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Cardiovascular Disease Primary Prevention/Lifestyle Guidelines

Screening for Lifestyle Risks of Cardiovascular Disease

Cardiovascular disease (CVD) risk factors associated with lifestyle include smoking, alcohol intake, diet, and exercise. Screening guidelines for modifiable lifestyle CVD risks in adults have been issued by the following organizations:

US Preventive Services Task Force (USPSTF)

American Heart Association (AHA)/American College of Cardiology (ACC)

European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS)

A comparison of the recommendations for diet, physical activity, and tobacco use screening and interventions are listed in Table 1, below.

Table 1. Recommendations for Diet, Physical Activity, and Tobacco Use Screening and Interventions (Open Table in a new window)

Adult Guidelines


Risk Factor

Screening Populations

Recommended Interventions

US Preventive Services Task Force (USPSTF)


Diet and physical activity

Overweight or obese adults with additional cardiovascular risk

Intensive behavioral counseling interventions to promote a healthful diet and physical activity



Diet and physical activity

Adult population with no known diagnosis of hypertension, diabetes, hyperlipidemia or CVD

The health benefit of initiating behavioral counseling in the primary care setting to promote a healthful diet and physical activity is small; clinicians may selectively counsel patients rather than incorporate counseling into the care of all adults

American Heart Association


Diet and physical activity

All adults

Clinicians should provide individual or group-based interventions to promote and maintain healthy diet and physical activity that include a combination of two or more of the following strategies:

· Setting specific, proximal goals

· Providing feedback on progress

· Providing strategies for self-monitoring

· Establishing a plan for frequency and duration of follow-up

· Using motivational interviews

· Building self-efficacy

European Society of Cardiology/European Atherosclerosis Society (ESC/EAS)


Diet, physical activity, and tobacco use

All adults

Risk estimation for CVD using the Systematic COronary Risk Evaluation (SCORE)

All smokers offered assistance to quit

All patients encouraged to adopt healthy diet and increase physical activity

Multimodal behavioral interventions, integrating health education, physical exercise, and psychological therapy for psychosocial risk factors and coping with illness, should be prescribed for all patients with CVD



Tobacco Use

All adults

Ask all adults about tobacco use; advise those who use tobacco to stop using it and provide behavioral interventions; in nonpregnant adults, provide FDA-approved pharmacotherapy for cessation

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