Thread by @DeveshRaiMD

#ASPC2021

Evolution of ABCs of Primary Prevention by Cardiac disease

How the guidelines have changed over the last two decade

@rickferraro getting plugged at #ASPC2021

ABCDEF of prevention is important!!

A: Assess risk
B: BP
C: Cholesterol/Cigarette
D: Diabetes/Diet/Weight
E: Exercise/Education
F: Failure

Shared decision making is the key to the prevention

#ASPC2021

@CardioNerds @DrMarthaGulati @ErinMichos @khurramn1 Identifying and providing help with social determinants of health is the first aspect of prevention.

Risk stratification by ASCVD risk is the next step to guide the optimal therapy.

#ASPC2021

ASCVD is the first step.

But, never forget the risk-enhancing factors as they can change the paradigm. South Asian descent is a strong risk factor.

Pregnancy is nature's stress test! #CardioObs

#ASPC2021

ASCVD risk tells about CVA in addition to MI and CHD as well

CAC is another key factor that provides additional information about risk factors on top of ASCVD.

#ASPC2021

@Gurleen_Kaur96 @RichardAFerraro

@Gurleen_Kaur96 @RichardAFerraro When can be aspirin be used?

Choose wisely, when used in the right setting it can prevent major adverse cardiovascular events.

#ASPC2021

@ErinMichos

@Gurleen_Kaur96 @RichardAFerraro @ErinMichos B for Blood pressure control:

Measure the BP in the appropriate settings.

Focus on diet and exercise prior to initiating medications.

Practicing mindfulness can help in decreasing BP as well.

#ASPC2021

C for cholesterol:

Statins are the first line.

Target LDL < 70 in very high-risk ASCVD as per ACC
Target LDL < 55 in very high-risk ASCVD as per ESC

Zetia is the next step.

PCSK9i is the next one to achieve target LDL

#ASPC2021

C for cholesterol:

Statins are the first line.

Target LDL < 70 in very high-risk ASCVD as per ACC
Target LDL < 55 in very high-risk ASCVD as per ESC

Zetia is the next step.

PCSK9i is the next one to achieve target LDL

D: Diet

Mediterranean diet has shown to have a preventive effect

Smoking cessation is the key to prevention.

#ASPC2021

D: Diabetes

More than 150 minutes of exercise per week is vital to the prevention

DM: Exercise, SGLT-2i, and GLP-1 have shown preventive benefits in HF and coronary events.

E: Exercise

The more you exercise, more protected you are from major adverse cardiovascular events

#ASPC2021

F: Failure

Many medications have been shown to prevent new episodes of HF

@NMHheartdoc

In Summary

#ABCDEF of prevention

#ASPC2021