Cardiovascular Disease Prevention and Management Clinical Practice Guidelines (2018)

Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE)

Reviewed and summarized by Medscape editors

November 01, 2018

Updated recommendations on the prevention and management of cardiovascular disease (CVD) in primary care were released in October 2018 by the Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE).[1]

Body Habitus

Monitor daily morning weight in patients with heart failure, with fluid retention or congestion that is not easily managed with diuretic agents, or in individuals with significant renal dysfunction.

Diet, and Sodium and Alcohol Intake

For hypertension prevention and blood pressure (BP) reduction in hypertensive adults, reduce daily sodium intake toward 2000 mg (5 g of salt or 87 mmol of sodium).

Encourage all individuals to moderate energy (caloric) intake to achieve/maintain a healthy body weight and to adopt a healthy dietary pattern to reduce their CVD risk, such as the following:

  • Mediterranean, Portfolio, or DASH (Dietary Approaches to Stopping Hypertension) dietary pattern

  • Dietary patterns high in nuts (≥30 g/day), legumes (≥4 servings/week), olive oil (≥60 mL/day), total fiber (≥30 g/day), and whole grains (≥3 servings/day), as well as those rich in fruits and vegetables (≥5 servings/day)

  • Low glycemic load or low glycemic index dietary patterns

  • Vegetarian dietary patterns


Offer diabetic patients timely self-management education tailored to enhance self-care practices/behaviors.


Include a dietary plan for health improvement as part of a weight-management strategy in obese adults.

A comprehensive healthy lifestyle intervention is recommended for overweight and obese patients.


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