Weight Management
ÎÎWeight management, as measured by body mass index and/or waist
circumference, should be assessed on each visit. A body mass index
of 18.5-24.9 kg/m2 and a waist circumference (measured horizontally
at the iliac crest) of <40 inches for men and <35 inches for women is
recommended. (I-B)
ÎÎAdditional weight management practices recommended include the
following:
• On each patient visit, it is useful to consistently encourage weight maintenance/
reduction through an appropriate balance of physical activity, reduced caloric
intake, and formal behavioral programs when indicated to maintain/achieve a
body mass index between 18.5 and 24.9 kg/m2. (I-B)
• If waist circumference is ≥35 inches in women or ≥40 inches in men, it is
beneficial to initiate lifestyle changes and consider treatment strategies for
metabolic syndrome as indicated. (I-B)
• The initial goal of weight loss therapy should be to reduce body weight by
approximately 10% from baseline. With success, further weight loss can be
attempted if indicated through further assessment. (I-B)
Smoking Cessation
ÎÎDiscontinue smoking and avoid exposure to environmental tobacco
smoke at work and home. Follow-up, referral to special programs,
or pharmacotherapy (including nicotine replacement) is useful, as is
adopting a stepwise strategy aimed at smoking cessation (the 5 As
are: Ask, Advise, Assess, Assist, and Arrange). (I-B)
Physical Activity
ÎÎThe patient's risk after UA/NSTEMI should be assessed on the basis
of an in-hospital determination of risk. A physical activity history or an
exercise test to guide initial prescription is beneficial. (I-B)
ÎÎGuided/modified by an individualized exercise prescription, patients
recovering from UA/NSTEMI generally should be encouraged to
achieve physical activity duration of 30-60 min/d, preferably 7 (but
≥5) days per week of moderate aerobic activity, such as brisk walking,
supplemented by an increase in daily lifestyle activities (eg, walking
breaks at work, gardening, and household work). (I-B)
ÎÎCardiac rehabilitation/secondary prevention programs are
recommended for patients with UA/NSTEMI, particularly those with
multiple modifiable risk factors and/or those moderate- to highrisk patients in whom supervised exercise training is particularly
warranted. (I-B)
ÎÎThe expansion of physical activity to include resistance training on
2 days per week may be reasonable. (IIb-C)
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