Abstract 12140: Clinical Care for Life’s Essential 8 by Medical Specialty in the United States

Background: The American Heart Association recognizes “Life’s Essential 8 (LE8)” as key to achieving cardiovascular health (CVH). Partnership between patients and clinicians will be vital to achieving LE8 and CVH, but one key question is which clinicians can influence their patients’ LE8. Here, we aimed to discover who provides clinical care for LE8 by clinician specialty.

Method: We used all adult respondents from the nationally representative 2017-2019 Medical Expenditure Panel Survey. We classified visits to the specialties most relevant to LE8 care. Four LE8 measures represented what clinician type prescribed (1) statins, (2) diabetes mellitus medications, (3) anti-hypertensive medication, and (4) tobacco cessation medication (buproprion amongst tobacco users or varenicline). We assessed four other LE8 measures by which clinician saw a patient who reported: (1) low physical activity, defined as lack of moderate-vigorous physical activity 5 times per week, (2) obesity, (3) tobacco use, and (4) insomnia. We also evaluated report of a general check-up. We were unable to assess diet. We performed descriptive statistics with complex survey weights. The OhioHealth Institutional Review Board ruled the study exempt.

Results: The study included 50,542 adults. Results, which are detailed in the table, found that for all measures, many people with gaps in LE8 saw neither a primary care doctor nor a cardiologist and between 2.5 and 5 times as many people with gaps in LE8 saw primary care without seeing a cardiologist than saw a cardiologist at all.

Discussion: We found that primary care provides the large majority of medical care for all of LE8. Patients with gaps in LE8 who saw neither cardiology nor primary care were also common. Our findings emphasize how particular supporting primary care in their core functions of preventive care and chronic disease management will be key to achieving cardiovascular health.