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Our current situation assessment tries to provide a complete, evidence-based overview of current conditions.
Current Situation Assessment
“According to the 2023 update on heart disease and stroke statistics carried out by the American Heart Association (AHA), approximately 20.5 million individuals aged 20 years and above in the United States are affected by CHD, indicating a prevalence rate of approximately 7.1%” (Chen et al., 2023). It is the leading cause of death for men and women, of various racial and ethnic groups. According to the CDC. Gov, 2023 heart disease kills 1-person every 33 seconds in the United States. Heart disease refers to a variety of conditions that effect that heart. Heart disease can affect the blood vessels, valves, and muscle of the heart. It can cause arrhythmias, or irregular beating of the of the heart. “To assess cardiovascular health, the American Heart Association (AHA) proposed seven major modifiable cardiovascular risk factors based on four metabolic factors body mass index (BMI), fasting plasma glucose, total cholesterol, and blood pressure] and three health behaviors smoking, diet and physical activity” (Soyer et al., 2023). It has been established that each of these risk factors has a unique relationship with cardiovascular risk and overall mortality. “A healthy lifestyle, risk factor modification, and medication adherence are vital for preventing mortality and recurrent events in individuals with coronary heart disease” (Jang-Whan Bae et al,.2021). In a study conducted by Shi (2021) structured patient education improved health behaviors in adults with coronary heart disease. An individualized patient centered approach that addresses all the aspects of a patient’s lifestyle should use in the treatment and prevention of heart disease. Best practice in preventing heart disease and its progression is following a healthy lifestyle. This patient population has already received a diagnosis of heart disease, have been prescribed medications, and have one or more comorbidities.
Modifiable Cardiovascular Risk Factors
Health conditions such as Type 2 diabetes and obesity can increase a patient’s risk of high cholesterol or hyperlipidemia. Patients may suffer from medical conditions or take medications that put them at an increased risk for high cholesterol. Patients can also be predisposed to high cholesterol due to genetic factors; however unhealthy lifestyle practices significantly increase the risk. Factors such as poor diet, smoking, drinking, inactivity, and age can also increase a patient’s risk of high cholesterol. These modifiable risk factors are the first line defense in lowering patients’ cholesterol levels. Through patient centered education we can educate patients about the necessary lifestyle needed to lower cholesterol levels. After patients have attempted lifestyle changes and modifications clinicians may prescribe medication or a combination of medications depending on the patients’ health needs.
High blood pressure or hypertension (HTN) is a risk factor for heart disease that can be controlled and modified through patient education. “In 2017, the American College of Cardiology and the American Heart Association released new blood pressure guidelines that suggest lowering the optimal blood pressure target from below 140/90 mm Hg to below 130/80 mm Hg;s” (Fegers-Wustrow etal, 2022). Normal systolic blood pressure is less than 120 with a diastolic less than 80. Some patients are at risk for HTN due to family history, age, and comorbidities. Patients can decrease their risk for HTN by eating a healthy diet. Diets consisting of “whole unprocessed foods, shift from saturated to unsaturated fats, avoidance of trans-fats and sugar-containing foods and beverages, and lower sodium intake” are recommended. Diets such as the DASH diet and the Mediterranean diet are recommended for improving cardiovascular health.
Type 2 diabetes is a condition that arises from an issue with how the body controls and processes sugar. Type 2 diabetes (T2DM) is major risk factor for heart disease. “It is widely recognized that T2DM fosters the progression of atherosclerosis, a pathological mechanism that can significantly contribute to the development of cardiovascular disease, this pathophysiological process largely depends on the long-term blood glucose level” (Chen et al., 2023). For patients with T2DM weight loss, dietary changes, and exercise can help to control and manage their diabetes. Risk factors of T2DM are identical to that of heart disease (obesity, inactivity, and cholesterol levels).
Modifiable Lifestyle Practices
Through patient education we can teach patients that maintaining a healthy weight and be physically active can help to lower blood pressure. Weight loss is one of the most effective ways for a patient to lower blood pressure. Regular physical activity is another way patients can lower their blood pressure. According to the Mayo Clinic 10 Ways to Control High Blood Pressure Without Medication, 2022 regular physical activity can lower high blood pressure by about 5 to 8 mm Hg. Patients should be encouraged to engage in a minimum of 30 minutes of moderate exercise each day. Given the age range of our patients 30 minutes day may not be possible. Collaboration between the nurses, doctors and physical therapist can provide patients with alternate mean of exercise that are appropriate for their needs.
“Cigarette smoking remains the leading cause of preventable disease, disability, and death in the United States” (Smoking and Tobacco Use, 2023). Smoking tobacco, smokeless tobacco, and secondhand smoke are linked to heart disease death and mortality. Smokers are at higher risk for myocardial infarctions (MI), ischemic heart disease, and sudden cardiac arrest than never smokers. “Smoking approximately doubles the risk of death from stroke for current smokers compared with never smokers” (Kalkhoran et al 2018). With routine screening of patients with heart disease, clinicians can help patients stop smoking or using tobacco products. Using evidence based smoking cessation treatment such as behavioral support and medication can be very effective. Explaining to patients how smoking even just 1 cigarette day increases a patient’s cardiovascular risk, and the benefits of quitting can make big impact. “Quitting smoking reduces the risk of overall mortality among adult smokers, with health benefits observed even among smokers who quit after the age of 65years or after the development of a tobacco-related disease” (Kalkhoran et al 2018). Using a framework like the 5A’s model: ask, advise, assess, assist, and arrange are beneficial in clinical settings. This method is helpful for clinicians to determine a patient’s readiness to quit, and how to treat. This framework can also be useful for patient that do not smoke but may live with smokers to get them to quit. Excessive consumption of alcohol has been related to a variety of negative health conditions including heart disease. Excessive alcohol intake can cause obesity, hypertension, heart failure and stroke. Reducing and/or stopping alcohol consumption can improve a patients cardiovascular and overall health. Clinicians can utilize evidence-based assessment tools such as ASBI to screen patients for excessive alcohol intake. ASBI can be used to identify persons “engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse.” (Alcohol Screening and Brief Intervention Before Prescribing Opioids | CDC, n.d.)
Patient Education
Through targeted and structured patient education, we can help to improve the cardiovascular health of patients with heart disease. Using educational tools and technologies we can help patients improve their health literacy, so they have an active role in their healthcare. Identifying patients preferred language, learning style, and cultural practices can help to create a patient education that is useful and meaningful to our patients.
Conclusion
Heart disease is a major health issue that impacts all people all over the world. Leading a healthy lifestyle that is comprised of a balanced diet, regular exercise, and maintaining healthy weight can help prevent heart disease. For those that have a diagnosis of heart disease modifying current lifestyle practices can help to improve their cardiovascular health. Clinicians can utilize evidence-based education to help improve patient outcomes.
References
10 ways to control high blood pressure without medication. (2022, July 12). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974
Alcohol screening and brief intervention before prescribing opioids | CDC. (n.d.). https://www.cdc.gov/alcohol/fact-sheets/alcohol-screening.html
Babb, S., Lucido, B., Merai, R., Schauer, G. L., Wall, H. K., Wright, J., Adsit, R., & Fiore, M. (2021, September 27). Clinician Action Guide on Identifying and Treating Patients Who Use Tobacco . Million Hearts. https://millionhearts.hhs.gov/files/Tobacco-Cessation-Action-Guide.pdf
Chen, J., Yin, D., & Dou, K. (2023). Intensified glycemic control by HbA1c for patients withcoronary heart disease and Type 2 diabetes: a review of findings and conclusions. CardiovascularDiabetology, 22(1), 1–16. https://doi.org/10.1186/s12933-023-01875-8
Felipe, R. A., Plescia, M., Peterman, E., Tomlin, H., Sells, M., Easley, C., Ahmed, K., & Presley-Cantrell, L. (2019). A Public Health Framework to Improve Population Health Through Health Care and Community Clinical Linkages: The ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative. Preventing Chronic Disease, 16, E124. https://doi.org/10.5888/pcd16.190065
Fegers-Wustrow I, Gianos E, Halle M, et al. Comparison of American and European Guidelines for Primary Prevention of Cardiovascular Disease. J Am Coll Cardiol. 2022 Apr, 79 (13) 1304–1313.https://doi.org/10.1016/j.jacc.2022.02.001
Heart disease | Cdc.gov. (2023, April 14). Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/index.htm
Heart Jang-Whan Bae, Woo, S., Lee, J., Sang-Don, P., Sung, W. K., Seong, H. C., Yoon, G., Kim, M., Seung-Sik Hwang, & Lee, W. K. (2021). mHealth Interventions for Lifestyle and Risk Factor Modification in Coronary Heart Disease: Randomized Controlled Trial. JMIR mHealth and uHealth, 9(9) https://doi.org/10.2196/29928
High Blood Pressure (n.d.). www.heart.org. https://www.heart.org/en/health-topics/high-blood-pressure
Kalkhoran S, Benowitz N, Rigotti N, et al. Prevention and Treatment of Tobacco Use. J Am Coll Cardiol. 2018 Aug, 72 (9) 1030–1045.https://doi.org/10.1016/j.jacc.2018.06.036
Smoking and tobacco use. (2023, August 18). Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/
Soyer, J., Gabet, A., Grave, C., Piffaretti, C., Verdot, C., Salanave, B., Deschamps, V., Fosse-Edorh, S., Carcaillon-Bentata, L., & Olié, V. (2023). Need for improvement of cardiovascular health: a clustering method to identify cardiovascular health profiles. From epidemiological surveillance to identification of targeted audiences for prevention campaigns. European Journal of Public Health, 33(4), 732–737. https://doi.org/10.1093/eurpub/ckad048
Current Situation Assessment
“According to the 2023 update on heart disease and stroke statistics carried out by the American Heart Association (AHA), approximately 20.5 million individuals aged 20 years and above in the United States are affected by CHD, indicating a prevalence rate of approximately 7.1%” (Chen et al., 2023). It is the leading cause of death for men and women, of various racial and ethnic groups. According to the CDC. Gov, 2023 heart disease kills 1-person every 33 seconds in the United States. Heart disease refers to a variety of conditions that effect that heart. Heart disease can affect the blood vessels, valves, and muscle of the heart. It can cause arrhythmias, or irregular beating of the of the heart. “To assess cardiovascular health, the American Heart Association (AHA) proposed seven major modifiable cardiovascular risk factors based on four metabolic factors body mass index (BMI), fasting plasma glucose, total cholesterol, and blood pressure] and three health behaviors smoking, diet and physical activity” (Soyer et al., 2023). It has been established that each of these risk factors has a unique relationship with cardiovascular risk and overall mortality. “A healthy lifestyle, risk factor modification, and medication adherence are vital for preventing mortality and recurrent events in individuals with coronary heart disease” (Jang-Whan Bae et al,.2021). In a study conducted by Shi (2021) structured patient education improved health behaviors in adults with coronary heart disease. An individualized patient centered approach that addresses all the aspects of a patient’s lifestyle should use in the treatment and prevention of heart disease. Best practice in preventing heart disease and its progression is following a healthy lifestyle. This patient population has already received a diagnosis of heart disease, have been prescribed medications, and have one or more comorbidities.
Modifiable Cardiovascular Risk Factors
Health conditions such as Type 2 diabetes and obesity can increase a patient’s risk of high cholesterol or hyperlipidemia. Patients may suffer from medical conditions or take medications that put them at an increased risk for high cholesterol. Patients can also be predisposed to high cholesterol due to genetic factors; however unhealthy lifestyle practices significantly increase the risk. Factors such as poor diet, smoking, drinking, inactivity, and age can also increase a patient’s risk of high cholesterol. These modifiable risk factors are the first line defense in lowering patients’ cholesterol levels. Through patient centered education we can educate patients about the necessary lifestyle needed to lower cholesterol levels. After patients have attempted lifestyle changes and modifications clinicians may prescribe medication or a combination of medications depending on the patients’ health needs.
High blood pressure or hypertension (HTN) is a risk factor for heart disease that can be controlled and modified through patient education. “In 2017, the American College of Cardiology and the American Heart Association released new blood pressure guidelines that suggest lowering the optimal blood pressure target from below 140/90 mm Hg to below 130/80 mm Hg;s” (Fegers-Wustrow etal, 2022). Normal systolic blood pressure is less than 120 with a diastolic less than 80. Some patients are at risk for HTN due to family history, age, and comorbidities. Patients can decrease their risk for HTN by eating a healthy diet. Diets consisting of “whole unprocessed foods, shift from saturated to unsaturated fats, avoidance of trans-fats and sugar-containing foods and beverages, and lower sodium intake” are recommended. Diets such as the DASH diet and the Mediterranean diet are recommended for improving cardiovascular health.
Type 2 diabetes is a condition that arises from an issue with how the body controls and processes sugar. Type 2 diabetes (T2DM) is major risk factor for heart disease. “It is widely recognized that T2DM fosters the progression of atherosclerosis, a pathological mechanism that can significantly contribute to the development of cardiovascular disease, this pathophysiological process largely depends on the long-term blood glucose level” (Chen et al., 2023). For patients with T2DM weight loss, dietary changes, and exercise can help to control and manage their diabetes. Risk factors of T2DM are identical to that of heart disease (obesity, inactivity, and cholesterol levels).
Modifiable Lifestyle Practices
Through patient education we can teach patients that maintaining a healthy weight and be physically active can help to lower blood pressure. Weight loss is one of the most effective ways for a patient to lower blood pressure. Regular physical activity is another way patients can lower their blood pressure. According to the Mayo Clinic 10 Ways to Control High Blood Pressure Without Medication, 2022 regular physical activity can lower high blood pressure by about 5 to 8 mm Hg. Patients should be encouraged to engage in a minimum of 30 minutes of moderate exercise each day. Given the age range of our patients 30 minutes day may not be possible. Collaboration between the nurses, doctors and physical therapist can provide patients with alternate mean of exercise that are appropriate for their needs.
“Cigarette smoking remains the leading cause of preventable disease, disability, and death in the United States” (Smoking and Tobacco Use, 2023). Smoking tobacco, smokeless tobacco, and secondhand smoke are linked to heart disease death and mortality. Smokers are at higher risk for myocardial infarctions (MI), ischemic heart disease, and sudden cardiac arrest than never smokers. “Smoking approximately doubles the risk of death from stroke for current smokers compared with never smokers” (Kalkhoran et al 2018). With routine screening of patients with heart disease, clinicians can help patients stop smoking or using tobacco products. Using evidence based smoking cessation treatment such as behavioral support and medication can be very effective. Explaining to patients how smoking even just 1 cigarette day increases a patient’s cardiovascular risk, and the benefits of quitting can make big impact. “Quitting smoking reduces the risk of overall mortality among adult smokers, with health benefits observed even among smokers who quit after the age of 65years or after the development of a tobacco-related disease” (Kalkhoran et al 2018). Using a framework like the 5A’s model: ask, advise, assess, assist, and arrange are beneficial in clinical settings. This method is helpful for clinicians to determine a patient’s readiness to quit, and how to treat. This framework can also be useful for patient that do not smoke but may live with smokers to get them to quit. Excessive consumption of alcohol has been related to a variety of negative health conditions including heart disease. Excessive alcohol intake can cause obesity, hypertension, heart failure and stroke. Reducing and/or stopping alcohol consumption can improve a patients cardiovascular and overall health. Clinicians can utilize evidence-based assessment tools such as ASBI to screen patients for excessive alcohol intake. ASBI can be used to identify persons “engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse.” (Alcohol Screening and Brief Intervention Before Prescribing Opioids | CDC, n.d.)
Patient Education
Through targeted and structured patient education, we can help to improve the cardiovascular health of patients with heart disease. Using educational tools and technologies we can help patients improve their health literacy, so they have an active role in their healthcare. Identifying patients preferred language, learning style, and cultural practices can help to create a patient education that is useful and meaningful to our patients.
Conclusion
Heart disease is a major health issue that impacts all people all over the world. Leading a healthy lifestyle that is comprised of a balanced diet, regular exercise, and maintaining healthy weight can help prevent heart disease. For those that have a diagnosis of heart disease modifying current lifestyle practices can help to improve their cardiovascular health. Clinicians can utilize evidence-based education to help improve patient outcomes.
References
10 ways to control high blood pressure without medication. (2022, July 12). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974
Alcohol screening and brief intervention before prescribing opioids | CDC. (n.d.). https://www.cdc.gov/alcohol/fact-sheets/alcohol-screening.html
Babb, S., Lucido, B., Merai, R., Schauer, G. L., Wall, H. K., Wright, J., Adsit, R., & Fiore, M. (2021, September 27). Clinician Action Guide on Identifying and Treating Patients Who Use Tobacco . Million Hearts. https://millionhearts.hhs.gov/files/Tobacco-Cessation-Action-Guide.pdf
Chen, J., Yin, D., & Dou, K. (2023). Intensified glycemic control by HbA1c for patients withcoronary heart disease and Type 2 diabetes: a review of findings and conclusions. CardiovascularDiabetology, 22(1), 1–16. https://doi.org/10.1186/s12933-023-01875-8
Felipe, R. A., Plescia, M., Peterman, E., Tomlin, H., Sells, M., Easley, C., Ahmed, K., & Presley-Cantrell, L. (2019). A Public Health Framework to Improve Population Health Through Health Care and Community Clinical Linkages: The ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative. Preventing Chronic Disease, 16, E124. https://doi.org/10.5888/pcd16.190065
Fegers-Wustrow I, Gianos E, Halle M, et al. Comparison of American and European Guidelines for Primary Prevention of Cardiovascular Disease. J Am Coll Cardiol. 2022 Apr, 79 (13) 1304–1313.https://doi.org/10.1016/j.jacc.2022.02.001
Heart disease | Cdc.gov. (2023, April 14). Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/index.htm
Heart Jang-Whan Bae, Woo, S., Lee, J., Sang-Don, P., Sung, W. K., Seong, H. C., Yoon, G., Kim, M., Seung-Sik Hwang, & Lee, W. K. (2021). mHealth Interventions for Lifestyle and Risk Factor Modification in Coronary Heart Disease: Randomized Controlled Trial. JMIR mHealth and uHealth, 9(9) https://doi.org/10.2196/29928
High Blood Pressure (n.d.). www.heart.org. https://www.heart.org/en/health-topics/high-blood-pressure
Kalkhoran S, Benowitz N, Rigotti N, et al. Prevention and Treatment of Tobacco Use. J Am Coll Cardiol. 2018 Aug, 72 (9) 1030–1045.https://doi.org/10.1016/j.jacc.2018.06.036
Smoking and tobacco use. (2023, August 18). Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/
Soyer, J., Gabet, A., Grave, C., Piffaretti, C., Verdot, C., Salanave, B., Deschamps, V., Fosse-Edorh, S., Carcaillon-Bentata, L., & Olié, V. (2023). Need for improvement of cardiovascular health: a clustering method to identify cardiovascular health profiles. From epidemiological surveillance to identification of targeted audiences for prevention campaigns. European Journal of Public Health, 33(4), 732–737. https://doi.org/10.1093/eurpub/ckad048
Current Situation Assessment
“According to the 2023 update on heart disease and stroke statistics carried out by the American Heart Association (AHA), approximately 20.5 million individuals aged 20 years and above in the United States are affected by CHD, indicating a prevalence rate of approximately 7.1%” (Chen et al., 2023). It is the leading cause of death for men and women, of various racial and ethnic groups. According to the CDC. Gov, 2023 heart disease kills 1-person every 33 seconds in the United States. Heart disease refers to a variety of conditions that effect that heart. Heart disease can affect the blood vessels, valves, and muscle of the heart. It can cause arrhythmias, or irregular beating of the of the heart. “To assess cardiovascular health, the American Heart Association (AHA) proposed seven major modifiable cardiovascular risk factors based on four metabolic factors body mass index (BMI), fasting plasma glucose, total cholesterol, and blood pressure] and three health behaviors smoking, diet and physical activity” (Soyer et al., 2023). It has been established that each of these risk factors has a unique relationship with cardiovascular risk and overall mortality. “A healthy lifestyle, risk factor modification, and medication adherence are vital for preventing mortality and recurrent events in individuals with coronary heart disease” (Jang-Whan Bae et al,.2021). In a study conducted by Shi (2021) structured patient education improved health behaviors in adults with coronary heart disease. An individualized patient centered approach that addresses all the aspects of a patient’s lifestyle should use in the treatment and prevention of heart disease. Best practice in preventing heart disease and its progression is following a healthy lifestyle. This patient population has already received a diagnosis of heart disease, have been prescribed medications, and have one or more comorbidities.
Modifiable Cardiovascular Risk Factors
Health conditions such as Type 2 diabetes and obesity can increase a patient’s risk of high cholesterol or hyperlipidemia. Patients may suffer from medical conditions or take medications that put them at an increased risk for high cholesterol. Patients can also be predisposed to high cholesterol due to genetic factors; however unhealthy lifestyle practices significantly increase the risk. Factors such as poor diet, smoking, drinking, inactivity, and age can also increase a patient’s risk of high cholesterol. These modifiable risk factors are the first line defense in lowering patients’ cholesterol levels. Through patient centered education we can educate patients about the necessary lifestyle needed to lower cholesterol levels. After patients have attempted lifestyle changes and modifications clinicians may prescribe medication or a combination of medications depending on the patients’ health needs.
High blood pressure or hypertension (HTN) is a risk factor for heart disease that can be controlled and modified through patient education. “In 2017, the American College of Cardiology and the American Heart Association released new blood pressure guidelines that suggest lowering the optimal blood pressure target from below 140/90 mm Hg to below 130/80 mm Hg;s” (Fegers-Wustrow etal, 2022). Normal systolic blood pressure is less than 120 with a diastolic less than 80. Some patients are at risk for HTN due to family history, age, and comorbidities. Patients can decrease their risk for HTN by eating a healthy diet. Diets consisting of “whole unprocessed foods, shift from saturated to unsaturated fats, avoidance of trans-fats and sugar-containing foods and beverages, and lower sodium intake” are recommended. Diets such as the DASH diet and the Mediterranean diet are recommended for improving cardiovascular health.
Type 2 diabetes is a condition that arises from an issue with how the body controls and processes sugar. Type 2 diabetes (T2DM) is major risk factor for heart disease. “It is widely recognized that T2DM fosters the progression of atherosclerosis, a pathological mechanism that can significantly contribute to the development of cardiovascular disease, this pathophysiological process largely depends on the long-term blood glucose level” (Chen et al., 2023). For patients with T2DM weight loss, dietary changes, and exercise can help to control and manage their diabetes. Risk factors of T2DM are identical to that of heart disease (obesity, inactivity, and cholesterol levels).
Modifiable Lifestyle Practices
Through patient education we can teach patients that maintaining a healthy weight and be physically active can help to lower blood pressure. Weight loss is one of the most effective ways for a patient to lower blood pressure. Regular physical activity is another way patients can lower their blood pressure. According to the Mayo Clinic 10 Ways to Control High Blood Pressure Without Medication, 2022 regular physical activity can lower high blood pressure by about 5 to 8 mm Hg. Patients should be encouraged to engage in a minimum of 30 minutes of moderate exercise each day. Given the age range of our patients 30 minutes day may not be possible. Collaboration between the nurses, doctors and physical therapist can provide patients with alternate mean of exercise that are appropriate for their needs.
“Cigarette smoking remains the leading cause of preventable disease, disability, and death in the United States” (Smoking and Tobacco Use, 2023). Smoking tobacco, smokeless tobacco, and secondhand smoke are linked to heart disease death and mortality. Smokers are at higher risk for myocardial infarctions (MI), ischemic heart disease, and sudden cardiac arrest than never smokers. “Smoking approximately doubles the risk of death from stroke for current smokers compared with never smokers” (Kalkhoran et al 2018). With routine screening of patients with heart disease, clinicians can help patients stop smoking or using tobacco products. Using evidence based smoking cessation treatment such as behavioral support and medication can be very effective. Explaining to patients how smoking even just 1 cigarette day increases a patient’s cardiovascular risk, and the benefits of quitting can make big impact. “Quitting smoking reduces the risk of overall mortality among adult smokers, with health benefits observed even among smokers who quit after the age of 65years or after the development of a tobacco-related disease” (Kalkhoran et al 2018). Using a framework like the 5A’s model: ask, advise, assess, assist, and arrange are beneficial in clinical settings. This method is helpful for clinicians to determine a patient’s readiness to quit, and how to treat. This framework can also be useful for patient that do not smoke but may live with smokers to get them to quit. Excessive consumption of alcohol has been related to a variety of negative health conditions including heart disease. Excessive alcohol intake can cause obesity, hypertension, heart failure and stroke. Reducing and/or stopping alcohol consumption can improve a patients cardiovascular and overall health. Clinicians can utilize evidence-based assessment tools such as ASBI to screen patients for excessive alcohol intake. ASBI can be used to identify persons “engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse.” (Alcohol Screening and Brief Intervention Before Prescribing Opioids | CDC, n.d.)
Patient Education
Through targeted and structured patient education, we can help to improve the cardiovascular health of patients with heart disease. Using educational tools and technologies we can help patients improve their health literacy, so they have an active role in their healthcare. Identifying patients preferred language, learning style, and cultural practices can help to create a patient education that is useful and meaningful to our patients.
Conclusion
Heart disease is a major health issue that impacts all people all over the world. Leading a healthy lifestyle that is comprised of a balanced diet, regular exercise, and maintaining healthy weight can help prevent heart disease. For those that have a diagnosis of heart disease modifying current lifestyle practices can help to improve their cardiovascular health. Clinicians can utilize evidence-based education to help improve patient outcomes.
References
10 ways to control high blood pressure without medication. (2022, July 12). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974
Alcohol screening and brief intervention before prescribing opioids | CDC. (n.d.). https://www.cdc.gov/alcohol/fact-sheets/alcohol-screening.html
Babb, S., Lucido, B., Merai, R., Schauer, G. L., Wall, H. K., Wright, J., Adsit, R., & Fiore, M. (2021, September 27). Clinician Action Guide on Identifying and Treating Patients Who Use Tobacco . Million Hearts. https://millionhearts.hhs.gov/files/Tobacco-Cessation-Action-Guide.pdf
Chen, J., Yin, D., & Dou, K. (2023). Intensified glycemic control by HbA1c for patients withcoronary heart disease and Type 2 diabetes: a review of findings and conclusions. CardiovascularDiabetology, 22(1), 1–16. https://doi.org/10.1186/s12933-023-01875-8
Felipe, R. A., Plescia, M., Peterman, E., Tomlin, H., Sells, M., Easley, C., Ahmed, K., & Presley-Cantrell, L. (2019). A Public Health Framework to Improve Population Health Through Health Care and Community Clinical Linkages: The ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative. Preventing Chronic Disease, 16, E124. https://doi.org/10.5888/pcd16.190065
Fegers-Wustrow I, Gianos E, Halle M, et al. Comparison of American and European Guidelines for Primary Prevention of Cardiovascular Disease. J Am Coll Cardiol. 2022 Apr, 79 (13) 1304–1313.https://doi.org/10.1016/j.jacc.2022.02.001
Heart disease | Cdc.gov. (2023, April 14). Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/index.htm
Heart Jang-Whan Bae, Woo, S., Lee, J., Sang-Don, P., Sung, W. K., Seong, H. C., Yoon, G., Kim, M., Seung-Sik Hwang, & Lee, W. K. (2021). mHealth Interventions for Lifestyle and Risk Factor Modification in Coronary Heart Disease: Randomized Controlled Trial. JMIR mHealth and uHealth, 9(9) https://doi.org/10.2196/29928
High Blood Pressure (n.d.). www.heart.org. https://www.heart.org/en/health-topics/high-blood-pressure
Kalkhoran S, Benowitz N, Rigotti N, et al. Prevention and Treatment of Tobacco Use. J Am Coll Cardiol. 2018 Aug, 72 (9) 1030–1045.https://doi.org/10.1016/j.jacc.2018.06.036
Smoking and tobacco use. (2023, August 18). Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/
Soyer, J., Gabet, A., Grave, C., Piffaretti, C., Verdot, C., Salanave, B., Deschamps, V., Fosse-Edorh, S., Carcaillon-Bentata, L., & Olié, V. (2023). Need for improvement of cardiovascular health: a clustering method to identify cardiovascular health profiles. From epidemiological surveillance to identification of targeted audiences for prevention campaigns. European Journal of Public Health, 33(4), 732–737. https://doi.org/10.1093/eurpub/ckad048
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