What are the primary prevention strategies for myocardial infarction (heart attack)?

From the Guidelines

The primary prevention strategies for myocardial infarction (heart attack) are focused on promoting a healthy lifestyle, including a balanced diet, regular physical activity, avoidance of tobacco use, and management of risk factors such as high blood pressure, high cholesterol, and diabetes.

Key Strategies

• Lifestyle Optimization: Improvements in diet, physical activity, and avoidance of tobacco use and exposure to secondhand smoke to minimize the risk of future ASCVD events 1.
• Risk Factor Management: Management of risk factors such as high blood pressure, high cholesterol, and diabetes through lifestyle changes and, if necessary, pharmacotherapy 1.
• Population-Based Approach: A population-based approach to risk factor modification, which involves shifting the entire distribution of risk factors and risk towards lower levels through population-wide interventions 1.

Specific Recommendations

• Diet: A healthy diet that is low in saturated fat, cholesterol, sodium, and calories, and high in plant-based foods 1.
• Physical Activity: Regular aerobic exercise, such as walking or jogging, for at least 30 minutes a day 1.
• Tobacco Use: Avoidance of tobacco use and exposure to secondhand smoke 1.
• Blood Pressure: Maintenance of a blood pressure level below 140/85 mmHg through lifestyle changes and, if necessary, pharmacotherapy 1.
• Cholesterol: Maintenance of a total cholesterol level below 5.0 mmol/l (LDL cholesterol <3.0 mmol/l) through lifestyle changes and, if necessary, pharmacotherapy 1.
• Diabetes: Optimal management of diabetes through lifestyle changes and, if necessary, pharmacotherapy, with a goal of achieving an HbA1c level below 7% 1.

From the Research

Primary Prevention Strategies for Myocardial Infarction

The primary prevention strategies for myocardial infarction (heart attack) involve a combination of lifestyle changes and pharmacological interventions. The key strategies include:

• Therapeutic lifestyle changes (TLCs) such as a healthy diet, regular physical activity, smoking cessation, and avoidance of heavy alcohol consumption 2, 3, 4, 5
• Management of risk factors such as hypertension, diabetes mellitus, dyslipidemia, and abdominal obesity 2, 3, 6, 4
• Use of evidence-based medications such as statins, blood pressure medications, aspirin, and drugs to treat insulin resistance and hyperglycemia 3, 6, 4

Lifestyle Modifications

Lifestyle modifications play a crucial role in the primary prevention of myocardial infarction. These include:

• Adoption of a healthy diet, such as a diet rich in fruits and vegetables, whole grains, and lean protein sources 2, 3, 5
• Engagement in regular physical activity, such as walking or bicycling for at least 40 minutes per day and exercising for at least 1 hour per week 5
• Smoking cessation and avoidance of secondhand smoke 2, 3, 4
• Limiting alcohol consumption to moderate levels, defined as up to 30 grams per day 5

Pharmacological Interventions

Pharmacological interventions can also be effective in the primary prevention of myocardial infarction. These include:

• Use of statins to lower cholesterol levels and reduce the risk of cardiovascular disease 3, 6
• Use of blood pressure medications to manage hypertension and reduce the risk of cardiovascular disease 3, 6, 4
• Use of aspirin to reduce the risk of myocardial infarction and stroke 3, 4
• Use of drugs to treat insulin resistance and hyperglycemia, such as metformin, to reduce the risk of cardiovascular disease 3