Published July 26, 2022
Linking the Importance of Behavioral Counseling to Cardiovascular Risk Management
A recent editorial in the Journal of the American Medical Association Cardiology highlights the direct connection between behavioral modification through counseling to marked improvements in risk factors related to Cardiovascular Disease (CVD) and decreased mortality rates. Carl J. Lavie, M.D., Medical Director, Cardiac Rehabilitation and Prevention, was the lead author on the editorial titled Improving Behavioral Counseling for Primary Cardiovascular Disease Prevention.
The editorial discusses a recently published recommendation statement by The US Preventative Services Task Force (USPSTF) on the necessity for behavioral counseling to promote healthy lifestyles for adults without CVD risk factors to proactively prevent development of the disease. The statement suggests that providers should individualize and prioritize referrals for behavioral counseling to promote heart healthy habits such as dietary modifications and physical activity.
Cardiovascular Diseases (CVD) continue to be the leading cause of death among adults in the United States. The editorial highlights a significant decrease in physical activity over several decades, and the desperate need for systematic intervention.
“We know that individuals, both male and female, regardless of ethnicity, are more likely to develop CVD risk factors when poor diets and sedentary lifestyles are involved,” explained Lavie. “The goal of the US Preventive Services Task Force is to reach individuals prior to the development of significant risk factors to instill the behaviors necessary to ward off complications and disease processes that could lead to death.”
The evidence report referenced in Dr. Lavie’s editorial included 113 randomized clinical trials (129,993 participants). With behavioral counseling, improvements were noted in participants’ dietary habits and physical activity levels. When compared to the control population, these studies revealed modest but statistically important improvements in CVD risk factors such as blood pressure and cholesterol levels.
The editorial also addresses significant barriers to achieving behavioral modifications in certain populations where social determinants of health are prevalent. It is known that unhealthy behaviors are widespread in individuals with lower socioeconomic status and minimal opportunities for education, access to healthy food choices, and affordable
