Missed opportunities in preventive counseling for cardiovascular disease--United States, 1995.

Cardiovascular disease (CVD), the leading cause of death in the United States, caused 960,592 deaths in 1995 (41.5% of all deaths). Approximately 58 million persons in the United States (20% of the total population) have one or more types of CVD, which include high blood pressure, coronary heart disease, stroke, rheumatic fever or rheumatic heart disease, and other forms of heart disease. Behavioral risk factors for CVD and other chronic diseases include physical inactivity, a diet high in fat, overweight, and smoking. The U.S. Preventive Services Task Force and the American Heart Association recommend that all primary-care providers offer their patients counseling to promote physical activity, a healthy diet, and smoking cessation as part of the preventive health examination. To characterize the provision of counseling by physicians about preventive health behaviors during office visits in 1995, data were analyzed from CDC's National Ambulatory Medical Care Survey (NAMCS). This report summarizes the results of that analysis, which indicates that a high proportion of office visits in 1995 did not include counseling for the prevention of CVD.