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New draft guidelines on heart attack treatment question benefits of omega-3

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Advising patients who have had a myocardial infarction to eat diets rich in oily fish may have only a limited impact on reducing their risk of a future cardiovascular event, according to the National Institute for Health and Care Excellence.

Guidelines on the care of people who have survived a heart attacks are being updated by NICE, including new advice on the secondary prevention of MIs.

The organisation has issued a number of new recommendations for public consultation aimed at improving the care given to hundreds of thousands of people in England and Wales who have survived heart attacks. The guidelines were first published in 2007.

The aim of the guidelines is to stem any progression of vascular diseases and to prevent repeat heart attacks.

The 2007 guidelines recommended that patients took part in cardiac rehabilitation programmes to increase their chances of a healthy recovery, but because the uptake of these courses was low, the new guidelines call for interventions to ensure more patients benefit from the programmes.

There have also been many changes in the way patients are treated in the immediate aftermath of a heart attack, and the guidelines have been updated to reflect these advances.

These focus particularly on the use of interventional procedures such as using stents rather than drugs as a means of widening blocked or narrowed coronary arteries.

There have also been some points removed since the previous guidelines were issued, including advising patients to eat oily fish, or take omega-3 fatty acid capsules or omega-3 fatty acid supplemented foods in a bid to prevent further heart attacks. The impact these methods may have had on preventing heart attacks could be minimal when compared with new treatments that are now available.

Instead, patients will be urged to enjoy a more Mediterranean-style diet, which would involve eating more bread, fruit, vegetables and fish, and less meat, while replacing butter and cheese with products based on plant oils.

Another area where the guidelines have been updated is regarding the use of drugs on patients following a heart attack, updating the best practice to reflect the latest advances in treatments.

Professor Mark Baker, director of the centre for clinical practice at NICE, said: “Healthcare professionals should ensure that a programme of education and activity to help people recover from a heart attack and lead their lives as normally as possible, is designed to motivate people to attend and complete it. “

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