The 2007 Guidelines
for Preventing Cardiovascular
Disease in Women, published in
a special women’s health issue of
Circulation: Journal of the American
Heart Association, advise health
care professionals to focus on
women’s lifetime heart disease
risk. The updated guidelines
also include new directions for
using aspirin, hormone therapy
and vitamin and mineral supplements
in heart disease and stroke
prevention in women.
The guidelines include a new
paradigm for risk assessment
based on risk factors and family
history, as well as the Framingham
risk score (estimates the risk
of developing coronary heart disease
within 10 years.)
Expanded recommendations on
lifestyle factors such as physical
activity, nutrition and smoking
cessation, as well as more indepth
recommendations on
drug treatments for blood pressure
and cholesterol control are
also included in the updated
guidelines.
Furthermore, guidelines
on hormone and aspirin
therapy and antioxidant
and folic acid supplements
are revised based on
recently published data. “Nearly all women are at risk for
CVD, underscoring the importance
of a heart-healthy lifestyle
in everyone,” the authors wrote.“Some women are at a higher
risk of future heart attack or stroke because they already have
CVD and/or multiple risk factors.
These women are candidates
for more aggressive preventive
therapy and we define them
as high risk.”
Physicians can easily identify
high-risk women, but tools to
determine other levels of risk are
limited, Mosca said. The authors
have aligned their recommendations
with treatments proven to
work and give strong advice for
what not to do, as well.
“The recommendations for highrisk
women are more aggressive
but we want to emphasize the
importance of these lifestyle
strategies to reduce risk in all
women,” she said.
• Recommended lifestyle
changes include weight
control, increased physical
activity, alcohol moderation,
sodium restriction, and an
emphasis on eating fresh
fruits, vegetables and low-fat
dairy products.
• Recommend counseling,
nicotine replacement or
other forms of smoking cessation
therapy.
• Recommend a minimum of
60-90 minutes of moderateintensity
activity on most,
and preferably all, days of
the week for women who
need to lose weight or sustain
weight loss.
• All women are encouraged
to reduce saturated fast
intake to less than 7 percent
of calories if possible.
• Recommend eating oily fish
(contains omega-3 fatty
acids) at least twice a week,
and consider taking a capsule
supplement of 850-1000
mg of EPA (eicosapentaenoic
acid) and DHA
(docosahexaenoic acid) in
women with heart disease,
two to four grams for
women with high triglycerides.
• Hormone replacement therapy
and selective estrogen
receptor modulators
(SERMs) are not recommended
to prevent heart
disease in women.
• Antioxidant supplements
(such as vitamin E, C and
beta-carotene) should not
be used for primary or secondary
prevention of CVD.
• Folic acid should not be
used to prevent CVD
• Routine low dose aspirin
therapy may be considered
in women age 65 or older
regardless of CVD risk status,
if benefits are likely to outweigh
other risks.
• The upper dosage of aspirin
for high-risk women increases
to 325 mg per day rather
than 162 mg.
• Consider reducing LDL cholesterol
to less than 70 mg/dL
in very high-risk women with
heart disease (which may
require a combination of
cholesterol-lowering drugs).
This 2007 update provides the most current clinical recommendations
for preventing CVD in women 20 and older and are based on a systematic
search of the highest quality science interpreted by experts in the
fields of cardiology, epidemiology, family medicine, gynecology, internal
medicine, neurology, nursing, public health, statistics and surgery.
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