American Heart Month – tackling heart disease

February is ‘American Heart Month’. Drs. Meredith Herzog and Kara Siegrist, cardiac anesthesiologists at Vanderbilt University Medical Center in Nashville, and colleagues of Perioperative Medicine's Section Editor Dr Andrew Shaw, write about heart health and the current challenges and advances the population and health care system face to tackle heart disease.

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Cardiovascular disease is the leading cause of death in the United States and threatens to become the leading cause in the entire world. According to the Centers for Disease Control and Prevention (CDC), 610,000 people died of heart disease in the US in 2014.

In addition to mortality, there is significant morbidity associated with cardiovascular disease, including heart attack and stroke. Patients also suffer from decreased quality of life and increased health care costs. This is why taking care of your heart is so important.

We are passionate about this problem because every day we see people who have ignored medical advice and are now undergoing major cardiac surgery. While we love our job and taking care of these patients, we would love to see initiative and prevention take the place of invasive interventions such as surgery.

Cardiovascular disease prevention

A large component of cardiovascular disease prevention is blood pressure control. More than 67 million people in the US have high blood pressure. Uncontrolled hypertension is a leading cause of heart disease and stroke. People with hypertension are four times more likely to die from a stroke and three times more likely to die from heart disease.

These risks are mitigated by blood pressure control, and that starts with regular visits to a primary care provider. Beyond that, it is important to stay compliant with the medication regimen prescribed and make appropriate lifestyle changes.

Another huge risk factor for heart disease is diabetes. 29.1 million US adults have diabetes—and one out of four does not know s/he has it. Diabetes is an independent risk factor for cardiovascular disease, and in combination with hypertension, the risk is doubled. We reiterate the importance of screening doctor visits and medication/diet compliance.

Making a change

Lifestyle changes are crucial, especially with the diagnoses of hypertension and/or diabetes.

Lifestyle changes are crucial, especially with the diagnoses of hypertension and/or diabetes. With appropriate lifestyle modifications, it is possible to decrease your risk to that of the general population. These modifications include eating a healthy diet, limiting salt intake, losing weight, exercising regularly, and not smoking.

Eating a healthy diet that includes a lot of fruits and vegetables and limits sodium, saturated and trans fats ( a type of unsaturated fat common in industrially produced foods), and cholesterol will help control blood pressure, blood sugar, and weight loss. Thirty minutes of moderate physical activity on most days of the week will improve not only your physical health but also your mental health.

The challenge for us

We, as health care providers, face several challenges related to improving heart health in the population. Despite our growing knowledge about the risk factors of cardiovascular disease, the incidence of obesity and diabetes continues to increase.

The CDC estimates that a third of US adults are currently obese, and that number is expected to increase to 42% by 2030. This percentage translates to 32 million obese Americans at an increased health care cost of $550 billion between now and 2030.

If we were somehow able to prevent this anticipated rise in obesity incidence, we could give $1,700 to every person in America with the money saved, in addition to making America healthier and happier.

We challenge everyone to take initiative this February, in honor of American Heart Month, and take control of your health and your future!

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