USPSTF Draft Recommendation: Behavioral Counseling Interventions for Adults at High Risk for CVD

By Kristin J. Kelley

The U.S. Preventive Services Task Force advises that primary care clinicians offer counseling to promote lifestyle interventions (e.g., healthy diet, exercise) for overweight and obese adults at high risk for cardiovascular disease. The draft statement is a grade B recommendation.

A review of some 70 trials of patients with risk factors for CVD (e.g., dyslipidemia, hypertension, impaired fasting glucose, BMI above 25) found that intense lifestyle counseling demonstrated a moderate benefit on CVD risk, including reduced diabetes incidence and improved BMI, blood pressure, and lipids. The USPSTF says it found insufficient evidence that behavioral changes result in improved CVD or mortality rates.

The USPSTF's draft statement updates a 2003 recommendation on dietary counseling for adults with cardiovascular risk factors. The new recommendation specifically focuses on patients who are overweight or obese.