Putting Prevention into Practice

An Evidence-Based Approach

Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults with Cardiovascular Risk Factors

 


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Am Fam Physician. 2015 Sep 15;92(6):509-510.

  Related U.S. Preventive Services Task Force Recommendation Statement: Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults with Cardiovascular Risk Factors: Recommendation Statement.

Author disclosure: No relevant financial affiliations.

Case Study

J.W., a 34-year-old man who smokes, presents for his annual checkup for hypertension. His blood pressure is elevated (142/95 mm Hg), and he has gained 10 lb (4.5 kg) since his last visit. J.W. is now considered overweight, with a body mass index (BMI) of 27 kg per m2. He reports no other symptoms or problems.

Case Study Questions

  1. Based on the U.S. Preventive Services Task Force (USPSTF) recommendation, which one of the following types of behavioral interventions is most appropriate for this patient?

    • A. Brief counseling and advice about nutrition and physical activity during his appointment.

    • B. One or two nutritional counseling sessions over the next 12 months.

    • C. An intensive weight-loss program.

    • D. A single group therapy session.

    • E. Intensive counseling, including a didactic education component.

  2. Behavioral counseling interventions are beneficial for persons who are overweight or obese, and who also have which of the following additional cardiovascular risk factors?

    • A. Hypertension.

    • B. Hyperlipidemia.

    • C. Elevated C-reactive protein level.

    • D. Impaired fasting glucose.

  3. Which one of the following statements about the benefits and harms of behavioral counseling interventions is correct?

Author disclosure: No relevant financial affiliations.

SOURCES

U.S. Preventive Services Task Force. Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(8):587–593.

Lin JS, O'Connor E, Evans CV, Senger CA, Rowland MG, Groom HC. Behavioral counseling to promote a healthy lifestyle in persons with cardiovascular risk factors: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014;161(8):568–578.

This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and the supporting evidence on the USPSTF website (http://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/healthy-diet-and-physical-activity-counseling-adults-with-high-risk-of-cvd.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of Putting Prevention into Practice published in AFP is available at http://www.aafp.org/afp/ppip.



 

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