CMAJ offers guideline for comprenhensive recommendations to manage heart disease

The updated C-CHANGE (Canadian Cardiovascular Harmonized National Guidelines Endeavour) guideline to manage cardiovascular disease can assist primary care physicians with patients at risk of heart disease. The guideline updates the 2014 guideline, with 52 additional or updated recommendations, including:

• A new, lower threshold for treatment and blood pressure in high-risk patients with hypertension;
• Treatment of high-risk patients with high cholesterol with statins to prevent cardiovascular disease;
• Diabetes testing with a two-hour plasma glucose after a 75 g oral glucose tolerance test;
• Use of direct oral anticoagulants instead of warfarin for nonvalvular atrial fibrillation; and
• Lifestyle changes, such as lower sodium intake, in people with hypertension and screening and advice on smoking cessation.