Person-centered models for cardiovascular care: a review of the evidence: a scientific statement from the American Heart Association

Rossi, Laura P.; Granger, Bradi B.; Bruckel, Jeffrey T.; Crabbe, Deborah L.; Graven, Lucinda J.; Newlin, Kimberly S.; Streur, Megan M.; Vadiveloo, Maya K.; Walton-Moss, Benita Jeanne; Warden, Bruce A.; Volgman, Annabelle Santos; Lydston, Melissa; on behalf of the American Heart Association Complex Cardiovascular Patient and Family Care Committee of the Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Quality of Care and Outcomes Research

doi:10.1161/cir.0000000000001141

Cited by 42Chronic Disease Management StrategiesClinical practice guidelines implementationPatient-Provider Communication in Healthcare

Person-centered models for cardiovascular care: a review of the evidence: a scientific statement from the American Heart Association

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Rossi, Laura P., Granger, Bradi B., Bruckel, Jeffrey T., Crabbe, Deborah L., Graven, Lucinda J., Newlin, Kimberly S., Streur, Megan M., Vadiveloo, Maya K. +5 more·2023·Circulation

DOI 10.1161/cir.0000000000001141

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Abstract

Cardiovascular disease remains the leading cause of death and disability in the United States and globally. Disease burden continues to escalate despite technological advances associated with improved life expectancy and quality of life. As a result, longer life is associated with multiple chronic cardiovascular conditions. Clinical guidelines provide recommendations without considering prevalent scenarios of multimorbidity and health system complexities that affect practical adoption. The diversity of personal preferences, cultures, and lifestyles that make up one’s social and environmental context is often overlooked in ongoing care planning for symptom management and health behavior support, hindering adoption and compromising patient outcomes, particularly in groups at high risk. The purpose of this scientific statement was to describe the characteristics and reported outcomes in existing person-centered care delivery models for selected cardiovascular conditions. We conducted a scoping review using Ovid MEDLINE, Embase.com, Web of Science, CINAHL Complete, Cochrane Central Register of Controlled Trials through Ovid, and ClinicalTrials.gov from 2010 to 2022. A range of study designs with a defined aim to systematically evaluate care delivery models for selected cardiovascular conditions were included. Models were selected on the basis of their stated use of evidence-based guidelines, clinical decision support tools, systematic evaluation processes, and inclusion of the patient’s perspective in defining the plan of care. Findings reflected variation in methodological approach, outcome measures, and care processes used across models. Evidence to support optimal care delivery models remains limited by inconsistencies in approach, variation in reimbursement, and inability of health systems to meet the needs of patients with chronic, complex cardiovascular conditions.

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Many published qualitative systematic reviews and meta-analyses exist on self-directed digital health interventions.
“There are, however, many published qualitative systematic reviews and meta-analyses on this topic.25–29”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The Limitations section describes this paper as a scoping review of cardiovascular care models, and its tables include some digital or home-based interventions. Searches for systematic reviews, meta-analyses, and digital self-management found no passage stating that many qualitative systematic reviews and meta-analyses exist on self-directed digital health interventions. (LLM, conf=0.70)
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Weight management has myriad benefits in T2D, including reductions of A1C and hepatic steatosis, and improvement in cardiovascular risk factors.
“Weight management has myriad benefits in T2D, including reductions of A1C and hepatic steatosis, and improvement in cardiovascular risk factors.26,29”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The Outcome Evaluation: Cost of Care table mentions HbA1c and cardiovascular risk measures in an evaluation of a nurse-led care model, not as benefits of weight management in T2D. Searches for weight management, hepatic steatosis, and weight-related glycemic improvement found no passage in our copy addressing the claimed benefits; the retrieved passages have no page numbers. (LLM, conf=0.76)
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Some weight regain from the nadir at 12 to 18 months postsurgery is common.
“Some weight regain from the nadir at 12 to 18 months postsurgery is common.26”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The Cardiac and Stroke Rehabilitation Care Models section discusses outcomes after cardiovascular events, not weight trajectories after bariatric surgery. Searches for “weight regain,” “bariatric surgery,” and the claimed 12-to-18-month interval found no passage in our copy addressing whether regain from the postsurgical nadir is common; the available passages have no page numbers. (LLM, conf=0.76)
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The beneficial effect on kidney and cardiovascular events with SGLT-2i was observed in patients regardless of background RASi or GLP-1 RA use, suggesting an independent and incremental benefit of SGLT-2i.
“The beneficial effect on kidney and cardiovascular events with SGLT-2i was observed in patients regardless of background RASi26 or GLP-1 RA10 use, suggesting an independent and incremental benefit of SGLT-2i.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The supplied passages and the searched sections on behavioral changes and adherence and care outcomes (page numbers unavailable) discuss care-delivery models and guideline-directed therapy, not SGLT-2 inhibitor effects. Searches for SGLT-2 inhibitors, RAS inhibitors, GLP-1 receptor agonists, and kidney outcomes found no passage addressing whether benefits persist regardless of background therapy. (LLM, conf=0.75)
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Epidemiologic data from observational cohorts suggest that higher levels of physical activity are associated with a lower risk of progression to HF among adults with elevated cardiac biomarkers.
“Moreover, epidemiologic data from observational cohorts suggest that higher levels of physical activity are associated with a lower risk of progression to HF among adults with elevated cardiac biomarkers.26”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The Discussion mentions physical activity as one component of a care intervention, but does not report an association between activity levels and progression to heart failure. Searches for cardiac biomarkers and incident heart failure found no passage addressing the claimed observational-cohort finding. Page numbers were unavailable for these passages. (LLM, conf=0.76)
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In the general population, MBS has low complication rates, with outcomes equivalent to a laparoscopic cholecystectomy.
“In the general population, MBS has low complication rates, with outcomes equivalent to a laparoscopic cholecystectomy.26”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The passages in the supplied copy concern person-centered cardiovascular care, including heart-failure follow-up and care costs (Evaluation of Behavioral Changes and Adherence; outcome tables; page numbers unavailable). Searches for MBS, bariatric surgery, complication rates, and laparoscopic cholecystectomy found no passage addressing the claimed comparison. (LLM, conf=0.75)
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GLP-1-based therapy often causes significant weight loss and improvements in CKM risk profiles and MASLD, while SGLT2i has a marked impact on CKD.
“GLP-1–based therapy often causes significant weight loss and improvements in CKM risk profiles and MASLD, while SGLT2i has a marked impact on CKD.19–30”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The ‘Evaluation of Behavioral Changes and Adherence’ section discusses adherence to guideline-directed cardiovascular therapy, not the effects of GLP-1–based therapy or SGLT2 inhibitors. Searches for GLP-1, SGLT2, MASLD, and CKD found no passage in our copy addressing the claimed weight-loss, risk-profile, liver-disease, or kidney-disease effects. The cited passages have no page numbers in our copy. (LLM, conf=0.76)
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The LIVE and FIGHT trials demonstrated numerically higher rates of CVD events with liraglutide, with the greatest risk in those with NYHA class III-IV functional status.
“However, the LIVE (Effect of Liraglutide on Left Ventricular Function in Stable Chronic Heart Failure Patients) and FIGHT (Functional Impact of GLP-1 for HF Treatment) trials demonstrated numerically higher rates of CVD events with liraglutide, with the greatest risk in those with NYHA class III-IV functional status.26”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The passages from Evaluation of Behavioral Changes and Adherence and the study tables discuss heart-failure follow-up and care interventions, not liraglutide outcomes. Searches for liraglutide, LIVE, FIGHT, and NYHA class III–IV found no passage addressing the claimed event rates or risk by functional status. (LLM, conf=0.72)
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A U-shaped curve is observed for mortality among patients with T2D and existing HF, highlighting potential harm from very aggressively targeting glycemia in this population.
“However, a U-shaped curve is observed for mortality among patients with T2D and existing HF,26–28 highlighting the potential harm associated with very aggressively targeting glycemia in this population.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The Evaluation of Behavioral Changes and Adherence section mentions higher readmission rates in patients with comorbid diabetes, while Nurse-Led Models discusses glycemic control as a care outcome. Neither passage addresses a U-shaped relationship between glycemia and mortality in patients with T2D and existing HF. Searches for “U-shaped,” “HbA1c mortality heart failure,” and aggressive glycemic control found no passage supporting the claim; page numbers were unavailable. (LLM, conf=0.76)
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Dual therapy with more than 1 RASi can worsen kidney function and lead to angioedema, hyperkalemia, and hypotension.
“Dual therapy with more than 1 RASi (ACEi/ARB/ARNI) should be avoided since it can worsen kidney function and lead to angioedema, hyperkalemia, and hypotension.26”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The retrieved References and Evaluation of Behavioral Changes and Adherence passages do not address combining renin–angiotensin system inhibitors or its adverse effects. Searches for dual ACEi/ARB/ARNI therapy, impaired kidney function, and hyperkalemia found no passage in our copy that supports or contradicts the claim. (LLM, conf=0.78)
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In persons with MASH and stage 2 or 3 fibrosis, the GLP-1RA semaglutide is associated with reductions in steatohepatitis and liver fibrosis.
“Additionally, in persons with MASH and stage 2 or 3 fibrosis, the GLP-1RA semaglutide is associated with reductions in steatohepatitis and liver fibrosis.11,26”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The passages from Evaluation of Behavioral Changes and Adherence discuss cardiovascular care and medication adherence, not MASH treatment. Searches of our copy for semaglutide, steatohepatitis, and stage 2 or 3 fibrosis found no passage addressing the claimed reductions. (LLM, conf=0.76)
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Resmetirom is the first FDA-approved MASLD treatment whose mechanism for improving liver histology is independent of weight loss.
“resmetirom has been the first FDA-approved MASLD treatment whose mechanism for improving liver histology is independent of weight loss.26”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The supplied passages and searches for resmetirom, MASLD, liver histology, and weight loss yielded material on cardiovascular care models, including the Evaluation of Behavioral Changes and Adherence section, but no passage addressing the treatment claim. Our copy therefore cannot verify its FDA-approval status or whether its histological effects are independent of weight loss; passage page numbers were not available. (LLM, conf=0.76)
Experimental — accuracy not yet measured
APOs are associated with higher subsequent risk for developing CKM risk factors and CVD.
“APOs are also associated with higher subsequent risk for developing CKM risk factors (hypertension, diabetes, dyslipidemia) and CVD (including HF, coronary heart disease, PAD, and vascular dementia).12,23–27”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The Nurse-Led Models section discusses blood-pressure, glycemic, and lipid control in cardiovascular care, not risk following adverse pregnancy outcomes. Searches for pregnancy, APOs, and subsequent CKM or CVD risk found no passage in our copy addressing the claimed association. (LLM, conf=0.76)
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Ileus has been reported; risk level is not well-established.
“Ileus Reported; risk level is not well-established.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The retrieved Symptom Management Care Models passage discusses cardiovascular symptom assessment and triage, not ileus. Searches for ileus, intestinal obstruction, and uncertainty about its risk found no passage in our copy addressing the claim; page numbers were unavailable. (LLM, conf=0.75)
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Orally administered drug absorption may be impaired during dose titration including oral contraceptives.
“Orally administered drug absorption may be impaired during dose titration including oral contraceptives.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The passages on medication titration (Reviewer Disclosures Continued; page unavailable) concern adjusting cardiovascular treatment doses, not impaired absorption. Searches for oral contraceptives and impaired absorption during dose titration found no passage in our copy addressing the claim. (LLM, conf=0.76)
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Nonarteritic anterior ischemic optic neuropathy (NAION) is rare.
“Rare; monitor for NAION during eye examinations”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The Symptom Management Care Models section discusses cardiovascular and stroke care, not nonarteritic anterior ischemic optic neuropathy. Searches for NAION, optic neuropathy, and eye examinations found no passage addressing its rarity or recommending monitoring during eye examinations. (LLM, conf=0.76)
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Thyroid C-cell tumors identified in rodents; human relevance not determined.
“Thyroid C-cell tumors identified in rodents; human relevance not determined.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The retrieved passages from the cardiovascular-care review discuss care models, clinical outcomes, and disclosures, not thyroid C-cell tumors. Searches for the quoted statement and for rodent thyroid tumors and human relevance found no passage addressing the claim in our copy. (LLM, conf=0.78)
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Acute pancreatitis has been reported, but causality has not been established.
“Acute pancreatitis has been reported, but causality has not been established.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The supplied passages are from the References and a table on cardiovascular care; none discusses acute pancreatitis. Searches for the claim’s wording and for pancreatitis, adverse events, and causality found no passage addressing whether pancreatitis was reported or causally linked. (LLM, conf=0.76)
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Necrotizing fasciitis of the perineum (Fournier gangrene) is rare.
“Rare; prompt treatment if suspected.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The supplied passages are from the References section and do not discuss Fournier gangrene. Searches of the paper for “Fournier gangrene,” “necrotizing fasciitis of the perineum,” and “rare; prompt treatment if suspected” found no passage addressing its rarity or treatment. (LLM, conf=0.76)
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DKA risk in individuals with insulin deficiency is much less common in those with T2D.
“Much less common in those with T2D.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [26]
The supplied passages and searches for DKA, insulin deficiency, and type 2 diabetes found no discussion of ketoacidosis risk. The closest diabetes-related passage, in “Nurse-Led Models” (page unavailable), concerns glycemic control rather than DKA, so our copy does not establish the claimed comparison. (LLM, conf=0.76)
Experimental — accuracy not yet measured

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Rapid Access Arrhythmia Clinics (RAACs) Versus Usual Care: Improving Efficiency and Safety of Arrhythmia Management
Klimis, H., Huben, A. V., Turnbull, S., Han, J., Chen, H., Nalliah, C. J., Thiagalingam, A., Chow, C. K., & Kumar, S. (2020) · Heart Lung and Circulation · doi:10.1016/j.hlc.2020.10.023 · Cited by 7 · see citing works
The association of hospital teaching intensity with 30‐day postdischarge heart failure readmission and mortality rates
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Research works printed but not linked: 2

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Sorted by citations

2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome
Ndumele, C. E., Rodriguez, F., Dixon, D. L., Khan, S. S., Mukherjee, D., Bajaj, M., Bangalore, S., Bozkurt, B., Breathett, K., Clarke, S. L., et al. (2026) · JACC · doi:10.1016/j.jacc.2026.03.056 · Cited by 90 · see citing works

Authors: Rossi, L. P., Granger, B. B., Bruckel, J. T., Crabbe, D. L., Graven, L. J., Newlin, K. S., Streur, M. M., Vadiveloo, M. K., Walton-Moss, B. J., Warden, B. A., Volgman, A. S., Lydston, M., & on behalf of the American Heart Association Complex Cardiovascular Patient and Family Care Committee of the Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Quality of Care and Outcomes Research
ORCID: Rossi, Laura P.
Granger, Bradi B.
Bruckel, Jeffrey T.
Crabbe, Deborah L.
Graven, Lucinda J.
Streur, Megan M.
Vadiveloo, Maya K.
Warden, Bruce A.
Volgman, Annabelle Santos
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2023-08-08
Volume: 148
Issue: 6
Pages: 512-542
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/cir.0000000000001141
OpenAlex: W4383711226
Semantic Scholar: caf539add6327517b274c8a8dea5912c720a7bbc
Cited by: 42
References: 201
Citations by year: 2026: 23 · 2025: 15 · 2024: 4
FWCI: 1.64
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords: person-centred care, multimorbidity, chronic cardiovascular disease, patient preferences, shared decision-making, clinical decision support, symptom management, health system complexity, care planning, patient outcomes
MeSH terms: American Heart Association, Cardiovascular Diseases, Delivery of Health Care, Humans, Palliative Care, Quality of Life, United States

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Person-centered models for cardiovascular care: a review of the evidence: a scientific statement from the American Heart Association

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