Article Analysis: Heart Failure in Minority Groups

Situation: Two patients in their 70s present to the office at different times today, each with documented heart failure: one diastolic and the other systolic, and both are hypertensive. First, discuss the difference between systolic and diastolic heart failure, providing appropriate pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate physiology. Now considering all of the above, describe an appropriate comprehensive plan of

“One in nine deaths in 2009 included heart failure as a contributing cause. About half of the people who develop heart failure die within 5 years of diagnosis” (Heart Failure Fact Sheet). “Researchers have proven that African-Americans are at an increased risk of congestive heart failure. This is due to diabetes and high blood pressure, rather than race alone”. “There is no cure for heart failure. Treatments are used to relieve symptoms of CHF and try to prevent any further damage. The exact plan to help the patient depends on the stage and the type of heart failure the patient has”

According to the office of the minority health, approximately 48% of African American women and 44% of African American men suffer from some form of the cardiovascular disease which includes heart disease and stroke and adults are 40 percent more likely to have high blood pressure while the women are 1.6 times more likely to die from heart diseases and complications than other ethnic groups (The Office of Minority Health, 2016).

African Americans are the third largest racial or ethnic population, totaling 13.2% of the United States population (CDC, 2015). Giger (2013) states, some health disparities associated with African Americans is due to discriminatory practices and inequalities in social, economic, and educational opportunities, rather than biological factors. Statistics identifies higher health disparities for this population reflected in overall mortality rates compared to other populations. According to the Office of Minority Health (2014), the adult mortality rate is higher in African Americans for heart disease, stroke, cancer, asthma, influenza, pneumonia, and diabetes, as well as higher rates of infant mortality. For instance, the overall adult mortality rate for African Americans is 860.5 per 100,000 population compared to 731.0 per 100,000 population in Caucasian Americans according to 2012 data (KFF, 2015).

Health disparities among African-Americans is a continuing problem that has been seen over many years. African-Americans have higher poverty rates, have lower rates of insurance coverage, and are more likely to be covered by Medicaid, than the White population (Copeland, 2005). This lack of insurance has led many of these individuals, to not seek treatment for illness, due to problem accessing health care (Kennedy, 2013). This leaves African-Americans with little to no treatment, which causes an increase of medical care that will be needed further on in their life or a sooner than expected death, caused by illness (Copeland, 2005).

The American Medical Journal explains that the heart disease is one of the deadliest medical conditions. Medical experts reckon that heart disease is a lifestyle disease, which emanates from excessive consumption of the wrong dietary combination. Foods such as fats and carbohydrates often expose individuals to the threat of heart disease. Consuming fast foods from McDonalds also expose people to the threat of heart disease. The most plausible means of mitigating the risk of contacting heart disease is by observing dietary combination. Individuals must keep a balanced diet always in order to avoid dietary concerns later on in life. The most common symptoms include chest discomfort, nausea, trouble sleeping, breathing problems, and unusual tiredness.

My phenomenon of interest is: The effect of health promotion on the outcome of African- American heart failure patients. Heart failure is fast becoming prevalent among African -Americans due to high incidence of CAD and hypertension. African Americans have the highest mortality rates from chronic diseases. Evidence depicts health promotion as vital to the outcome of heart failure patients. The role of nursing in health promotion has been shown to promote positive outcomes such as adherence, knowledge of illness and improved quality of life. There is a need to decrease readmission and mortality rates in African American heart failure

Keywords: socioeconomic status (SES), cardiovascular disease (CVD), African American, risk factors, social determinants, and health disparities, institutionalized racism.

Heart disease, also known as cardiovascular disease (CVD), is the leading cause of death in the world (World Health Organization [WHO], 2016). A depressing number of Americans are diagnosed with heart disease every year at 11.5% (Center for Disease Control and Prevention [CDC] 2016a). With 1 in every 4 deaths being from heart disease, the national age adjusted death rate of 167 and over half of the deaths are from men, we can see that heart disease is a serious problem (CDC, 2016b; CDC, 2016c). Oklahoma is no exception, with a CVD related death rate of 228.1 (CDC, 2016d). Community and individuals are dependent upon the demographics and qualities of that community to determine their health. Currently, Oklahoma faces a number of issues that affect overall health, including cardiovascular health of the entire state and the included communities. Therefore, this paper will analyze CVD statistics in Oklahoma, compare data and demographic features to Minnesota, and discuss lifestyle risks related to Healthy People 2020.

Centers for Disease Control and Prevention defines High Blood Pressure as the force of blood pushing against the walls of your arteries, which carry blood from your heart to other parts of your body. Blood pressure normally rises and falls throughout the day. But if it stays high for a long time, it can damage your heart and lead to health problems. High blood pressure raises your risk for heart disease and stroke, which are leading causes of death in the United States. One out of every three adults over the age of twenty- that’s nearly eighty million Americans have high blood pressure. What’s more interesting is that nearly twenty percent don’t even know they don’t have it. Consequently, African American suffer more from this disease than any other race. According to the American Heart Association, forty percent of African American men and women have high blood pressure (AHA, 2016). Notably, adults twenty years and older consist of 42.6 percent are men and 47.0 percent are women that have this illness. For years’ researchers, have tried to understand why High Blood Pressure affect the African American at a higher rate than others. As a

African Americans are more likely to eat a lot of greasy, fat food, and hardly every think about working out. Most importantly African American men are less likely to go to the doctor and check on themselves. This causes more heart

These differences in heart disease, known as health disparities, are a key reason that there is a racial discrepancy in life expectancy in Baltimore City: African-American men die 6.7 years earlier than Whites and African-American

610,000 people die of heart disease each year. Heart disease is the leading cause of death of both children and adults . Having the experience of a family death because of heart disease was heartbreaking. Imagine being seven and finding out that your most awaited baby sister might arrive dead or with serious problems that she won’t be like the others kids and will never be allowed to run or participate in anything for her serious conditions. That your parents will basically live in the hospital and you would spend most days with a baby sitter. Also finding out that if she does live she would have to go through a heart open surgery 6 days after she’s born and would have a plastic vein placed in her heart . That throughout her lifetime she would have about like 6 surgeries while waiting for a heart transplant and would never have the privilege to live as a normal child. Having your mom tell you that you won’t have the opportunity to meet the baby (your sister) after she’s born and you’ll have to wait 1 month because she’ll be in the hospital. Imagine only having a baby sister for 2

Congestive heart failure is a chronic disease that requires daily monitoring and life style management. Affecting the elderly, and their family the adjustment is a challenge. Daily life skills include the monitoring of daily weights, intake and output, and a low sodium diet. The person with congestive heart failure is generally admitted to the hospital for medication adjustments when their symptoms increase. The patient is often times short of breath, with a decrease in energy and an increase in their weight. The patients are generally elderly 60-65 years of age or older, and when comparing African Americans to Caucasians the African Americans have a 1.5 greater chance of developing heart failure ("Heart Failure," 2017). The

As the population ages heart failure is expected to increase exceptionally. About twenty-two percent of men and forty-four percent of women will develop heart failure within six years of having a heart attack. “Thirty years ago patients would have died from their heart attacks!” (Couzens)