Healthcare Providers Urged to Aggressively Treat Unhealthy Lifestyles 

American Heart Association calls physicians to do more than address high blood pressure, cholesterol


DAYTON, Ohio (January 13, 2014) – For nearly two years, Katrina Paulding, MD, saw a patient come through her doors for various acute issues and each time she would go beyond the immediate issue at hand to gently counsel the gentlemen to quit smoking.

“He had been an active smoker for eight years and each time I would see him I told him, ‘I’m going to dance and sing the day you quit smoking,’” said Dr. Paulding, a Premier HealthNet physician who practices at Samaritan North Family Physicians.

She was held to that promise recently when he returned with the good news: He had not only put away the cigarettes, but had also quit drinking alcohol as well. Dr. Paulding did her victory dance with joy – not only for what the lifestyle choice meant for this one man, but what it meant for the time she puts into each patient visit to encourage patients to make wise lifestyle choices.

“One of the things we do well in the medical field is patching people up,” Dr. Paulding said. “We have wonderful interventional tools, but what we don’t do a good job at all the time is helping our patients from getting to the point where they need to be patched up.”

Dr. Paulding’s sentiments are not alone. In recent months, major health organizations including the American Cardiology Council, the National Heart, Blood and Lung Institute and the American Heart Association (AHA) have each called for a greater focus to be placed on the treatment of lifestyle behaviors historically proven to increase one’s risk for heart disease. In October 2013, the AHA issued a policy statement urging healthcare physicians 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.

As part of this approach, the AHA asks doctors to implement the “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. The organization hopes that this approach to preventative care will help it reach its 2020 goal: A 20 percent improvement in cardiovascular health of all Americans and a 20 percent reduction in deaths from cardiovascular diseases and stroke.

“I think that is a very rigorous and challenging goal to get to,” said Timothy Markus, MD, FACC at Dayton Heart Center, a Premier Health Specialists practice. “We have seen a reduction in cardiovascular deaths and that curve is still tending to decline over time, but I think a good portion of that is due to the fact that we have the technology and treatment, better public awareness and education of the symptoms and signs of a heart attack. Now, the real challenging portion of this is to get individuals to modify their behaviors that will make them at less of a risk for heart disease.”

Heart disease has a big impact on our society and some of it is attributable to lifestyle choices. According to the AHA, 79 million American adults, or one in three, have cardiovascular disease. The disease accounts for more than a third of the deaths in the country. Each year, $44 billion – including $33 billion in medical costs and $9 billion in lost productivity – due to heart disease, cancer, stroke and diabetes is attributed to poor nutrition. In the year 2000, the annual estimated direct medical costs of physical inactivity were $76.6 billion.

There are risk factors such as genetics and family history over which one has little control. However, there are numerous behaviors such as cigarette smoking and lack of regular exercise that can be modified to reduce risk of the disease. Dr. Markus said all factors – from high blood pressure on down to tobacco use – must be addressed and treated the same in order to achieve better health. Dr. Paulding agrees.

“I think the message from a primary care perspective is that it doesn’t matter how busy we are as physicians, we have to make prevention a key issue,” Dr. Paulding said. “This young man I treated is a great example. He saw how passionate I was and it made a huge difference. It’s not about extending a patient visit, it’s about infusing prevention into each one.”

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