New Guidelines for Preventing Second Heart Attack

Based on compelling evidence from recent clinical trials, the American Heart Association (AHA) and the American College of Cardiology have issued new guidelines for preventing heart attacks in people who have already had one or in people with other forms of cardiovascular disease. The guidelines were published in the September 25, 2001, issue of Circulation and will also be published in the November issue of the Journal of the American College of Cardiology.
The new guidelines recommend treating all heart attack survivors indefinitely with angiotensin-converting enzyme (ACE) inhibitors, which have been shown to reduce deaths in these patients, and to control risk factors more aggressively. The guidelines also recommend giving beta-blocker drugs to heart attack survivors and others whose hearts are not getting an adequate blood supply. The revisions also recommend that patients avoid secondhand smoke, eat foods high in omega-3 fatty acids, and use the newer antiplatelet agents if they are unable to take aspirin to reduce the risk of blood clots.

The guidelines incorporate findings from several major heart disease studies, including the discovery that hormone replacement therapy is ineffective in preventing heart attacks in women with cardiovascular disease and the significant value of lowering cholesterol.
Included in the guidelines are recent recommendations from the American Diabetes Association on managing the risk factor of diabetes.

"Far too often patients don't get all the recommended treatments, even for something as common as a heart attack,” said Sidney C. Smith, M.D., chief science officer of the AHA. "For example, a meager one-third of eligible heart attack patients in the United States are prescribed cholesterol-lowering drugs before hospital discharge, despite the widely documented benefits.”




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