Major Causes and Steps in Addressing Cardiovascular Disease - Assignment Example

Cardiovascular Disease (CVD) CARDIOVASCULAR DISEASE (CVD) Introduction Cardiovascular disease or CVD are illnesses involving the cardiovascular system or the circulatory system, which includes blood vessels and the heart and transports blood throughout the body (Stanner, 2012). Principally, these diseases include peripheral arterial disease, vascular diseases of the kidney and brain, and cardiac diseases. Some examples of cardiac diseases, which involve the heart, are arrhythmia, heart attack, angina, dilated cardiomyopathy, and congenital heart disease, among others. Some of the vascular diseases, which involve blood vessels, include venous blood clots, stroke, renal artery disease, atherosclerosis, aneurism, among others (Stanner, 2012). This paper aims to identify major causes of CVD and key steps in CVD management from cohort study designs, as well as to develop leading questions on CVD mitigation for the local health department. Moreover, the paper will also present a rudimentary protocol for disseminating CVD information to local community leaders, while also making recommendations for prevention of CVD in the workplace. Major Causes of CVD and Steps in addressing CVD There are numerous causes and risk factors of CVD with some like age, ethnicity, and family history being non-modifiable, while others can be changed or treated, such as hypertension, tobacco exposure, physical inactivity, obesity, high cholesterol, harmful alcohol use, and unhealthy diets. Berry et al (2012) found that hypertension is a significant cause for CVD, especially stroke and heart attacks, while abnormal lipid levels in blood including low levels of HDL cholesterol, high levels of LDL, high triglyceride levels, and high total cholesterol also cause CVD, especially stroke and heart attack. In addition, Huxley and Woodward (2011) also find that the use of tobacco over a long time, whether by smoking or chewing it, increases an individual risk of developing CVD, especially where one began to smoke as a young person, is a woman, or smokes very heavily. It was also found that passive smoking causes CVD. Physical inactivity and type 2 diabetes mellitus are identified by Appleton et al (2013) as major causes of CVD with the former increasing CVD risk by 50% by increasing risk of obesity and subsequent diabetes that, in turn, predisposes individuals to strokes and coronary heart diseases especially in pre-menopausal women. Finally, Van Dierren et al (2012) find that diets with high fat saturation increase CVD risk, while abuse of alcohol damages heart muscle and subsequent CVD and specific medicines like hormone replacement therapy and contraceptive pills increase the risk of CVD. Weintraub et al (2011) note that there are five essential steps required in addressing cardiovascular disease. The first step is ensuring a balanced diet, especially by adhering to dietary policies that are relevant to the health of the cardiovascular system, such as replacing saturated fat calories with polyunsaturated or monounsaturated fats, while also eliminating intake of industrial trans fatty acids. The next step is to tackle sedentary lifestyles by taking advantage of the health benefits attributed to regular physical activity, while also reducing one’s caloric intake (Weintraub et al, 2011). The next step involves reduction and curtailment of tobacco use, especially by at-risk groups like pre-menopausal women, with the burden of tobacco smoke on the cardiovascular system having been long established. Another step in addressing CVD involves the early detection of hyperlipidemia and hypertension through diagnostics and screening services, specifically to identify and treat these disorders and prevent the incidence of CVD. Finally, Weintraub et al (2011) identify the treatment of CVD with various medications once it sets in, especially to tackle blood clots, hypertension, and hyperlipidemia. Antithrombotic medicines are widely used to prevent blood clots from forming and reducing the risk of CVD, while beta-blocking agents, diuretic medicines, calcium channel blockers, and renin-angiotensin system agents all lower blood pressure and treat hypertension. Finally, lipid-modifying medicines, such as statins, are used in treating hyperlipidemia and preventing CVD. Questions for the Local Health Department regarding CVD Mitigation 1. What is the health department’s vision for the future with regards to the favorable circumstances to be achieved in order to arrest and reverse the incidence of CVD? It is important to know the future envisioned by the health department regarding CVD mitigation, including the environmental and social conditions that will be favorable to health, because they are essential for low prevalence of CVD risk-factors, lower frequency of CVD mortality, and predominance of behaviors for health promotion (Vandvik, 2012). 2. What is the status of screening and risk assessment for CVD at the health department? There is strong evidence that CVD screening by GPs is an effective strategy for the identification of unknown CVD cases, especially since screening for hyperlipidemia and hypertension helps to identify two of the most significant causes of CVD (Vandvik, 2012). 3. What health promotion efforts does the health department undertake to decrease the population’s risk of developing CVD? There is strong evidence that promotion of healthy behavior adoption reduces the risk of developing CVD, including the elimination of use and exposure to tobacco, maintenance of healthy weight, physical activity, and eating a healthy diet (Vandvik, 2012). 4. Does the health department undertake early interventions to reduce the risk of CVD among high risk individuals in the population? While the evidence in support of specific interventions related to medications for treating hyperlipidemia and hypertension as a way of mitigating CVD is limited, there is some evidence that successful improvement of medication adherence does reduce the incidence of CVD (Vandvik, 2012). 5. Does the health department provide training and education for its staff to provide interventions that reduce CVD risk in the population? Education and training of healthcare staff with regards to identifying and monitoring at-risk individuals, as well as providing intervention measures to reduce the risk of developing CVD, is essential to CVD prevention practices, such as living a healthy lifestyle and increased physical activity (Vandvik, 2012). Protocol for Dissemination of CVD Information to Local Community Leaders Vandvik (2012) identifies the need to develop educational resources for opinion leaders, in this case community leaders, which are credible, standardized, and accessible, as well as those that target an array of literacy levels and are adaptable to the needs of diverse communities. Prior to disseminating this information, it is important to undertake an audit of all the informational resources presently used by the health department for mitigating CVD to identify gaps and evaluate their quality, after which these gaps will be filled. The information to be disseminated should create an informed group of community leaders that can recognize acute symptoms and signs of CVD, while also understanding the need for evidence-based and timely emergency response. One strategy to do this will be through the dissemination of evidence-based and consistent educational materials to inform the community leaders of the symptoms and emergency response to CVD. Core messages on CVD mitigation are then adopted and disseminated in multiple languages. Moreover, educational materials on symptoms of CVD will be provided through various methods and venues, such as worksites and school settings, specifically encouraging training in cardiopulmonary resuscitation. Another strategy will be through the creation and dissemination through electronic resources of evidence-based and reliable materials on best practice, level of care capabilities at the health department, and resources available to the health department. Preventing Proliferation of CVD in the Workplace There are numerous opportunities for the mitigation of CVD proliferation in the workplace, particularly because most Americans spend at least 30% of their day at work. As such, employers have a unique chance to aid in the creation of a healthier staff through the fostering of healthy environment in the following ways; Employers should provide places where their workers can buy healthy beverages and food. Although there is still much that remains to be learnt concerning the role played by particular nutrients in decreasing CVD risk-factors, dietary patterns emphasizing fruits, vegetables, and legumes, while limiting dairy products and red meat are associated with decreased risk of hypertension and hyperlipidemia (Li & Siegrist, 2012). Employers should provide and discount onsite exercise facilities or, alternatively, subsidize the cost of external facilities. There is overwhelming evidence that physical activity reduce the risk factors related to CVD through its impact on bodily weight control and on hormones. The employer should also seek to avail devices for monitoring blood pressure, while also instructing employees to conduct self-assessments. Early detection of CVD could potentially alter the disease’s natural history by reducing morbidity and mortality, specifically through recommendations for pharmacological interventions and altered lifestyles (Li & Siegrist, 2012). The employer may also consider providing health insurance coverage with low costs for lipid or cholesterol control medications. This is essential where a worker has already been identified as being at-risk and requires medication to treat hyperlipidemia or hypertension, thus increasing their work productivity. Moreover, the employer may provide subsidized or free one-on-one counseling on lifestyle behaviors for obese or overweight employees. This would help these employees to change their lifestyles towards healthy eating, physical activity, and regular screening (Li & Siegrist, 2012). Finally, the employer should ensure that the worksite is a tobacco free zone. With the use of tobacco being the single largest preventable risk-factor for CVD, protecting the employees from second-hand smoke will aid in preventing the proliferation of CVD. References Appleton, S. L., Seaborn, C. J., Visvanathan, R., Hill, C. L., Gill, T. K., Taylor, A. W., & Adams, R. J. (2013). Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study. Diabetes Care, 36, 8, 2388-2394. Berry, J. D., Dyer, A., Cai, X., Garside, D. B., Ning, H., Thomas, A., Greenland, P., & Lloyd-Jones, D. M. (2012). Lifetime risks of cardiovascular disease. The New England Journal of Medicine, 366, 4, 321-329. Huxley, R. R., & Woodward, M. (2011). Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studies. Lancet, 378, 9799, 1297-305. Li, J., & Siegrist, J. (2012). Physical Activity and Risk of Cardiovascular Disease—A Meta-Analysis of Prospective Cohort Studies. International Journal of Environmental Research and Public Health, 9, 12, 391-407. Stanner, S. (2012). Cardiovascular Disease. Oxford: John Wiley & Sons. Van Dierren, S., Beulens, J. W., Kengne, A. P., Peelen, L. M., Rutten, G. E., Woodward, M., & Moons, K. G. (2012). Prediction models for the risk of cardiovascular disease in patients with type 2 diabetes: a systematic review. Heart (British Cardiac Society), 98, 5, 360-369. Vandvik, P. O. (2012). Primary and Secondary Prevention of Cardiovascular Disease. Chest Journal, 141, 2, 637-648 Weintraub, W. S., Daniels, S. R., Burke, L. E., Franklin, B. A., Goff, D. C. J., Hayman, L. L., & Lloyd-Jones, D. (2011). 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