ABSTRACT
A Consensus Panel of the American Heart Association (AHA) published its Guide to Comprehensive Risk Reduction for Patients with Coronary and Other Vascular Diseases in 1995 (1) with four goals: to extend overall survival; to improve quality of life; to decrease the need for intervention procedures such as coronary angioplasty and coronary bypass grafting; and to reduce the incidence of subsequent myocardial infarction. This guide to risk reduction was also endorsed by the American College of Cardiology (ACC) (2). The guide addresses well-established risk factors such as smoking, dyslipidemia, obesity, and hypertension as well as interventions not directly related to specific measurable risk factors (i.e., antiplatelet therapy, ACE-inhibitors, beta-blockers, exercise, hormone replacement therapy). The AHA Consensus statement did not specifically address blood glucose control, psychosocial factors, or nutritional factors, but these issues were discussed by the ACC’s 27th Bethesda Conference (2).
