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Arnett et al 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease September 10, 2019 Circulation. 2019;140:e596–e646. DOI: 10.1161/CIR.0000000000000678 e624 CLINICAL STATEMENTS AND GUIDELINES PRESIDENTS AND STAFF American College of Cardiology C. Michael Valentine, MD, FACC, President Timothy W. Attebery, MBA, FACHE, Chief Executive Officer William J. Oetgen, MD, MBA, FACC, Executive Vice Presi- dent, Science, Education, Quality, and Publishing MaryAnne Elma, MPH, Senior Director, Science, Educa- tion, Quality, and Publishing Amelia Scholtz, PhD, Publications Manager, Science, Education, Quality, and Publishing American College of Cardiology/ American Heart Association Katherine A. Sheehan, PhD, Director, Guideline Strategy and Operations Abdul R. Abdullah, MD, Senior Manager, Guideline Science Thomas S.D. Getchius, Manager, Guideline Operations American Heart Association Ivor Benjamin, MD, FAHA, President Nancy Brown, Chief Executive Officer Rose Marie Robertson, MD, FAHA, Chief Science and Medicine Officer Gayle R. Whitman, PhD, RN, FAHA, FAAN, Senior Vice President, Office of Science Operations Cammie Marti, PhD, MPH, RN, Science and Medicine Advisor, Office of Science Operations Jody Hundley, Production and Operations Manager, Scientific Publications, Office of Science Operations ARTICLE INFORMATION This document was approved by the American College of Cardiology Clinical Policy Approval Committee, the American Heart Association Science Advisory and Coordinating Committee, and the American Heart Association Executive Committee in February 2019. Supplemental materials are available with this article at https://www. ahajournals.org/doi/suppl/10.1161/CIR.0000000000000678 This article has been copublished in the Journal of the American College of Cardiology. Copies: This document is available on the websites of the American College of Cardiology (www.acc.org) and the American Heart Association (professional. heart.org/). A copy of the document is also available at https://professional.heart. org/statements by selecting the “Guidelines & Statements” button. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com. The expert peer review of AHA-commissioned documents (eg, scientific statements, clinical practice guidelines, systematic reviews) is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit https://professional.heart.org/statements. Select the “Guidelines & Statements” drop-down menu near the top of the web page, then click “Publication Development.” Permissions: Multiple copies, modification, alteration, enhancement, and/ or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are are located at https://www.heart.org/permissions. A link to the “Copyright Permissions Request Form” appears in the second paragraph (https://www. heart.org/en/about-us/statements-and-policies/copyright-request-form). REFERENCES 1. INTRODUCTION S1-1. 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. S1-2. Johnson NB, Hayes LD, Brown K, et al. CDC National Health Report: leading causes of morbidity and mortality and associated behavioral risk and protective factors—United States, 2005–2013. MMWR Suppl. 2014;63:3–27. S1-3. Xu J, Murphy SL, Kochanek KD, et al. Mortality in the United States, 2015. NCHS Data Brief. 2016:1–8. S1-4. 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. S1-5. Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s Strategic Impact Goal through 2020 and beyond. Circulation. 2010;121:586–613. S1-6. Turco JV, Inal-Veith A, Fuster V. Cardiovascular health promotion: an issue that can no longer wait. J Am Coll Cardiol. 2018;72:908–13. S1-7. Younus A, Aneni EC, Spatz ES, et al. A systematic review of the preva- lence and outcomes of ideal cardiovascular health in US and non-US populations. Mayo Clin Proc. 2016;91:649–70. 1.1 Methodology and Evidence Review S1.1-1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:e13–115. S1.1-2. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139:e1082–1143. 1.5 Class of Recommendation and Level of Evidence S1.5-1. Halperin JL, Levine GN, Al-Khatib SM, et al. Further evolution of the ACC/AHA clinical practice guideline recommendation classification system: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2016;133:1426–8. 2 OVERARCHING RECOMMENDATIONS FOR ASCVD PREVENTION EFFORTS 2.1 Patient-Centered Approaches for Providing Comprehensive ASCVD Prevention S2.1-1. Carter BL, Rogers M, Daly J, et al. The potency of team-based care interventions for hypertension: a meta-analysis. Arch Intern Med. 2009;169:1748–55. S2.1-2. Chisholm-Burns MA, Kim Lee J, Spivey CA, et al. US pharmacists’ effect as team members on patient care: systematic review and meta-analyses. Med Care. 2010;48:923–33. S2.1-3. Fazel MT, Bagalagel A, Lee JK, et al. Impact of diabetes care by pharmacists as part of health care team in ambulatory settings: a systematic review and meta-analysis. Ann Pharmacother. 2017;51:890–907. S2.1-4. Mills KT, Obst KM, Shen W, et al. Comparative effectiveness of implementation strategies for blood pressure control in hypertensive patients: a systematic review and meta-analysis. Ann Intern Med. 2018;168:110–20. Downloaded from http://ahajournals.org by on October 7, 2026