| Lifestyle interventions |
|
| Cigarette smoking: consistently encourage women to avoid smoking, active or passive |
I, B, 1 |
| Physical activity: consistently encourage women to perform exercise of moderate intensity, for 30 min (brisk walking), on most days of the week, preferably on all days of the week |
I, B, 1 |
| Cardiac rehabilitation: women, after an acute coronary event, or an intervention in coronary arteries, or with chronic angina pectoris, should participate in a comprehensive risk reduction regimen such as cardiac rehabilitation programme, or should implement the instructions of the physician at home, or should participate in a community programme |
I, B, 2 |
| Heart healthy diet: constant encouragement to follow a healthy diet, e.g. consumption of a variety of fruits, vegetables, cereals, dairy products with low or without fat, consumption of fish, legumes, and proteins with low content of unsaturated fat (poultry, lean meat, plant). Restriction of consumption of unsaturated fat (< 10% of total calories), cholesterol (300 mg/daily), and trans-fatty acids |
I, B, 1 |
| Weight maintenance or reduction: constant encouragement of maintenance of body weight or reduction, a proper balance between physical activity and caloric uptake, and, if necessary, implementation of a regular programme, for a body weight index of 18.5 kg/m2 to 24.9 kg/m2 and a waist circumference<88 cm to be maintained/accomplished |
I, B, 1 |
| Psychosocial factors: women with CV disease should be evaluated for potential depression, and should be reported or cured when there are indications |
IIa, B, 2 |
| Ω-3 fatty acids: these substances may be administered in high risk women, in the form of diet supplements |
IIb, B, 2 |
| Folic acid: it may be administered in high risk women, as a diet supplement, if homocysteine levels are high |
IIb, B, 2 |
| Major RF intervention |
|
| Arterial hypertension – lifestyle: encouragement to maintain a favourable blood pressure level of < 120/80 mmHg, during all lifetime |
I, B, 1 |
| Arterial pressure – drugs: pharmacotherapy is indicated when arterial pressure is>140/90 mmHg, or lower, in combination with damage of target organ, influenced by hypertension. Thiazide diuretics should be one of the drugs if there are no contraindications |
I, A, 1 |
| Lipids, lipoproteins: women's favourable levels are<100 mg/dl for LDL cholesterol,>50 mg/dl for HDL cholesterol,<150 mg/dl for triglycerides, and<130 mg/dl for non-HDL cholesterol (total cholesterol – HDL cholesterol). Lifestyle change should be encouraged |
I, B, 1 |
| Lipids – dietary therapy: consumption of saturated fat should be reduced to<7% of total calories, and cholesterol to 200 mg daily, in high risk women, or with elevated plasma LDL cholesterol levels. Consumption of trans-fat should also be reduced |
I, B, 1 |
| Lipids – pharmacotherapy – high risk: initiation of LDL lowering treatment (statins preferred), along with lifestyle change, in high risk women, and LDL cholesterol ≥ 100 mg/dl. Initiation of treatment with statins for LDL lowering in high-risk women, and LDL cholesterol <100 mg/dl, unless contraindicated. Initiation of treatment with nicotinic acid or fibrates when HDL cholesterol is low or non-HDL cholesterol is elevated |
I, A, 1 |
|
I, B, 1 |
|
I, B, 1 |
| Lipids – pharmacotherapy – moderate risk: iInitiation of LDL lowering treatment (statins preferred), along with lifestyle change, when LDL cholesterol is ≥ 130 mg/dl. Nicotinic acid or fibrates when HDL cholesterol is low, or non-HDL cholesterol is high, after the target LDL cholesterol level has been accomplished |
I, A, 1 |
|
I, B, 1 |
| Lipids – pharmacotherapy – low risk: initiation of LDL lowering treatment in women with 0-1 RFs or fibrates when HDL cholesterol is low, or non-HDL cholesterol is high, after the target LDL cholesterol level has been accomplished |
IIa, B |
|
IIa, B, 1 |
| Diabetes mellitus: lifestyle change and pharmacotherapy for HbA1c level (haemoglobulin adult 1c) <7% to be accomplished |
I, B, 1 |
