If someone has a heart attack or stroke, receiving professional treatment gives them the best chance of survival. But when it comes to preventing those problems in the first place, new research suggests that the most important care happens in general primary care clinics.

Or if some people are unable, unwilling, or unwilling to take the time to see their GP or nurse, none of this will happen at all.

The study found that among the controllable risk factors for cardiovascular disease, which the American Heart Association calls “life’s eight essentials,” high cholesterol, high blood pressure, diabetes, a very high body mass index, smoking, low physical activity, and It focuses on seven sleep problems. insomnia. The data sources used in the study do not include information on the eighth risk factor, healthy food intake.

This research Circulation: cardiovascular quality and outcome; The majority of people are taking any of these key measures to improve and maintain cardiovascular health, and the majority of people are taking medication to manage four of those measures. had only seen a primary care clinician in the past year. See a cardiologist alone or in addition to seeing your primary care provider.

The study also found that even though the majority of people with these major cardiovascular risk factors said they took medications to control blood pressure, cholesterol, blood sugar, and blood sugar levels in the past year, They were also found to have not seen either type of health care provider. I don’t smoke.

More than 50% of all smokers, 44% of those with low physical activity levels, and 38% of severely obese people said they had not seen a primary care provider or cardiologist in the past year. Ta. Among people taking medications to control cardiovascular risk factors, 15% to 20% said they had not seen a health care provider in the past year.

For the study, researchers used data from more than 66,000 adults interviewed in detail about their health and health care over the past year through the federal government’s nationally representative Health Expenditure Panel Survey.

“As a society, we need to recognize that to prevent common conditions, we need health care professionals who see patients frequently and can see the whole patient. That’s the role of primary care.” said lead author Jeremy Sussman, a general internist and associate professor at the university. Michigan Department of Internal Medicine.

“While cardiovascular care guidelines are often created by specialists and subspecialists, this study shows that access to primary care is critical to preventing or slowing some of the nation’s most common causes of death. It shows that there is.”

The current crisis in access to primary care for American adults does not bode well for a move into the Essential Eight, Sussman said. This crisis is driven by both a shortage and uneven distribution of physicians, nurses, and physician assistants who choose to practice general medicine, family medicine, and geriatrics.

When wait times for appointments are long and providers are not available to accept new patients, identification and management of cardiovascular risk factors, such as starting new prophylactic medications or adjusting dosages to properly control risk factors, may be difficult. There may be delays.

People who need to see their primary care provider at least once a year, even for a telehealth appointment, should already be on antihypertensive medication to lower high blood pressure or diabetes medication to lower blood sugar levels. This includes people who are prescribed it. Statins to control cholesterol or prescribed smoking cessation drugs.

Regular testing can help ensure that these medications are maximizing their preventive power.

But even if they’re not taking medications, most adults with at least one cardiovascular risk factor on the “Essential 8” list should see their primary care provider regularly, Sussman says.

“Primary care providers today can manage most cases of high blood pressure, high cholesterol, diabetes, and smoking cessation without referral to a specialist. ”he says. “They can also be an important entry point into nutritional counseling, weight management and exercise programs, and the diagnosis and treatment of sleep disorders.”

Policy measures to strengthen access to primary care by training more providers and encouraging practice in shortage areas, as well as efforts to support primary care providers in managing cardiovascular risk factors, will be important. The authors say that.

But in the meantime, we encourage people with any of these risk factors to request an appointment at a clinic or find a clinic if they don’t have a regular primary care provider.

In addition to Sussman and Sterling, general internists and researchers at Weill Cornell University, the research team also included author Michael Johansen, a family medicine physician at OhioHealth who trained at the University of Michigan. There is.

Sussman is a member of the University of Michigan Institute for Health Policy Innovation, VA Clinical Management Research Center, and Division of General Medicine.

The AHA committee that Sussman and Sterling serve on is a joint subcommittee of the Care Quality and Outcomes Research Council and the Cardiovascular and Stroke Nursing Council.

Additional co-authors are from Michigan Medicine and the University of Michigan Academic Medical Center. Ohio Health; and Weill Cornell Medicine.

Source: University of Michigan