Behavioral counseling improves heart health

This review offers recommendations for adults with high blood pressure, high cholesterol, or other risks for heart attack or stroke. 

Cardiovascular disease (CVD) puts people at risk of heart attack, heart failure, and stroke. Risk factors for CVD include high blood pressure, being overweight, and unhealthy blood lipid levels including cholesterol. All of these risks are have multiple causes including genetics, lifestyle, and environment. These risks can be reduced by improving lifestyle factors such as diet and exercise. 

A CVD-friendly diet includes plenty of fruits and vegetables, whole grains, and other high-fiber foods. It also reduces salt, butter, and other saturated fats, and sugar. Additionally, 75 minutes of vigorous exercise or 150 minutes of moderate exercise is recommended weekly.

Behavioral counseling can make it easier to start and stick with a new way of eating and moving. Behavioral counseling consists of regular meetings with a clinician, nutritionist, therapist, or exercise specialist. Counseling can be individual or in a group. The counselor offers resources and education on healthful diet and exercise. They also aid in setting and maintaining achievable fitness goals.

This national health recommendation reviews the role of behavioral counseling for people at risk of CVD.

This review included 94 studies of 52,174 people with high blood pressure, high blood lipids, or other risks for CVD. A group of participants were given behavioral counseling on diet and/or exercise. They were compared to participants with similar backgrounds who were not given counseling.

Behavioral counseling led to significant improvements in blood pressure and in cholesterol (reduction of 3.5 mg/dL). Participants also lost an average of 1.6 kg (3.5 lbs).

9 studies of 12,551 randomly assigned participants looked at the rate of CVD events. Participants were 20% less likely to have a heart attack, stroke, or other CVD events if they were given counseling. The review recommends behavioral counseling for people at risk for cardiovascular disease.

This review found that behavioral counseling can reduce the risk of heart attack and stroke for people with CVD risks including high blood pressure or high blood lipids.

Few of the included studies had both a large number of participants and a long period of follow-up. Additional larger studies would confirm these findings.

Talk to your health care provider about whether behavioral counseling would help you achieve your long-term health goals.