"These new guidelines represent the best of what scientific research can tell us about how to prevent heart disease and stroke," Dr. Mariell Jessup, president of the American Heart Association and the University of Pennsylvania in Philadelphia, said in a statement. "These recommendations will help guide the clinical decisions doctors make every day to protect their patients from two of the nation's biggest killers."
The guidelines were based on rigorous, comprehensive, systematic evidence reviews conducted by professional groups and multiple stakeholder organizations were invited to review and endorse the final documents, Jessup said.
The guidelines suggest obesity should be managed and treated like a disease, not just a lifestyle issue.
"The key message here is that we know weight loss isn't just about will power," Dr. Donna Ryan, co-chairwoman of the committee that wrote the obesity guideline and professor emeritus at Louisiana State University's Pennington Biomedical Research Center in Baton Rouge. "It's about behaviors around food and physical activity, and getting the help you need to change those behaviors."
Cholesterol-lowering statin drugs should now be prescribed to an estimated 33 million Americans without cardiovascular disease who have a 7.5 percent or higher risk for a heart attack or stroke within the next 10 years -- dramatic change from the 2002 federal cholesterol guideline. The older guideline recommended people should only take a statin if their 10-year risk level exceeded 20 percent and only considered a person's risk for heart disease, leaving out the risk for stroke.
Doctors can now calculate 10-year risk for a heart attack or stroke using new risk equations available online. For decades, health providers had to rely on risk equations based on long-term research in a white population -- a group less at risk for heart attack and stroke than African-Americans. Doctors also often had to assess heart disease and stroke risk separately.
Also recommended in the guidelines are dietary patterns that emphasize fruits, vegetables, whole grains, low-fat dairy products, poultry, fish and nuts. Red meat, processed meat, sugary foods and beverages should be limited. Salt should be reduced for most people.
Just 40 minutes of moderate to vigorous aerobic exercise -- brisk walking -- three to four times a week was also found to be sufficient for most people.