Health Promotion Program: Cardiovascular Disease Mortality Decrease

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Epidemiology of Cardiovascular Disease

Around the world cardiovascular disease (CVD) happens to be the leading cause of death, and among the major causes of disability and diminished productivity in adults. In the United States of America, it is estimated that one out of three adults, constituting about 71.3 million of the population, are afflicted by cardiovascular disease. Cardiovascular disease affects all races, though variations are found within racial, ethnic, geographic, and socio-demographic groups. The prevalence is also found to increase with advancing age, making the age group of 55-64 the special group with regards to concerns on cardiovascular disease.

The incidence of cardiovascular disease is low in children and young adults. However, with high mortality rates, sudden death through cardiovascular disease is an area of concern in children and young adults. Mortality as a result of cardiovascular disease is a major concern, as in 2003 heart disease and stroke were the first and third leading causes of death in the United States. These two elements of cardiovascular disease were responsible for 34.4% of the 2.4 million deaths that occurred in 2003. Strikingly it is seen that with the exclusion of cancer, mortality from heart disease and stroke was more than the combined mortality through the fifteen other leading causes of death in the United States of America (Menshah & Brown, 2007).

Risk Factors, Targeted Risk Factor, and Intervention

In addition to a family history of coronary heart disease, tobacco smoking, hypertension, abnormal blood lipids and lipoproteins, physical inactivity, obesity, and diabetes are risk factors for cardiovascular disease. The presence of two or more factors heightens the risk for cardiovascular disease (Wilmore, Costill & Kenney, 2008). Tobacco smoking is considered to be the most preventable cause of cardiovascular disease.

Tobacco smoke is known to increase the risk for acute myocardial infarction, sudden cardiac death, stroke, aortic aneurysm, and peripheral vascular disease. Very low dose exposure is sufficient to make tobacco smoke a risk for cardiovascular disease. However, this risk is swiftly reduced by cessation of smoking and avoiding exposure to second-hand smoke (Bullen, 2008). This is the reason for the choice of reduced smoking and exposure to second-hand smoke to achieve the aim of reducing the reduction in mortality from cardiovascular disease in the program

Description of the Intervention

In the United States laws prohibiting smoking are not found in all the States, and where it is present, it is restricted to workplaces, restaurants, and bars (CDC, 2004). These laws need to be made uniformly applicable in all states with enhanced restrictions to all places except private residences. This step would reduce the opportunity currently being provided to smokers to smoke when and where they please and thereby reduce their smoking.

In addition, it reduces the exposure to second-hand smoke for non-smokers. This measure reduces the risk for cardiovascular disease and through that the mortality from cardiovascular steps. Additional steps are required at the secondary level, which involves reducing the time taken for interventions to be initiated in patients with acute cardiovascular events like acute myocardial infarction. The emergency department would have to be capable and equipped to take on this function, including initiating reperfusion before the patient is shifted to the acute cardiac intensive care units. Prompt and efficient interventions for patients with acute cardiovascular events will reduce mortality from these events. At the tertiary level, it is necessary to have rehabilitation centers to enable cardiovascular patients to return to as normal a life as possible and reduce the probability of acute cardiovascular events.

Health Promotion Intervention Chart

Intervention level Population targeted Intervention Factor targeted Outcome expected
Primary Total population Fines in case of smoking in places other than private residences Smoking and exposure to secondhand smoke Reduce the risk for cardiovascular disease
Secondary Victims of acute cardiovascular events. Establish Emergency Departments with reperfusion capability to reduce door to needle times for reperfusion. Efficient and quick ambulance service for quick transport. Appropriate and adequate cardiac intensive care units. Mortality from acute cardiac events Decreased mortality from acute cardiac events
Tertiary Persons with chronic cardiovascular diseases. Establish rehabilitation centers Hospitalization from cardiovascular disease and improved quality of life Reduced loss of productive life, probability of an acute cardiac event, and increased life span.

Literary References

Bullen, C. (2008). Impact of Tobacco Smoking and Smoking Cessation on Cardiovascular Risk and Disease. Expert Review of Cardiovascular Therapy, 6(6), 883-895.

CDC. (2004). Impact of a Smoking Ban on Restaurant and Bar Revenues — El Paso, Texas, 2002. MMWR Weekly, 53(07), 150-152.

Menshah, G. A. & Brown, D. W. (2007). An Overview Of Cardiovascular Disease Burden In The United States. Health Affairs, 26(1), 38-48.

Wilmore, J. H., Costill, D. L., & Kenney, W. L. (2008). Physiology of Sport and Exercise, Fourth Edition. Champaign, IL: Human Kinetics.

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