A Novel Program to Prevent Heart Attacks and Strokes in the United states
It is a well-known fact that nearly 50 percent of the major diseases affecting humanity are lifestyle related. For example, diabetes is common in the obese; high-salt intake favors the onset of hypertension; about two thirds of lung cancers are related to cigarette smoking; high-fat intake and smoking cause heart disease and strokes; and sedentary habits lead to multiple problems in the body. Interestingly, many of these afflictions can be prevented by a few basic lifestyle changes along with regular intake of simple drugs. And yet most people are reluctant to follow these easy-to-practice instructions with the result that heart disease and stroke continue to be leading causes of death in this country.
So, what is the answer? Recently, the Department of Health and Human Services (HHS) unveiled an ambitious plan to reduce the burden cardiovascular diseases. This ‘Million Hearts Initiative’ aims to prevent 1 million heart attacks and strokes over the next five years through appropriate clinical interventions, including changes in dietary habits, promoting regular exercise and cessation of tobacco abuse.
Strokes and heart attacks strike more than 2 million Americans each year, and almost half of them die, according to HHS. The survivors are often left with significant disability, which takes them out of the workforce. "This isn't just a human tragedy, it's also a huge drain on our economy," said HHS Secretary Dr. Kathleen Sebelius in a recent press conference. Most of us are unaware that the medical costs and lost productivity related to cardiovascular disease add up to a whopping $450 billion a year.
The cure, it appears, is far less expensive. "We know that most heart attacks and strokes can be prevented with simple, low-cost care," added Sebelius.
This program brings together such diverse partners as the American Heart Association, the American Medical Association, the YMCA, Walgreens, the American Pharmacists Association, America's Health Insurance Plans, and numerous government agencies, including the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS). This would mean that you can walk into any Walgreens and get a free BP check and even some advice from the nurse on duty or pharmacist. Most health insurance plans now covers your trip to YMCA and other health maintenance programs and screening.
Although heart attacks may have decreased to a small extent over the past decade, the incidence of strokes has definitely increased since the early 2000. And, the disability from strokes continues to be a significant problem in spite of the advent of major interventions during the acute phase. This private-public partnership may finally lead us to quantifiable measures of improvement in these two devastating medical conditions.
To understand this concept better, one needs to know the ‘ABCS’s of prevention of cardiovascular diseases. These are AAspirin for high-risk patients, control of Blood pressure and Cholesterol, and Smoking cessation.” You will be surprised at the variance in these measures among the patients at large, even among those who are supposedly on right therapy. And this would need to improve.
Which is exactly the intention of this novel initiative? By 2017, the partnership aims to “increase the use of aspirin among people at high risk to 65 percent from 47 percent today, the percentage of those whose blood pressure is under control to 65 percent from 46 percent, and the percentage of people with their cholesterol at recommended levels to 65 percent from 33 percent.” It also aims to cut the smoking rate to 17 percent from 19%, and work with the food industry to reduce sodium intake by 20 percent and intake of artificial trans fats in foods by 50 percent.” The daily salt intake in America by far is much higher than many other countries in the world.
"If we reach our goals, 10 million more Americans with high blood pressure will have it under control; 20 million more Americans with high cholesterol will have effective treatment; 4 million fewer Americans will smoke; consumption of artificial trans fat will be cut by half and of sodium 20 percent," said Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention.
And it would result in the prevention of one million heart attacks and strokes in the next five years, definitely the right solution for a serious contemporary problem. So, add a few healthy habits and some activity too into your life. And don’t forget to take the drugs your doctor has prescribed.
Dr. M. P. Ravindra Nathan is a Brooksville cardiologist.