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Medical Groups Update Heart, Blood Pressure Care Guidelines
Date:6/13/2011

to manage symptoms.
  • Tobacco use: Patients should be screened for tobacco use and should receive tobacco-cessation counseling, if needed.
  • Antiplatelet therapy: Physicians should prescribe aspirin or clopidogrel.
  • Beta-blocker therapy: It should be prescribed for people with prior myocardial infarction or a left ventricular ejection fraction of less than 40 percent.
  • ACE inhibitor/ARB therapy: This should be prescribed for people with diabetes or a left ventricular ejection fraction of less than 40 percent.
  • Cardiac rehabilitation referral: Early referrals should be made for people who've had an acute heart attack, coronary artery bypass graft surgery, stenting, cardiac valve surgery or a heart transplant.
  • In the area of hypertension, the new measures include:

    • Blood pressure control: Patients should have a blood pressure of less than 140/90 mm Hg. If their blood pressure is higher, at least two antihypertensive medications should be prescribed.

    "This report represents an update and revision of guidelines last published in 2005" and "clearly outlines what is appropriate care for patients with coronary artery disease and/or hypertension," said Dr. Louis Evan Teichholz, chief of cardiology and medical director of cardiac services at Hackensack University Medical Center in New Jersey. "A significant change is the addition of cardiac rehabilitation referral from an outpatient setting."

    Although the blood pressure and lipid guidelines have not changed much, he said, both are "in the midst of revision and new recommendations will be available late in 2011 or early 2012."

    More information

    The U.S. National Heart, Lung, and Blood Institute has more about coronary heart disease.

    -- Robert Preidt
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