Answers to questions about the new guidelines

美国心脏协会和美国心脏病学会周二发布了四项心血管预防指南, 提供循证指导，帮助医疗保健提供者在胆固醇领域为患者提供最佳护理, 肥胖, 生活方式和风险评估.

在接下来的几个月里，心.Org将提供一些新工具，帮助医疗保健提供者和患者更好地了解如何结合这些建议来帮助预防心脏病, stroke and other cardiovascular issues.

与此同时，以下是你可能想知道的一些基本问题的答案:

I know that my overall health isn’t great.  Do the new guidelines say I should start statins right away? 我还能怎么办呢?

There are two things you should do: First, talk to your doctor. Second, assess what kind of lifestyle changes you should try to adopt. 停止吸烟, 吃更健康的食物和做足够的运动是你总是可以而且应该做的事情，以改善你的健康. The 美国心脏协会’s My Life Check tool can help.

新的胆固醇指南称，更多的人应该服用他汀类药物，以避免心脏病和中风. How do I know if I need to start taking these?

Check with your healthcare professional. 他们会对所有可能使你处于危险中的因素进行全面评估:你是否吸烟, 你的体重, 你的血压, 身体活动水平, 饮食, 血糖和胆固醇都将被考虑在内，以决定你是否需要将他汀类药物添加到我们应该遵循的沙巴足球体育平台方式中.  If that risk assessment suggests that statins would provide a benefit for you, your provider will discuss the potential benefits and risks with you.  The assessment might suggest that you don’t need medications now, but a healthy lifestyle remains important. 

我已经在吃他汀类药物了. Do the new guidelines change my dosage?

This is a great question for your healthcare provider. 答案很可能取决于与你整体心血管健康有关的许多因素. 这些指导方针的主题之一是，你的医生现在将着眼于大局.  一般来说, statins are most helpful for people who already have heart disease, people with LDL cholesterol levels of 190 or higher, and people between the ages of 40 and 75 with Type 2 diabetes or other risks.  新的指导方针将有助于确定最适合你的风险水平的他汀类药物剂量, 但你的医疗保健提供者会根据他们对你的全面了解来决定.  人们对你通过生活方式和药物达到的低密度脂蛋白确切水平的关注就会减少, but some monitoring will still be done to be sure your medication is working. 

The new 肥胖 guidelines talk about treating 肥胖 like a disease. How do I know if I’m obese and need a doctor’s help?

最简单的检查方法是使用美国心脏协会的在线计算器来检查你的身体质量指数, 或身体质量指数. When you see your healthcare provider, he or she will now start assessing whether you need treatment based on your BMI. If your BMI is over 30, you are considered obese and in need of treatment. 

How will my doctor treat my 肥胖?

新的指导方针鼓励医生为你提供建议，并真正参与到你的护理中. 指南还提供了你的医生需要的工具，让他们参与到你的病例中，并与你密切合作. 该指南承认，没有一种固定的减肥计划适用于所有人, and that each person needs an individual plan. 你的医生可能会给你一个医学监督的减肥计划或建议减肥手术.

保险呢?? What aspects of 肥胖 treatment will be covered?

私人保险计划所涵盖的范围差别很大，所以最好咨询一下你的保险公司. 然而, 根据《平价医疗法案, 医疗保险和大多数私人保险计划已经为体重指数在30以上的成年人提供肥胖筛查和咨询服务, 为任何有高胆固醇或其他心血管疾病风险因素的成年人提供饮食咨询. 从2014年开始, 通过健康保险市场销售的所有新计划还必须免费提供这些和其他预防性服务.

Do the lifestyle guidelines suggest any major changes?

美国心脏协会一直给出的建议没有大的变化. 本质上, we continue to urge people to keep following what we call “Life’s Simple 7,” which are factors and behaviors that can lower your risk: Don’t smoke, 多做运动, 健康饮食, maintain a healthy body weight, and control 你的血压, 胆固醇和血糖.

Do the new guidelines suggest any major 饮食 changes I should consider?

No. You should keep shooting for the same eating patterns we’ve always recommended, one that includes plenty of fruits, 蔬菜, 全谷物,  鱼和其他瘦肉蛋白, 但不是过量的钠, 脂肪或添加糖. The 美国心脏协会’s Nutrition Center offers more guidance. 

钠呢?? 我应该不吃盐吗?

You need sodium in your body and in your 饮食, but the average American takes in more than 3,每天400毫克——这个量太高了，会增加你患高血压的风险, stroke and other major problems. Unless your doctor tells you that you need more salt, the guidelines continue to urge you to reduce how much you consume. The new guidelines still advise 1,500 milligrams a day as the level with the greatest effect on blood pressure. 但它也表示，高血压患者可以将血压“降”到2毫克,400 milligrams on the way to 1,500. 

What does the risk assessment guideline mean to me?

这是一个指导方针，真正的目的是为您的医疗保健提供者提供指导. 结果是，您的医疗保健提供者现在有了新的工具来更好地评估您的整体风险. And a real improvement is having better data for African-Americans.  再一次。, 这些指南的一个主要主题是关注你心血管健康的大局. And your provider will help you do that.