The 2011 update to the American Heart Association’s (AHA) guidelines for the prevention of cardiovascular disease (CVD) in women includes “effectiveness-based” as well as “evidence-based” recommendations.

The AHA guidelines have primarily been based on findings observed in clinical research since their inception in 1999. However, the update now encourages practitioners to consider patient diversity when addressing CVD risk—not just the individual’s race and ethnic and geographic origin, but such factors as age, language, culture, literacy, disability, frailty, socioeconomic status, occupational status, and religious affiliation.

The update, published online in Circulation,  outlines key strategies to help clinicians manage obstacles presented by these factors, beginning with the critical first step of initiating a dialogue with the patient.

“If the clinician doesn’t ask the woman if she’s taking her medicine regularly, if she’s having any side effect, or if she’s following recommended lifestyle behaviors, the problems may remain undetected,” noted Lori Mosca, MD, MPH, PhD, chair of the writing committee. “Improving adherence to preventive medications and lifestyle behaviors are the best strategies to lower the burden of heart disease in women.”


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In a separate project that also acknowledged the importance of preventive measures on cardiovascular risk, researchers sought to clarify the relationship between fruit-and-vegetable consumption and mortality risk from ischemic heart disease (IHD).

After analyzing data from the European Prospective Investigation into Cancer and Nutrition-Heart study, Francesca L. Crowe, PhD, and colleagues discovered that after an average of 8.4 years of follow-up, participants who consumed at least eight daily portions (80 g/portion) of fruits and vegetables had a 22% lower risk of fatal IHD than did persons who consumed fewer than three portions per day. A one-portion increase in fruit-and-vegetable intake was associated with a 4% lower risk of fatal IHD. The results were published online in the European Heart Journal.