Update on Primary Prevention of Atherosclerotic Cardiovascular Disease

There has been substantial improvement in atherosclerotic cardiovascular disease (ASCVD) outcomes in recent decades.  BUT… ASCVD remains the leading cause of morbidity and mortality globally.  In the United States, it is also the leading cause of death for people of most racial/ethnic groups, with an estimated cost of >$200 billion annually in healthcare services, medications, and lost productivity. Much of this is attributable to poor implementation of prevention strategies and uncontrolled ASCVD risk factors in many adults.
Most Americans who have had a myocardial infarction (MI) had unfavorable levels of at least 1 cardiovascular risk factor before their ASCVD event.  Increasing number of optimal cardiovascular health factors have been associated with a lower prevalence and incidence of ASCVD events.

In 2019  the American College of Cardiology/American Heart Association (ACC/AHA) published updated guidelines on the primary prevention of cardiovascular disease (CVD) recommending that low dose aspirin may be considered among adults 40 to 70 years of age who are at higher risk of CVD but not at increased risk of bleeding.

Physicians will apply updated guidelines and be able to counsel patients on why aspirin recommendations have changed, patients will take or not take aspirin as appropriate based on recommendations and risk factors specific to each patient

Cultural and Linguistic Competency:

Recommendations for aspirin vary based on patient age, and these will be emphasized.

References:

• 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. AU Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Himmelfarb CD, Khera A, Lloyd-Jones D, McEvoy JW, Michos ED, Miedema MD, Muñoz D, Smith SC Jr, Virani SS, Williams KA Sr, Yeboah J, Ziaeian B SO Circulation. 2019;140(11):e596. Epub 2019 Mar 17. 
• Weir, HK, Anderson, RN, Coleman King, SM, et al. Heart disease and cancer deaths—trends and projections in the United States, 1969–2020. Prev Chronic Dis. 2016;13:E157
• Greenland, P, Knoll, MD, Stamler, J, et al. Major risk factors as antecedents of fatal and nonfatal coronary heart disease events. JAMA. 2003;290:891–7
• Younus A, Aneni EC, Spatz ES, et al. A systematic review of the prevalence and outcomes of ideal cardiovascular health in US and non-US populations. Mayo Clin Proc. 2016;91:649–70.
• ASCEND Study Collaborative Group, Bowman L, Mafham M, et al. Effects of aspirin for primary prevention in persons with diabetes mellitus. N Engl J Med. 2018;379:1529–39. 
• Gaziano JM, Brotons C, Coppolecchia R, et al. Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. Lancet. 2018;392:1036–46

*Hot Lunches will be available for pick up at the following locations*:
- 2nd Floor Cafeteria Back Conference Room, SSF 11:45 AM-12:30 PM
- 6th Floor, TPMG Admin Office (Mary Cion’s Office), Daly City 12:15 PM-12:45 PM
- 3rd Floor Physical Therapy Conf Room, San Bruno 11:45 AM-12:15 PM
- 220 Oyster Point, SSF (Josie Garcia to distribute) 11:45 AM-12:15 PM
- 2001 Junipero Serra Blvd. Daly City (Aurora Gomez to distribute) 11:45 AM-12:15 PM
- 901 El Camino Real, San Bruno (Dr. Eva Liu’s Office) 11:45 AM-12:15 PM

Post Presentation Survey: Will be send out in a follow-up email