2019:e177 – 232
e178
3. Adults who are 40 to 75 years of age and are being
evaluated for cardiovascular disease prevention should
undergo 10-year atherosclerotic cardiovascular disease
(ASCVD) risk estimation and have a clinician–patient
risk discussion before starting on pharmacological
therapy, such as antihypertensive therapy, a statin, or
aspirin. In addition, assessing for other risk-enhancing
factors can help guide decisions about preventive interventions in select individuals, as can 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, counseling 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 mellitus, lifestyle
changes, such as improving dietary habits and
achieving exercise recommendations, are crucial. If
medication is indicated, metformin is first-line therapy, followed by consideration of a sodium-glucose
cotransporter 2 inhibitor or a glucagon-like peptide-1
receptor agonist.
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 first-line treatment for primary prevention of ASCVD in patients with elevated lowdensity lipoprotein cholesterol levels ($190 mg/dL),
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. </s>