Top Things to Know: The Role of Primary Care in Achieving Life's Essential 8
Prepared by Paul St. Laurent, DNP, RN; Vice President, Science and Medicine, American Heart Association
- The American Heart Association's Life’s Essential 8 (LE8) includes four health behaviors (diet, physical activity, nicotine exposure, sleep) and four health factors (body mass index, blood lipids, blood glucose, blood pressure) critical for cardiovascular health (CVH).
- As defined by the World Health Organization, primary care supports first-contact, accessible, continuous, comprehensive, and coordinated care.
- Due to its central role in patient care across the lifespan, primary care is strategically positioned to help people achieve LE8, offering person-centered, team-based, and community-aligned care.
- This statement aims to provide evidence-based guidance on how primary care, as a field and practice, can support patients to achieve LE8 by describing the role and functions of primary care, providing evidence for how primary care can be leveraged to achieve Life’s Essential 8, examining primary care’s role in providing access to care and mitigating disparities in CVH, reviewing existing challenges in primary care, and proposing solutions to address them.
- The Social Ecological Model, a framework that describes how health is influenced across five social domains, can be applied to understand how primary care's core functions and activities can impact LE8.
- Primary care clinicians play a central role in counseling on healthy diets and physical activity, which is essential for optimal CVH. They can also manage nicotine exposure through behavioral and pharmacotherapy interventions, address sleep issues by screening and referring to specialists, and diagnose and treat elevated blood pressure, glucose, and lipids using various approaches and technologies.
- There are significant disparities in CV health by socioeconomic status, race, ethnicity, sex, and region.
- Collaborative care, one of the few evidence-based interventions shown to reduce health disparities, can be optimized in the primary care environment.
- Adopting effective practices to optimize LE8 is often inconsistent and slow. Strategies to mitigate these challenges include increasing resources, improving care coordination, and supporting the primary care workforce.
- Primary care can effectively identify and treat LE8 behaviors and factors and is well poised to impact populations affected by disparities in CVH. However, for primary care to have maximum impact on LE8, it must be supported, promoted, and valued by the healthcare community, public health system, and policymakers.
Citation
Sterling MR, Ferranti EP, Green BB, Moise N, Foraker R, Nam S, Juraschek SP, Anderson CAM, St. Laurent P, Sussman J; on behalf of the American Heart Association Primary Care Science Committee of the Council on Quality of Care and Outcomes Research and the Council on Cardiovascular and Stroke Nursing; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; and Council on Lifestyle and Cardiometabolic Health. The role of primary care in achieving Life’s Essential 8: a scientific statement from the AmericanHeart Association. Circ Cardiovasc Qual Outcomes. Published online November 13, 2024. doi: 10.1161/HCQ.0000000000000134