Primary care practices are uniquely positioned to help people maintain heart health

Primary care physician checking a patient's blood pressure © rocketclips - stock.adobe.com

According to a newly released scientific statement from the American Heart Association (AHA), primary care physicians and practices play a unique and critical role in ensuring that patients achieve optimal cardiovascular health. The statement, published in the AHA’s peer-reviewed journal, Circulation: Cardiovascular Quality and Outcomes, primary care professionals are best equipped to reduce the risk of heart disease and stroke through screening, diagnosing and treating factors highlighted in the AHA’s “Life’s Essential 8” health metrics.

“Primary care plays a central role in people’s health and health care across their lifetime,” Madeline R. Sterling, MD, MPH, MS, FAHA, chair of the statement writing group and associate professor of medicine at Weill Cornell Medicine in New York, said in an organizational release. “Primary care professionals have the potential to greatly improve the identification and treatment of cardiovascular risk factors and health behaviors in their patients.”

According to the AHA, cardiovascular disease is the leading cause of death in the US, although they estimate that one in four deaths caused by cardiovascular disease could be prevented by addressing modifiable risk factors through either lifestyle changes or medical treatment. The AHA’s recommendations for improving and maintaining optimal cardiovascular health come in the form of the AHA's Life’s Essential 8 guidelines, a list of four health behaviors—diet, physical activity, nicotine exposure and sleep—and four health factors—body mass index (BMI), blood lipids, blood glucose and blood pressure—each of which are modifiable by behavioral changes or medical intervention.

The AHA news release references data backing primary care as being more effective than specialty care when it comes to supporting patients in addressing the health behaviors and factors included in Life’s Essential 8. It’s usually primary care physicians who screen for, diagnose and treat conditions including high blood pressure, blood sugar and cholesterol. The statement credits effective primary care as being person-centered, team-based, community-oriented and optimized to achieve better health at lower costs.

“Primary care, as a field, can address some of these disparities by providing preventative care to screen patients for cardiovascular disease risk factors, encouraging people to adopt heart-healthy lifestyle behaviors to prevent health problems from developing or worsening and initiating treatment to improve cardiometabolic health, if necessary,” Jeremy Sussman, MD, MPH, MS, associate professor of medicine at the University of Michigan and vice chair of the scientific statement, said in the AHA release.

Despite the proven effectiveness of primary care in cardiovascular health, the group expressed concerns regarding current industry trends in the statement. Namely, the group cited the shrinking workforce, increasing burnout, struggles with coordinating care with other health professionals, insufficient financial support and reimbursement along other potential barriers to care as key shortcomings.

“Primary care as a profession is under-valued and under-resourced, accounting for 35% of health care visits in the US, while accounting for only 5% of health care expenditures,” Sterling said. “For primary care to have a maximum impact on the variables outlined in Life’s Essential 8, it must be supported, promoted and valued by the health care community, public health systems and policymakers.”

In the statement, the AHA offered their take on potential solutions to current industry challenges, including payment reform, leveraging technology and promoting team-based care. “Effective support of primary care would require federal and state legislation to increase the overall portion of health care spending to primary care and to update how care and supporting programs are paid,” Sussman explained.