Personalized Strategy Is Best for Heart Health

American Heart Association Suggests New Ways to Manage Lifestyle Changes to Cut Heart Risk

By Katrina Woznicki
WebMD Health News

Reviewed By Elizabeth Klodas, MD, FACC

July 12, 2010 -- Combining individualized approaches to heart health -- including counseling, long-term one-on-one follow-up with a health care provider, and self-monitoring of diet and exercise -- are more effective than general approaches such as self-help support groups, web sites, and brochures, according to new recommendations from the American Heart Association (AHA).

The AHA statement is based on a review of 74 studies conducted among adults in the U.S. between January 1997 and May 2007. The statement is published in today's issue of Circulation: Journal of the American Heart Association.

The purpose of the statement is to provide expertise on how to best manage lifestyle changes for the long term so that patients can reduce their risk of cardiovascular disease and improve their health.

Nancy T. Artinian, PhD, RN, associate dean for research and director of the Center for Health Research at Wayne State University College of Nursing in Detroit, said her team's findings suggest that health care policies should be designed to encourage these types of interventions, which could help people improve their lifestyle behaviors for the long term and reduce their risk of cardiovascular disease.

Obesity and physical inactivity are both major risk factors for cardiovascular disease, a leading cause of death in the U.S. An estimated one in three U.S. adults has cardiovascular disease, which includes heart attack, stroke, and heart failure -- conditions that claim one life every 37 seconds. Experts estimate that the eradication of cardiovascular disease would increase life expectancy by about seven years.

During the review, Artinian and her team identified components of various behavioral change programs that were associated with more effective outcomes. These components included:

  • Setting realistic dietary and exercise goals
  • Keeping track of progress toward goals
  • One-to-one counseling, which provided customized support to implementing and maintaining lifestyle changes
  • Participating in smaller groups who share the same health-improvement goals
  • Health care providers using motivational interview techniques to encourage patients
  • Counseling patients on how to manage setbacks
  • Maintaining recurring follow-up visits with patients to get updates on their progress and discuss concerns

Making Behavioral Changes

"We need to do a better job finding ways to help people not only change their behaviors, but maintain them over a lifetime," said Artinian. "As health care providers, we're pretty good at saying that you are at risk for a disease, you need to lose weight, be more physically active, and eat more fruits and vegetables. While that's easy to say, it's not easy for the person to actually translate it into their everyday life."

The health care reform bill signed by President Barack Obama calls for more prevention services for patients to control for risk factors, such as obesity, that contribute to heart disease, heart attacks, and stroke.

Ralph Sacco, MD, president of the American Heart Association, says the first step to making lifestyle changes is to know your status, such as body mass index, cholesterol levels, and blood pressure measurements, which all indicate a person's risk for cardiovascular disease. Understanding your status can help you change and track changes in these areas.

"Lifestyle change is never easy and often underemphasized in clinical encounters with our patients," Sacco says. "This statement shows what types of programs work and supports the increased need for counseling and goal setting to improve healthy cardiovascular habits. We need to find more effective ways to make lifestyle change programs available, especially to the groups at highest risk for cardiovascular diseases -- older Americans, African-Americans, and people of Hispanic origin."

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SOURCES: News release, American Heart Association.

American Heart Association tips statement.

American Heart Association's Health Policy Initiatives statement.

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