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 less than 40 inches for men and less than 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 or more in women or 40 inches or more
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 days
(but at least 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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