SSF - Grand Rounds 7/8/2020- Update on Primary Prevention of Atherosclerotic Cardiovascular Disease

South San Francisco, CA US
July 8, 2020

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.


  • 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 


Target Audience

All physicians, but most importantly primary care physicians, will have a major role in closing this gap.


Learning Objectives

As a result of this activity, participants should be able to:

  1. Review primary prevention of cardiovascular disease based on current ACC/AHA 2019 guidelines
  2. Use recommendations in current literature to counsel patients on use of aspirin in primary prevention. 

Additional Information

South San Francisco Medical Center
Conference room: 
MS Teams +1 213-533-9530 Conference ID: 158 539 69#
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit(s)™
Course opens: 
Course expires: 
Event starts: 
07/08/2020 - 12:30pm PDT
Event ends: 
07/08/2020 - 1:30pm PDT
Kaiser Permanente
1200 El Camino Real
MS Teams Meeting
South San Francisco, CA 94080
United States
+1 (650) 742-3365

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+1 213-533-9530   United States, Los Angeles (Toll)

Conference ID: 158 539 69#

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Kunal Mehtani, MD, Cardiology

Planning Committee:

  • Jie Zheng, MD, Chief of Medical Education
  • Archana Petkar, MD, CME DLC Grand Round Planner
  • Jennifer A Jones, MD, CME Grand Round Planner
  • Tenisha Jones, MLIS/Library Services
  • Agnes Lau, Sr. Quality Specialist

Speaker Dr. Kunal Mehtani has disclosed that his spouse works for Genentech and receives salary. The PowerPoint for this activity has been reviewed by the grand rounds planner, and the CME Department has determined that there is no bias and/or relevant conflict of interest with this CME activity.

Kaiser Permanente South San Francisco has determined that the planning committee, Dr. Jie Zheng, Dr. Jennifer Jones, Dr. Archana Petkar, Tenisha Jones and Agnes Lau, for this activity do not have any relevant financial relationships with commercial interests .

Kaiser Permanente South San Francisco takes responsibility for the content, quality, and scientific integrity of this CME activity.

Kaiser Permanente does not endorse any brand-name products.

Accreditation Statement:

Kaiser Permanente South San Francisco is accredited by the California Medical Association (CMA) to provide continuing medical education for physicians.

Credit Statement:

The Kaiser Permanente South San Francisco Medical Center designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses may report up to a maximum total of 1.0 AMA PRA Category 1 Credit(s)™ towards the Continuing Medical Education requirements for license renewal by the California Board of Registered Nurses.

FOR CME CREDIT: Scan the QR code and claim credit through the link provided or use the link sent with the flyer . A survey will be emailed to all who participate. Please complete the survey. The survey will be open for 10 days.

Available Credit

  • 1.00 AMA PRA Category 1 Credit(s)™
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