American Heart Association Guide for Improving Cardiovascular Health at the Community Level

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Abstract
This Guide for Improving Cardiovascular Health at the Community Level (Community Guide) is intended to provide persons and organizations interested in improving the cardiovascular health of their communities with a comprehensive list of goals, strategies, and recommendations that might be implemented on a community-wide basis. It targets not only health professionals but also public health practitioners, voluntary health agencies, and community leaders in general. The Community Guide will complement the American Heart Association (AHA) Guidelines for Primary Prevention of Cardiovascular Disease and Stroke,1 the American Stroke Association Scientific Statement on the Primary Prevention of Ischemic Stroke,2 AHA/American College of Cardiology (ACC) Guidelines for Preventing Heart Attack and Death in Patients with Atherosclerotic Cardiovascular Disease,3 and the Guidelines for Preventing Ischemic Stroke in Patients with Prior Stroke and Transient Ischemic Attack.4 This Guide differs from these four clinical guidelines because it provides a comprehensive approach to reducing the burden of cardiovascular disease (CVD) through improving the local policies and environment as a means to promote cardiovascular health. Changes toward a healthier environment could be expected to enhance the clinically oriented guidelines because both the primary and secondary prevention guidelines recommend that healthcare providers encourage behavior change in individual patients. Improvements in facilities and resources in the places where people work and live should enhance the achievement of many goals, including: cessation of tobacco use and avoidance of environmental tobacco smoke; reduction in dietary saturated fat, cholesterol, sodium, and calories; increased plant-based food intake; increased physical activity; access to preventive healthcare services; and early recognition of symptoms of heart attack and stroke. Healthcare providers and their patients have better opportunities for successfully implementing the clinical guidelines when they live in such communities. Although complementary to and supportive of the clinical guidelines, the Community Guide provides a fundamentally different …