Heart Disease Improvement Proposal

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).

I work in the coronary care unit. Coronary artery disease is the most common chronic disease I see in my patients. According to American Heart Association, heart disease is the no. 1 cause of death in the United States, killing over 370,000 people a year (Heart and Stroke Statistics, 2015). It also states that about 750,000 people in the U.S. have heart attacks each year among them, about 116,000 die. It is scary to know that cardiovascular disease claims more lives each

1. Innovation to improve the mortality and morbidity of cardiovascular disease in developing countries may involve new surgical procedures, new implants and pacemakers, coronary artery bypasses, surgical treatments for Atrial fibrillation, repair of congenital heart defects, heart transplants, aortic arteries repair, replacement or repair of heart valves, and aneurysm repair (Hsieh, Chang, Lee, Chen, & Chan, 2012). Moreover, the innovation involves the integration of computer charting and data collection. This may involve a computer-based data registry that is responsible of storing patient related data. Developing countries are stepping away from the pen and paper charting system to a more sophisticated computerized system (Hsieh et al., 2012). This will allow for better tracking and follow up of complicated cases. Moreover, technological advances in imaging, screening, and diagnosing methods may also help reduce morbidity and mortality related to cardiovascular disease. Developing countries are now able to conduct ECG’s, stress monitoring, heart changes monitoring, radiological procedures, and labs that could target specific cardiac markers Hsieh et al., 2012).

High blood pressure (hypertension) is a major health condition which affects many Americans. This health condition may increase the risk of cardiovascular disease and stroke. A normal blood pressure consists of systolic blood pressure divided by diastolic blood pressure, 120/80mmHg (millimeters of mercury). High blood pressure is defined as systolic pressure which is greater than 140mm Hg, and diastolic pressure which is over 90mm Hg. Hypertension influences the health outcomes of black Americans more than other races in the United States. Racial discrimination and socioeconomic status are two major factors which influence the rate of high blood pressure in the black American population.

Summit County has several factors leading to poor access to comprehensive, quality health care. The poverty rate is 16%, the unemployment rate is 7.2%, and the uninsured rate is 14.1% (Centers for Disease Control and Prevention, 2012). There is also a high obesity rate of 28.4% . (Centers for Disease Control and Prevention, 2012). According to Milio's framework for prevention (2014) the people that make up these statistics show that lower income, uninsured individuals have a poor health status compared to employed, insured individuals. Therefore, they are at a higher risk for cardiovascular disease. It is also interesting to mention that in Nancy Milio's research she found that most people, whether low, middle, or upper class, will choose the easiest option available the majority of the time (Nies & McEwen, 2015). People making unhealthy choices such as smoking, abuse of alcohol and/or drugs, eating poorly, and remaining physically inactive, pose the greatest risk to heart disease. These lifestyle choices lead to obesity, hypertension, diabetes, and high cholesterol which are the main causes of cardiovascular

It is significant in underserved communities and it is most preventable. The risk factors to name a few are high blood pressure, poor diet & physical inactivity and obesity. It is pivotal to address these risks to prevent heart failure and strokes. The risk is controllable if certain life style changes are made. More than one in three adults which is 81.1 million lives with heart disease. In the Healthy people 2020 statistics the target for deaths caused by heart disease and stroke has declined from 1999 and 2011 from 194.6 to 109.2 deaths per 100,000 populations. This shows some progress. To maximize these results I would push for promotion of healthy eating habits and physical activities for people of all ages in underserved communities along with education specifically for unfortunate people.

Creating social and physical environment that promote good health is another goal set by Healthy People 2020 that is designed to create and promote a healthy physical as well as social environment by the year 2020. Everyone deserves to have the equal opportunity to make healthy decisions that will promote good and healthy lifestyle. For this to be achieved, health care advances and improvements need to be made. Community integration and planning, social factors such as quality education, community based resources, social support system, hazard free environment all have significant impact on people’s health. With the challenges we face, nurses can promote a safe and healthy environment through nursing education and wellness programs, disease control programs, immunization programs and many more to alleviate and or eliminate burdens, reduce untimely deaths, and create safe environment that promotes a healthy lifestyle for all.

The risks of getting those diseases are even higher for African Americans.” (American Heart Association). High blood pressure and obesity are the common conditions that increase a heart disease. High blood pressure is a condition in which the blood flow is abnormally higher than usual in the arteries. “Nearly 42% percent black men and 45% black women of twenty years and older have high blood pressure” (DeNoon). Researchers may have found a gene in blacks that make them more sensitive to salt, which in the long run increases the risk of high blood pressure. Obesity in african americans is more common as well, which increases the risk of heart disease. 63% of black men and 77% of black women are overweight or obese. A solution for high blood pressure and obesity is a healthy diet and exercise. It won’t only reduce the chances of getting these conditions but also reduce the chances of a heart disease or a

Hypertension is a developing problem worldwide associated with an increased risk of cardiovascular morbidity and mortality. In 2020, the world population will be approximately 7.8 billion people, and there will be 1 billon people who may be affected by hypertension (Tomson & Lip, 2005). One in three adults in the United States has high blood pressure. According to the report “Health, United States, 2010 with Special Feature on Death and Dying,” the prevalence of hypertension among adults 20 years old or older increased from 24% to 32% during 1988-1994 and 2005-2008. The African-American population has a higher prevalence of this health condition than white Americans do. In 2005 to 2008, the prevalence of hypertension among black males (41.4%) was more than 10%,

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

Hypertension (HTN), also referred to as high blood pressure, is a condition characterized by elevated systemic arterial blood pressure. An elevated blood pressure is considered to be a systolic pressure of at least 140 millimeters of mercury (mmHg) or a diastolic pressure of at least 90 mmHg. HTN is among the most common risk factors for heart disease among African Americans (Ferdinanc, 2006) and one of the leading causes of deaths in the United States. Spencer et.al., (2011) states that it is one of the leading indicators that contribute to heart disease, the leading cause of death in Baltimore City. Sickness and death from heart disease are much more likely to strike African Americans than Whites in Baltimore (DHMH, 2005). Spencer continues that in Baltimore City hospitalization percentage for 100,000 populations under 75 years old was 136.6 for Blacks and 15 for Whites.

Cardiovascular diseases (CVDs) are the most common cause of mortality worldwide, especially in developed countries. But they are also largely preventable, and many studies have tried to clarify the related risk factors, and what could be done to avoid them.

The number of U.S. deaths due to cardiovascular disease has drastically increased over the past century.

Public health nurses "play a strategic role in helping reduce environmental and lifestyle-related health hazards by promoting a positive lifestyle, including exercise, stress management, accident prevention, weight maintenance, and nutrition education that is sensitive to socio-economic status and cultural beliefs” ("Obesity's Impact on Public Health Nursing," n.d.). Nurses can help by involving themselves in policy development by being active participants in the policy process as it closely resembles the nursing process. Through community assessments, public health nurses can determine health factors by assessing the socioeconomic, environmental, and behavioral factors of the population to determine interventions

Factors that contribute to hypertension are age, ethnicity, gender, and lifestyles as shown in Figure 1 (Yoon, Burt, Louis, & Carroll, 2012). While the prevalence of hypertension is relatively equal among men and women, certain ethnicities have a higher propensity for developing hypertension. The prevalence of hypertension in African-Americans is among the highest in the United States for a single ethnic group (Ferdinand & Armani, 2007). In the United States, around 78% of people suffering from hypertension are aware of their condition, with only 68% using hypertensive medications to control their blood