AHA: Assessment and Promotion of Physical Activity for CVD Prevention

Physical inactivity is associated with greater risks for cardiovascular disease, obesity, Alzheimer’s disease, depression, and cancer. In a new scientific statement published in Circulation, the American Heart Association (AHA) provided updated guidelines for the routine assessment of physical activity for healthcare systems and providers as a means of potentially preventing future health complications and to meet the AHA’s 2020 Impact Goals.

Because of the effect physical inactivity has on various health outcomes, it is estimated that >11% of US aggregated healthcare expenditures are a result of physical inactivity in the population. Moreover, healthcare costs reaching >$50 billion may be associated with physical inactivity on a global scale. According to the AHA writing committee, a carefully coordinated multi-level approach is needed to improve physical activity levels.

Physical activity counseling, which can be initiated by a physician, physical therapist, or other healthcare provider, represents a primary recommendation in the new scientific statement. Based on findings from recently published research, physical activity counseling offers a small to moderate positive effect on improving physical activity levels in patients with little to no exercise habits.

Interventions including multiple behavior-change resources targeting physically inactive patients at risk for cardiovascular disease offer better results in changing behavior and improving patient outcomes. In addition, patients who are referred for exercise by a primary care provider are more likely to attain physical activity recommendations compared with usual care, according to the AHA.

The AHA also provides criteria for the use of wearable activity monitoring devices (ie, pedometers, accelerometers, smartphones) in the healthcare setting for recording physical activity in the patient’s electronic health record. Connecting physical activity to the electronic health record offers an opportunity for healthcare professionals to evaluate patients’ activity levels and initiate discussion and counseling on physical activity as a whole.

Practicing physicians need the necessary knowledge and counseling skills, both of which rely on greater discussion of lifestyle medicine in medical education, according to the AHA. By following this approach, physicians and other healthcare providers may be more likely to possess the “necessary knowledge, skills, and abilities to effectively and efficiently counsel their patients toward adopting and sustaining healthier behaviors.”

Reference

Lobelo F, Rohm Young D, Sallis R, et al. Routine assessment and promotion of physical activity in healthcare settings: a scientific statement from the American Heart Association [published online April 4, 2018]. Circulation. doi:10.1161/CIR.0000000000000559