Guidelines Updated on Secondary Prevention for Atherosclerotic Vascular Disease

The American Heart Association (AHA)/American College of Cardiology (ACC) released updated guidelines on secondary prevention for patients with atherosclerotic vascular disease and published them in the May 16 issue of Circulation.
"Since the 2001 update of the AHA/ACC consensus statement on secondary prevention, important evidence from clinical trials has emerged that further supports and broadens the merits of aggressive risk-reduction therapies for patients with established coronary and other atherosclerotic vascular disease, including peripheral arterial disease, atherosclerotic aortic disease, and carotid artery disease," write Sidney C. Smith, Jr, MD, and colleagues from the AHA/ACC. "This growing body of evidence confirms that aggressive comprehensive risk factor management improves survival, reduces recurrent events and the need for interventional procedures, and improves quality of life for these patients. Compelling evidence from recent clinical trials and revised practice guidelines provided the impetus for this update of the 2001 recommendations with evidence-based results."
Important issues addressed by the committee based on recent evidence included findings from additional lipid reduction trials resulting in new optional therapeutic targets; specific recommendations for clopidogrel use in post–acute coronary syndrome or post–percutaneous coronary intervention–stented patients; recommendations for lower-dose aspirin for chronic therapy; confirmation of the benefit of aldosterone antagonist therapy for patients with impaired left ventricular function; findings of a trial involving angiotensin-converting enzyme (ACE) inhibitor therapy in patients at relatively low risk with stable coronary disease and normal left ventricular function; and a new recommendation regarding influenza vaccination.
"The writing group emphasizes the importance of giving consideration to the use of cardiovascular medications that have been proved in randomized clinical trials to be of benefit," the panel writes. "This strengthens the evidence-based foundation for therapeutic application of these guidelines. The committee acknowledges that ethnic minorities, women, and the elderly are underrepresented in many trials and urges physician and patient participation in trials that will provide additional evidence with regard to therapeutic strategies for these groups of patients."
http://www.medscape.com/viewarticle/532692?sssdmh=dm1.262212&src=nldne