Doctors need to treat patients' unhealthy lifestyle habits -- such as smoking, poor eating and being overweight -- as aggressively as high blood pressure, high cholesterol and other cardiovascular disease risk factors, a new American Heart Association policy statement says.
As part of this approach, doctors need to implement "five A's" when caring for patients: assess their risk behaviors for heart disease; advise change, such as weight loss or exercise; agree on an action plan; assist with treatment; and arrange for follow-up care.
"We're talking about a paradigm shift from only treating biomarkers -- physical indicators of a person's risk for heart disease -- to helping people change unhealthy behaviors, such as smoking, unhealthy body weight, poor diet quality and lack of physical activity," statement lead author Bonnie Spring, a professor of preventive medicine and psychiatry and behavioral sciences at Northwestern University, said in an AHA news release.
"We already treat physical risk factors that can be measured through a blood sample or a blood pressure reading in a doctor's office, yet people put their health at risk through their behaviors. We can't measure the results of these behaviors in their bodies yet," she added.
Doctors also need to refer patients to behavior change specialists such as dieticians or psychologists, and insurance reimbursement policies need to be changed so these specialists become part of the primary care team, according to the statement published in the Oct. 7 issue of the journal Circulation.
"This isn't a problem that can be solved alone by the patient or the doctor who is strapped for time," Spring said. "We need to break out of our silos and get ahead of the curve in prevention."
She added that cardiovascular-disease prevention has to be made a priority to achieve the AHA's goals of a 20 percent improvement in the cardiovascular health of all Americans and a 20 percent reduction in deaths from cardiovascular diseases and stroke by 2020.