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Am Fam Physician. 2022;106(4):439-440

Related USPSTF Clinical Summary: Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for CVD Prevention in Adults Without CVD Risk Factors

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Case Study

A 49-year-old patient, S.B., presents for a wellness visit. S.B.'s blood pressure is 128/72 mm Hg, and their body mass index is 29 kg per m2. S.B. works in an office setting and exercises about one hour a week at a gym. S.B. usually eats fast food for lunch and red meat or chicken for dinner, rarely eats vegetables, and typically drinks two to three cans of soda each day. S.B. has no significant medical history, and their social history, physical examination, and laboratory values are unremarkable. S.B. does not drink alcohol and has never smoked. S.B. recently read that cardiovascular disease (CVD) is the leading cause of death in the United States and would like to know how they could prevent a heart attack or stroke.

Case Study Questions

1. For which one of the following risk factors does the U.S. Preventive Services Task Force (USPSTF) recommend that physicians selectively, but not routinely, offer behavioral counseling intervention to promote healthy diet and physical activity for CVD prevention in adults without CVD risk factors?

  • A. Hypertension.

  • B. Low levels of physical activity.

  • C. Obesity.

  • D. 10-year CVD risk greater than 7.5%.

  • E. Dyslipidemia.

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This series is coordinated by Joanna Drowos, DO, contributing editor.

A collection of Putting Prevention Into Practice published in AFP is available at

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