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Do paediatric cardiologists discuss cardiovascular risk factors with patients and their families?

Published online by Cambridge University Press:  24 May 2005

Benjamin J. Lentzner ,
Dana M. Connolly  and
Colin K. L. Phoon
Benjamin J. Lentzner
Affiliation:
Pediatric Cardiology Program, New York University School of Medicine, New York, USA
Dana M. Connolly
Affiliation:
Pediatric Cardiology Program, New York University School of Medicine, New York, USA
Colin K. L. Phoon
Affiliation:
Pediatric Cardiology Program, New York University School of Medicine, New York, USA
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Abstract

Atherosclerotic disease of the heart likely has its origins in childhood. The promotion of cardiovascular health in children, however, has been studied only for those practicing in general paediatrics. We hypothesised that paediatric cardiologists do not consistently discuss cardiovascular risk factors with patients and their families. We therefore, carried out a nationwide survey of paediatric cardiologists to determine how often they discussed atherosclerosis and 4 modifiable risk factors, specifically weight, smoking, diet and nutrition, and physical activity. Only two-fifths reported that they discussed atherosclerotic disease frequently to always. For patients with cardiovascular disease, weight was discussed frequently to always by 59%, smoking by 61%, diet and nutrition by 63%, and physical activity by 92%. In contrast, for patients without cardiovascular disease, weight was discussed frequently to always by 35%, smoking by 46%, diet and nutrition by 39%, and physical activity by 62%. These differences are statistically significant (p < 0.003 by χ2 analysis). Cardiovascular risk factors were discussed more consistently as children grew older (p < 0.0001). Respondents stated that, in their opinion, the promotion of cardiovascular health was a role more appropriate for providers of primary care than for paediatric cardiologists (p < 0.0001). Constraints of time, and the perceived role of the cardiologist, were the most common barriers to anticipatory guidance. We suggest that these findings indicate that paediatric cardiologists can assume a more prominent role in preventive cardiology and education, although their precise role or roles, and the optimal methods of anticipatory guidance, remain controversial.

Keywords

Cardiovascular diseaseschildhoodcoronary arterial diseasehealth promotionheart diseasespreventive medicine
Type
Original Article
Information
Cardiology in the Young , Volume 13 , Issue 6 , December 2003 , pp. 551 - 558
Copyright
© 2003 Cambridge University Press

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Footnotes

This work was supported in part by a grant from KiDs of NYU Foundation, Inc. (to CKL Phoon).

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