Heart Disease and Stroke Prevention in the US


The Healthy People 2020 initiative is an official resource that provides evidence-based goals for enhancing the health of Americans. One of the topics covered by this resource is heart disease and stroke assigned a national priority in the US. It should be noted that this disease belongs to preventable ones, which makes prevention strategies rather important. This paper aims to discuss heart disease and related objectives to better understand its nature, including incidence, prevalence, epidemiology, costs, policy, and the impact on the interprofessional team.

Disease, Description, Incidence, and Prevalence

Heart disease is acute or chronic myocardial damage resulting from the decrease or loss of arterial blood supply to the heart muscle, based on pathological processes in the coronary artery system. Stroke is represented by a group of diseases caused by acute vascular pathology of the brain, which is characterized by the sudden disappearance or impairment of brain functions, leading to death or lasting for more than one day. There are specific symptoms that can suggest pathology of cerebral circulation. The following signs may be present: violation or confusion of consciousness, the loss of consciousness even for a few moments, headache, which may be accompanied by nausea and vomiting, and weakness in the limbs.

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Heart disease is the foremost cause of death in the US, while stroke is regarded as the fifth leading reason for death (“Heart disease and stroke,” n.d.). In general, there are about 610,000 people who die every year, which is 25% of the country’s overall mortality level, meaning that one out of four persons dies due to this disorder (Benjamin et al., 2017). 735,000 Americans have a heart attack, and more than 525,000 have it twice in their life. In 2017, it was reported that half of Americans dealt with one or more symptoms of the mentioned disease. Atrial fibrillation that helps to minimize heart disease impact is held by 6.2 million people living in America.

Given this situation, Healthy People 2020 promotes the importance of improving cardiovascular health, prevention of stroke and heart disease, and detection of risk symptoms. The reduction in death and recurrent cases of diseases are also considered critical to address the described acute and chronic conditions. Among the related objectives, one may note the decrease in morbidity, paying more attention to adults with prehypertension, and increase the proportion of those who follow the recommended guidelines. The awareness of aspirin use, alarming symptoms, and response strategies are also the objectives formulated in the Healthy People 2020 initiative.

Epidemiology, Cost, and Population

In the adult population of the US, heart disease and stroke account for more than one of three cases of all deaths. Moreover, the mortality rate of men exceeds the mortality rate of women in general from heart disease by 7.2 times and from stroke by 9.1 times. The average age of the first heart attack is 72 among women and 65.6 among men. Despite the fact that in America, there is a certain decrease in mortality, the situation in the country remains extremely serious, which is emphasized in numerous publications (Benjamin et al., 2017; Micha et al., 2017). Children and adults, who meet the criteria of healthy lifestyles, are less prone to heart disease compared to their peers. As for the racial representation of the disease, Hispanics and African-Americans are characterized as those who are at a higher risk of developing heart disease.

It is known that up to 60% of cardiovascular mortality depends on the prevalence in the population of risk factors, which include hypertension, impaired carbohydrate metabolism, smoking, alcohol abuse, and obesity (Benjamin et al., 2017). Given the situation that changed in recent years, the World Health Organization (WHO) recommends paying close attention to factors that are directly or indirectly associated with an unhealthy lifestyle: unhealthy diet, low physical activity, and excessive weight (Micha et al., 2017). Accordingly, the majority of the preventative measures are designed inconsistency with the healthy lifestyle concept that targets proper nutrition, physical activity, and social well-being.

As for the costs related to heart diseases, it is essential to stress that US healthcare allocates significant resources to assist patients and research. The expenses associated with heart disease and stroke approximate $320 billion in health care expenditure annually (“Heart disease and stroke,” n.d.). Compared to the statistics of 2015, the mentioned indicator was $275 billion, which means that the costs tend to grow (Stinson, 2015). It is anticipated that by 2030, the projects devoted to heart disease treatment and prevention would reach the burden of $818 billion. The mentioned figures demonstrate that federal agencies, non-profit organizations, private companies, and communities should work together towards addressing strokes and heart diseases.

Specific Legislators and Policy

There is a range of programs and related policies directed to reduce the negative impact of heart disease on patients’ health. Considering that women remain one of the most underexplored categories of patients, it seems to be relevant to mention the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program. According to WISEWOMAN, women with a low income and those who are uninsured are to receive financial assistance to conduct screening for cardiovascular problems (Tabung, Daguisé, Lydiard, & Steck, 2017). At the same time, the program aims to connect females whose screening verified health problems with lifestyle programs. The community resources such as health counseling are also to be involved in promoting healthy behavior change. It should be stressed that women with no or lower education may need additional help with navigating the offered interventions.

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As for specific legislators who are responsible for the WISEWOMAN program implementation in terms of heart disease prevention, it is possible to refer to the state and national policy advocates. The federal agencies may contact the local authorities to evaluate the program’s effectiveness and make further decisions. In addition, the Centers for Disease Control and Prevention (CDC) is the head agency that controls the use of the given program and makes conclusions about its impact and future changes.

Interprofessional Team

The policy discussed in the previous section promotes the interprofessional collaboration between all care providers engaged in providing services to patients. In case of heart disease and stroke, comprehensive cardiologic diagnostics and general clinical examination on expert-class equipment and the analysis of all clinical data are essential. For example, the final stage of diagnosis is coronary angiography, which is the most accurate modern method, allowing determining the number and size of atherosclerotic plaques as well as their location in the vessels of the heart. A team of qualified specialists is expected to be united by a single task and the principles of clinical thinking, including a cardiologist, neurologist, nutritionist, and other specialists (Tabung et al., 2017). The doctors of functional, ultrasound, and laboratory diagnostics, specialists in the field of physiotherapy, and competent nurses of different positions also should be engaged in the common goal of improving a patient’s life quality.

The use of a modern approach to treatment in accordance with current international and national clinical recommendations prescribes the combination of drug treatment with physiotherapy. To follow this assumption, the interprofessional care team needs to work together to adjust practices and act as a single mechanism (Tabung et al., 2017). The correction of risk factors: the transition to a balanced therapeutic diet, physical activity, the accomplishment of target levels of blood pressure, heart rate, glucose, and cholesterol can be achieved only in cooperation. The other benefits of the interprofessional team are the combination of clinical work with research, continuous training of doctors, and methodological guidance of leading leaders.

Conclusion

To conclude, one should state that heart disease and stroke are among the leading death causes in the US, while the main risk factors are hypertension, sedentary lifestyles, improper nutrition, stress, and hypertension. The evidence shows that men and older adults are more likely to develop the mentioned conditions since their mortality and morbidity rates are higher than those of other populations. The costs of treating and preventing heart disease are extremely high, and there is a tendency towards their increase. Among other programs developed by US agencies, WISEWOMAN is controlled by the CDC. It is found that the emergence of the interprofessional team is beneficial for enhancing patient health through more focused and comprehensive care.

References

Benjamin, E. J., Blaha, M. J., Chiuve, S. E., Cushman, M., Das, S. R., Deo, R.,… Jiménez, M. C. (2017). Heart disease and stroke statistics-2017 update: A report from the American Heart Association. Circulation, 135(10), 146-603.

Heart disease and stroke. (n.d.). Web.

Micha, R., Peñalvo, J. L., Cudhea, F., Imamura, F., Rehm, C. D., & Mozaffarian, D. (2017). Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States. JAMA, 317(9), 912-924.

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Stinson, C. (2015). Heart disease and stroke cost America nearly $1 billion a day in medical costs, lost productivity. Web.

Tabung, F. K., Daguisé, V. G., Lydiard, D., & Steck, S. E. (2017). An integrated approach to addressing chronic disease risk factors in financially disadvantaged women in South Carolina. American Journal of Health Promotion, 31(4), 325-332.

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