Doctors need to treat
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
As part of this approach,
doctors need to implement "five A's" when caring for patients: assess
their risk behaviours for heart disease; advise change, such as weight loss or
exercise; agree on an action plan; assist with treatment; and arrange for
"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 behaviours,
such as smoking, unhealthy body weight, poor diet quality and lack of physical
activity," statement lead author Bonnie Spring, a professor of preventative
medicine and psychiatry and behavioural 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 behaviours. We can't measure the results of these behaviours in
their bodies yet," she added.
What doctors need to
Doctors also need to refer
patients to behaviour change specialists such as dietitians 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% improvement in the cardiovascular health of all Americans
and a 20% reduction in deaths from cardiovascular diseases and stroke by 2020.
The US National Institutes
of Health outlines steps you can take to reduce