Juggling Multiple Guidelines: A Woman's Heart in the Balance

Journal of Women's Health
Nanette K Wenger

Abstract

In 2011, the American Heart Association (AHA) issued the pivotal "Effectiveness-based Guidelines for the Prevention of Cardiovascular Disease in Women-2011 Update." In the interim, multiple guidelines have dramatically altered recommendations for preventive cardiovascular care. This article addresses how I juggle these multiple guidelines in my clinical practice. In brief, my approach to risk stratification is to use the Pooled Cohort Equations, but I also routinely assess the risk factors unique to or predominant in women such as pregnancy complications and systemic autoimmune collagen vascular diseases. I follow the 2013 AHA/American College of Cardiology (ACC) Guidelines on Lifestyle Management to Reduce Cardiovascular Risk, but find value in the detailed aspects of physical activity recommendation in the 2011 Women's Guideline, including those for weight loss or weight loss maintenance. Based solely on epidemiological data, I consider a blood pressure (BP) of 120//80 mmHg ideal in women who remain asymptomatic at that level. I typically titrate BP therapy to 120-130/80-90 mmHg as tolerated. I endorse the current ACC/AHA recommendations for cholesterol management, but for my women patients older than age 75 who previously to...Continue Reading

References

Oct 30, 2003·Medical Care·Kurt KroenkeJanet B W Williams
Mar 9, 2005·The New England Journal of Medicine·Paul M RidkerJulie E Buring
Jul 7, 2005·JAMA : the Journal of the American Medical Association·I-Min LeeJulie E Buring
Nov 3, 2007·BMJ : British Medical Journal·Leanne BellamyDavid J Williams
Oct 24, 2008·The American Journal of Medicine·Jane E Salmon, Mary J Roman
Oct 24, 2012·Annals of Internal Medicine·Virginia A Moyer, UNKNOWN U.S. Preventive Services Task Force
Jul 17, 2013·Journal of the European Academy of Dermatology and Venereology : JEADV·C HorreauM-A Richard
Nov 6, 2013·The American Journal of Cardiology·Nanette K Wenger
Nov 14, 2013·Journal of the American Pharmacists Association : JAPhA
Nov 14, 2013·Journal of the American Pharmacists Association : JAPhA
Feb 8, 2014·Stroke; a Journal of Cerebral Circulation·Cheryl BushnellUNKNOWN Council for High Blood Pressure Research
Feb 26, 2014·Circulation·Judith H LichtmanUNKNOWN American Heart Association Statistics Committee of the Council on Epidemiology and Prevention and the Council on Cardiovascu
Mar 13, 2014·Journal of the American College of Cardiology·Raheel AhmedVijay Kunadian
Jul 23, 2014·Circulation·Jennifer H MieresUNKNOWN Cardiovascular Imaging and Intervention Committee of the Council on Cardiovascular Radiology and Intervention
Jul 26, 2014·Journal of the American College of Cardiology·Aakriti GuptaHarlan M Krumholz
Apr 2, 2015·Hypertension·Clive RosendorffUNKNOWN American Heart Association, American College of Cardiology, and American Society of Hypertension

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Citations

Mar 20, 2016·Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN·Gina P LundbergNanette K Wenger
Oct 4, 2016·Current Atherosclerosis Reports·Karen M GoldsteinHayden B Bosworth

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