An estimated 47 million people in the U.S. are living with cardiometabolic disorders. These disorders represent a cluster of interrelated risk factors — primarily high blood pressure, elevated fasting blood sugar, dyslipidemia, abdominal obesity, and elevated triglycerides — that together can progress to the development of atherosclerotic cardiovascular disease and type 2 diabetes.
Reducing these cardiometabolic risk factors and preventing further disease progression is an increasingly important topic among cardiovascular professionals, primary care physicians (PCPs) and other health care providers.
According to a CardioSurve survey of 162 cardiologists, 76 Cardiac Care Associate (CCA) members and 253 PCPs, the number of patients with cardiometabolic risk factors has increased over the last few years. A large percentage of both cardiologists (49%) and PCPs (42%), and even more CCAs (86%), now report that more than half of their current patient populations have cardiometabolic risk factors or disease. How to best manage these patients, however, is up for some debate. While the majority of all clinicians surveyed say they are very comfortable in managing patients with hypertension and dyslipidemia, CCAs and cardiologists indicate that they are less comfortable managing patients with a sedentary lifestyle, obesity and elevated blood glucose, as compared to PCPs.
According to the survey, cardiologists and CCAs are more likely to refer their patients with cardiometabolic risk factors to a PCP as compared to a specialist. Both CCAs and cardiologists indicate that coordination of care was more of their respective roles. PCPs feel they should have the primary responsibility for managing the cardiometabolic risk factors in their patients and take the lead in screening/treating these patients.
When it comes to communicating with patients about risk factors, PCPs and CCAs indicate they spend more time discussing these topics with patients as compared to cardiologists. CCAs, in particular, report spending more time working with patients on issues of self-care related to hypertension, dyslipidemia, and sedentary lifestyle and less on issues related to obesity and elevated blood glucose.
Screening early for cardiometabolic issues and treating aggressively are viewed as very important components by all clinicians. Nearly nine out of ten physicians and two out of three CCAs say their practices use physicians and/or nurses to counsel patients on medication and lifestyle modifications in order to help them control their cardiometabolic risk factors.
However, approximately two out of five cardiologists and CCAs indicate they do not have what they need to assess and treat cardiometabolic risk factors in their diverse patient populations. These clinicians are interested in multi-lingual patient targeted resources either online or via brochures/handouts. They also indicate a need for clinical education around the best and latest treatment options for managing patients from diverse populations.
This CardioSurve survey comes on the heels of efforts by the ACC and other groups to help cardiovascular professionals, PCPs and others address cardiometabolic issues in a coordinated team- based manner. The College recently launched an online clinical community dedicated to management of cardiometabolic disease that features relevant news articles, case challenges, hot topics, interactive discussions and clinical resources. In addition, the CardioMetabolic Health Alliance – a partnership between the ACC, the National Minority Quality Forum, the American Association of Clinical Endocrinologists and the Association of Black Cardiologists – is planning to use the survey results to inform additional programs and tools as part of ongoing Alliance efforts.