Cardiovascular

Seeing Red

Cardiovascular disease remains the #1 killer of women and men in this country. Look around you: one of three adults you see has, or will, have cardiovascular disease.
February is American Heart Month. But what’s there to celebrate? Some of us are killing ourselves with stress and obesity. We know what to do but have trouble taming our behaviors to reduce our risk of stroke and heart disease. And it’s not just us; it’s our family, friends—a whole nation hurtling toward an unhealthy future. About 9 million American children and teens are overweight, many of them headed toward early cardiovascular disease.
We know stress increases the risk of other health problems, too. With the economic challenges of the past year, more adults are avoiding expenditures, including needed health care, such as provider visits, procedures, and medications. For many, lack of health care has resulted in declining health and well-being.
A December 2008 Harris Interactive poll reported that over the past year, 45% of women hadn’t received medical care due to cost. Men tend to seek health care less often or only when seriously ill.
Last summer, researchers identified 11 recognized measures for decreasing cardiovascular disease. Most focused on cholesterol reduction, diabetes management, and aspirin for those at risk for myocardial infarction (MI), as well as smoking cessation and weight reduction to achieve a body mass index (BMI) below 30 kg/m2. Using mathematical modeling, they predicted that over the next 30 years, implementing all the measures could reduce MIs by 63% and strokes by 31%. (More realistic projections suggest MIs could be reduced by one-fifth and strokes by one-third.) Addressing these risk factors also might reduce cancer incidence, especially in diabetics. Although some of these approaches will increase healthcare costs, smoking cessation and weight reduction can lower the burden of illness and cost to society with little or no out-of-pocket costs.
Solutions appear relatively simple but challenge our knowing/doing gap: We know we should eat right, get regular exercise, stop smoking, organize and prioritize activities, and practice a relaxation technique each day. These simple recommendations aim to combat our sed­entary lifestyles and weight gain as well as reduce obvious risk factors such as smoking and stress. Yet not nearly enough of us act on our knowledge. Many suffer from the “too busy” syndrome—but it’s all about choices.
The National Heart, Lung, and Blood Institute offers tips and programs to promote heart health. National Wear Red Day (February 6) is part of its The Heart Truth, a national awareness campaign for women about heart disease. Many women with acute cardiovascular symptoms defer getting help because they don’t want to bother someone or sound what they think might be a false alarm. Although the survival rate for women hospitalized with MIs has risen over the past decade and now matches that of men, women who’ve had severe MIs with ST-segment elevation have a lower survival rate than men.
Need more convincing? Recent results of a long-term study of more than 21,000 men suggest regular exercise may help men of any weight avoid heart failure. Those who exercised regularly and kept a normal weight had the lowest risk of developing heart failure; obese men had an almost 200% greater risk than thin men. (For more on heart failure, see Managing acute decompensated heart failure article.)
The American Heart Association’s Start! movement also promotes physical activity and heart-healthy living. By advocating walks in communities across the country, it hopes to get more than 1 million people moving, learning about healthy eating, and developing an esprit de corps with others to combat cardiovascular disease. The walks support a major fundraising campaign to aid cardiovascular research.
So February is a time to see red and celebrate the wealth of information that if acted on, can help prevent cardiovascular disease and help us live healthier lives. To help close the knowing/doing gap:
Know: your risk for cardiovascular disease, your cholesterol level, your BMI, where to get help to quit smoking, and nutritional guidelines.
Do: enact a plan to address your own risk factors; encourage others to manage their stress, eat better, maintain a healthy weight, and control other risk factors; carefully assess the impact of decisions to delay obtaining health care; and help bridge others’ knowing/doing gap.

Pamela F. Cipriano, PhD, RN, FAAN, NEA-BC
Editor-in-Chief


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