Background
It is essential to note that the healthcare delivery process requires both cultural competency and ethical awareness, as it involves adhering to established medical principles. Cardiovascular disease (CVD) and peripheral arterial disease (PAD) are two of the leading causes of death worldwide. Both conditions are related to the health of the circulatory system and can lead to serious health complications and even death if not properly managed. A holistic, community-based, and comprehensive treatment approach is necessary to ensure an effective treatment of PAD as a form of CVD.
Research Questions
- How are body systems affected by cardiovascular diseases?
- How can cultural traditions affect the treatment of CVD and PAD?
- How does PAD contribute to gangrene, heart disease, skin disease, circulation problems, ischemia, and amputation?
- How do medical ethical theories apply to PAD and its consequences?
- What is the most effective, culturally sensitive, and ethically plausible solution to PAD, as a prevalent form of CVD?
Statistics
Cardiovascular disease is a leading cause of death in the United States. CVD accounted for about 840,768 deaths in the US in 2019, or about 1 in every three deaths. Coronary artery disease (CAD), stroke, and hypertension are the most common types of CVD. The estimates suggest that about 92.1 million American adults have some form of CVD or the after-effects of stroke (Bigeh et al., 2020).
Additionally, it is estimated that about 2,300 Americans die of CVD each day, an average of one death every 38 seconds. The prevalence of CVD is higher among certain populations, including older adults, African Americans, and people with diabetes (Bigeh et al., 2020). Risk factors for CVD include smoking, high blood pressure, high cholesterol, obesity, physical inactivity, and poor diet.
Peripheral arterial disease is a common condition in the United States. It is currently affecting an estimated 8-12 million Americans (Conte & Vale, 2018). It is more prevalent in older adults, with the highest rates occurring in those aged 70 and older. The disease is more common in men than in women. The estimates suggest that about 20% of people aged 70 or older have PAD (Conte & Vale, 2018). Its prevalence increases with age and is higher among such populations as African Americans, people with diabetes, and people with a history of smoking.
PAD can lead to serious health problems, including amputation, heart attacks, and strokes. The risk of death is higher among people with PAD than among those without the condition. It is stated that about 200,000 amputations are performed in the US each year due to PAD and that it is responsible for about half of all amputations in the country.
Scientific Perspective
When the cardiovascular system is affected by the disease, it can lead to a variety of complications throughout the body. The cardiovascular system is responsible for pumping blood throughout the body, delivering nutrients and oxygen to tissues and cells, and removing waste products (Csige et al., 2018). The most common types of cardiovascular diseases include coronary artery disease, heart failure, and stroke.
CAD occurs when the coronary arteries become narrowed or blocked by plaque, which supplies blood to the heart muscle. It can cause shortness of breath, chest pain, and a heart attack. Heart failure occurs when the heart is unable to pump blood effectively, resulting in fluid accumulation in the lungs and other organs. A stroke can lead to brain tissue damage, occurring when blood flow to the brain is interrupted.
These diseases can affect other body systems, including the circulatory, respiratory, and nervous systems. The circulatory system is responsible for carrying blood throughout the body, and when it is affected by cardiovascular disease, it can lead to poor circulation and organ damage (GrĂĽneboom et al., 2019). The respiratory system plays a crucial role in delivering oxygen to the body, so cardiovascular disease can result in shortness of breath and difficulty breathing. The nervous system is responsible for controlling the body’s functions, and when it is affected by cardiovascular disease, it can lead to weakness, numbness, and difficulty with coordination.
In addition to these primary impacts, cardiovascular diseases can lead to secondary conditions like anemia, kidney failure, and peripheral artery disease. Anemia occurs when there is not enough oxygen-carrying hemoglobin in the blood, which can lead to fatigue and weakness. Kidney failure occurs when the kidneys are unable to filter waste products from the blood, resulting in a buildup of toxins in the body. Peripheral artery disease occurs when the blood vessels in the legs become narrowed or blocked, leading to pain and difficulty walking.
PAD is a condition in which the blood vessels that supply blood to the legs, feet, and other parts of the body become blocked or narrowed. The most common causal factors are plaque buildup in the blood vessels, a process known as atherosclerosis. It can occur as a result of other conditions, such as hypertension or high blood pressure, diabetes, and high cholesterol. In addition, the disease can contribute to several serious health problems, including gangrene, which is the death and decay of body tissue due to a lack of blood flow (Conte & Vale, 2018). Gangrene can occur in the toes, feet, or other parts of the body affected by PAD. It can contribute to heart attacks and strokes by increasing the risk of blood clots forming in the narrowed or blocked blood vessels.
In addition to these serious health problems, PAD can cause skin problems, such as skin ulcers, and can lead to poor circulation, which can cause weakness in the legs and feet, as well as numbness and pain. PAD can also cause ischemia, a condition characterized by a lack of oxygen and nutrients in the body’s tissues, resulting in tissue damage (Conte & Vale, 2018). The most serious complication of PAD is amputation, which may be necessary if gangrene or other serious complications develop.
Amputation can have a significant impact on a person’s quality of life and can lead to additional health problems. To prevent or manage PAD, it is important to control risk factors such as high blood pressure, high cholesterol, and diabetes (Conte & Vale, 2018). Managing or preventing PAD hinges on lifestyle modifications, such as improving diet, exercising consistently, and stopping smoking. For more advanced cases, treatments such as medication or other procedures may be necessary to clear obstructed blood vessels.
Cultural Aspects
CVD is a global health issue that affects people of all cultures and backgrounds. However, certain cultural factors can influence its prevalence and management. For example, in some cultures, there may be a lack of awareness or understanding of the risk factors for CVD, such as high blood pressure, high cholesterol, and diabetes (Osokpo & Riegel, 2021). Certain cultural practices and beliefs may contribute to the development of CVD, such as a diet high in saturated fats and a lack of physical activity.
Cultural beliefs and practices can play a role in the management of CVD. In some cultures, there may be a strong emphasis on traditional or alternative medicine, which can lead to a delay in seeking medical treatment (Osokpo & Riegel, 2021). Additionally, certain cultures may have a strong stigma surrounding CVD, which can lead to a lack of willingness to discuss the condition or seek treatment.
Culture strongly impacts the treatment of PAD in the US. Due to the nation’s focus on individualism and self-reliance, some individuals may delay consulting a doctor for their symptoms, choosing instead to manage the condition on their own (Parmenter et al., 2020). Additionally, the cultural tradition of valuing physical activity and fitness may lead some individuals to ignore PAD symptoms and continue to engage in physical activity despite the risks.
Another cultural tradition that affects the treatment of PAD in the US is the emphasis on Western medicine. Many individuals in the US rely solely on Western medical treatments, such as surgery and medication, to manage PAD symptoms (Parmenter et al., 2020). However, there are alternative and complementary therapies, such as acupuncture, that may be effective in managing PAD symptoms but are not widely utilized in the US.
Cultural and linguistic barriers can impact the treatment of PAD in the US. For example, some individuals may not seek medical treatment for PAD symptoms because they do not speak English or because they are not familiar with the American healthcare system (Parmenter et al., 2020). Additionally, some individuals may not understand the risks and complications associated with PAD and may not fully understand the importance of adhering to treatment plans. In addition, the cultural tradition of mistrust of the health system and healthcare providers plays a role in the treatment of PAD in the US (Parmenter et al., 2020).
Some people may not seek professional medical care for PAD because they do not trust healthcare providers or the system. Furthermore, some individuals may not trust the information provided by healthcare providers or may not believe that treatment will be effective (Parmenter et al., 2020). Overall, cultural traditions in the US can greatly affect the treatment and management of PAD. Addressing these cultural barriers and promoting cultural sensitivity among healthcare providers can help improve the diagnosis, treatment, and management of PAD in the US.
Ethical Considerations
From an ethical perspective, CVD presents several challenges. One major issue is access to healthcare. In many low- and middle-income families, access to healthcare is limited, and people living in these areas may not have access to the necessary medical treatments and medications to manage their CVD. This can lead to disparities in health outcomes between individuals living in impoverished and affluent families (Morgan et al., 2018). Another ethical issue is related to the cost of healthcare. The cost of medical treatments and medications for CVD can be prohibitively expensive for many people, leading to a lack of access to care.
Medical ethical theories play a crucial role in the treatment and management of PAD and its progression. Four key principles of medical ethics include autonomy, beneficence, non-maleficence, and justice (Varkey, 2021). Autonomy is the fundamental principle that requires healthcare professionals to respect a person’s right to decide their own medical treatment.
For patients with PAD, this means providers must honor the patient’s choices regarding their treatment options, even if the provider does not agree with those choices (Varkey, 2021). For example, an individual may choose not to undergo a surgical procedure to treat the disease and instead opt for alternative or complementary therapies, and healthcare providers should respect this decision.
Beneficence refers to the principle of acting in the best interest of the patient, which means that medical providers are responsible for preventing or alleviating suffering and promoting the patient’s well-being. For example, healthcare providers should ensure that patients receive appropriate treatment, such as surgery or medication (Varkey, 2021). It is needed to prevent or slow the progression of the disease and reduce the risk of serious complications such as gangrene, heart and circulation issues, ischemia, and amputation.
Non-maleficence refers to the principle of “do no harm,” meaning that healthcare providers should take steps to minimize the risk of harm to patients. For example, they should avoid administering medications that may interact negatively with other medications the patient is taking or avoid surgical procedures that carry significant risks or complications (Varkey, 2021).
Justice refers to the principle of fair distribution of resources. In the context of PAD, this means that healthcare providers should ensure that individuals with PAD have access to appropriate treatment, regardless of their race, ethnicity, socioeconomic status, or other factors. This includes making sure that individuals with PAD are not denied treatment because of their inability to pay for it.
Recommended Solutions
A healthcare solution for peripheral arterial disease is a holistic and community-based treatment approach, which typically involves a combination of lifestyle changes, medication, and medical procedures. Lifestyle changes, such as quitting smoking, eating a healthy diet, and getting regular exercise, can help reduce the risk of developing PAD. Physical activity is also important, with a goal of at least 30 minutes of moderate-intensity aerobic activity, such as brisk walking, at least five days a week. To manage the condition (Conte & Vale, 2018). Healthy eating can include eating a diet low in saturated fat, cholesterol, and salt and high in fruits, vegetables, and whole grains.
An ethically sound and culturally sensitive solution to PAD would involve a community-based approach that addresses the underlying social determinants of health that contribute to the development of the disease. One potential solution would be to implement community health worker programs that provide education, outreach, and support to individuals at high risk for PAD. These programs could focus on increasing awareness of symptoms and risk factors, as well as providing resources and support for individuals to make lifestyle changes that can reduce their risk of developing the disease (Varkey, 2021).
Another solution would be to implement community-based interventions that address the social determinants of health, such as poverty, limited access to healthy food, and a lack of safe places to exercise. These interventions may include community gardens, farmers’ markets, and safe routes to school programs, which can promote healthy eating and physical activity. It is essential to collaborate with community organizations and leaders to ensure that these interventions are culturally sensitive and tailored to the specific needs and preferences of the communities they serve.Â
References
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Osokpo, O., & Riegel, B. (2021). Cultural factors influencing self-care by persons with cardiovascular disease: An integrative review. International Journal of Nursing Studies, 116, 1-13. Web.
Parmenter, B. J., Mavros, Y., Dias, R. R., King, S., & Singh, M. F. (2020). Resistance training as a treatment for older persons with peripheral artery disease: A systematic review and meta-analysis. British Journal of Sports Medicine, 54(8), 452-461. Web.
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