Using Shared Decision Making to Prevent CVD in Patients Without Risk Factors

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January 18, 2022

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The US Task Force on Preventive Services has released a draft recommendation encouraging clinicians to use shared decision making when considering behavioral counseling to promote healthy eating and physical activity for the prevention of cardiovascular disease.

The grade “C” recommendation only applies to adults without CVD risk factors and does not apply to obese adults, the USPSTF wrote.

A 2020 CDC report showed that cardiovascular disease killed an estimated 659,000 people in the United States in 2018, making it the leading cause of death among men, women, and people in historically under-served populations. represented in the United States. Healio has previously reported that the COVID-19 pandemic will likely increase the number of deaths from cardiovascular disease. According to the USPSTF, nearly half of American adults are expected to have some form of cardiovascular disease by 2035.

The task force’s draft recommendation is based on a review of 113 randomized clinical trials that included 129,993 men and women of various racial backgrounds and a wide range of ages, according to the authors of the evidence review.

“Behavioral healthy eating and physical activity interventions for people with no known risk of cardiovascular disease were associated with very small but statistically significant benefits on a variety of important intermediate health outcomes and with small to moderate effects on dietary and physical activity behaviors,” they wrote. . “There is very little evidence regarding the health outcomes or harmful effects of these interventions.”

The USPSTF’s new draft recommendation parallels its 2017 final recommendation, which is supported by the American Academy of Family Physicians. The American Heart Association recommends that clinicians promote physical activity for CVD prevention in all adult patients, according to the USPSTF.

The task force noted that it issued a separate grade “B” recommendation in 2020 on behavioral counseling interventions for adults who have established risk factors for CVD.

“We found that people who want to make changes to their diet and physical activity are most likely to benefit from counseling, so clinicians are encouraged to talk with their patients and decide together if behavioral counseling is right for them. agree”, Lori Pbert, PhD, a member of the task force and associate chief of the division of preventive and behavioral medicine at UMass Chan Medical School, said in a press release.

Comments on the draft recommendation are accepted until February 14 at www.uspreventiveservicestaskforce.org/tfcomment.htm.

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