Table 3.

Summary recommendations for outpatient management of patients with and at high risk for cardiovascular disease during the COVID-19 pandemic.

1.Angiotensin converting enzyme inhibitors and angiotensin receptor blockers should be continued in patients already taking these medications. There is no recommendation to initiate these therapies in the absence of other clinical indications (e.g., hypertension, heart failure, or diabetes).

2.Where possible, it is strongly preferred to continue patient visits via telehealth rather than delaying or deferring visits.

3.Patients should be counseled to promptly report any new or concerning cardiac symptoms and not delay evaluation for severe symptoms.

4.Barriers to medication access should be reviewed with patients, with implementation of strategies to ensure ongoing provision of medications during the crisis.

5.Team-based care should be leveraged and enhanced to improve delivery of guideline directed cardiovascular care and adherence to lifestyle related recommendations.

6.Physical activity should continue to be promoted with safe distancing for outdoor activities and recommendations for several opportunities for exercise that can be done at home.

7.Health care professionals should assess patient access to food items and changes in dietary patterns, with recommendations and encouragement for healthy food options.

8.Adaptive strategies for cardiac rehabilitation should be implemented including home based cardiac rehabilitation, potentially involving innovative platforms, to ensure continuity of this essential service.