Heart Diseases and Risk Management Approaches

Introduction

The teaching plan allows for the improvement of family health characteristics among specific populations. The teachings will be focused on promoting, protecting and improving the health of individuals, and communities at large. The undesired behavior of family members will be shaped. Through community teaching, a person will learn to positively influence the health behavior of individuals, groups, and communities while addressing lifestyle factors, such as nutrition, physical activity, sexual behavior and drug use, and living conditions that influence health. The lesson focuses on heart disease as a potential health concern in the family

What is heart disease?

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Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. One person dies every 36 seconds in the United States from cardiovascular disease. About 655,000 Americans die from heart disease each year, that is 1 in every 4 deaths (CDC, 2020). Heart disease costs the United States about $219 billion each year from 2014 to 2015. This includes the cost of health care services, medicines, and lost productivity due to death.

High-Risk Approach versus Population Approach

According to perspectives on prevention, the lesson will elaborate on the high-risk approach versus the population approach. The traditional epidemiological studies of determinants of cardiovascular disease offer the opportunity to target those individuals who are likely to develop heart disease and those most likely to benefit from prevention and treatment efforts and, thus, could play a role in preventing and controlling cardiovascular diseases. (Virani et al., 2020) The results of the programs using the high-risk approach(sometimes call it individual approach) proved that they were efficient to reduce the incidence of cardiovascular disease among the high-risk individuals even in less than five years. Most major large-scale community-based cardiovascular disease intervention projects use a population approach or a combination of a high-risk approach and population approach “comprehensive community-based approach.

Single Cardiovascular Risk-Management versus Comprehensive Cardiovascular Risk-Management

According to how many risk factors are targeted, the programs can be classified as Single Cardiovascular Risk-Management versus Comprehensive Cardiovascular Risk-Management. Cardiovascular disease (CVDs) prevention too frequently focuses on single risk factors rather than on comprehensive cardiovascular risk. There were many prevention programs that only addressed one risk factor of CVD to test the effect of the targeted risk factor change or its impact on CVD incidence, morbidity, or mortality, such as high blood pressure control, cholesterol concentration reduction, changes in nutrition, community-based smoking cessation (Virani et al., 2020). Although the single cardiovascular risk-management approach can be effective, many intervention studies demonstrated that for CVD prevention activities to achieve the greatest benefits, a paradigm shift is required from the treatment of risk factors in isolation to a comprehensive cardiovascular risk-management approach. People should focus on an integrated multifactorial approach in community primary prevention for CVD is also because two or more cardiovascular risk factors clustering in one person is very common in the real life, and the clustering of risk factors may act synergistically increasing the risk more than any one single factor acting alone. The majority of the major community-based intervention projects, that use the population approach also deal with more than one “classical” risk factor at the same time and emphasized both diet and smoking.

Individual behavior Change versus Policy and Environmental changes

According to the components of interventions, the programs can be classified as Individual behavior Change (educational approach) versus Policy and Environmental changes. Community-based CVD prevention projects in the USA, such as Stanford Three-Community Study, Stanford Five-City Project, Minnesota Heart Health Program, Pawtucket Heart Health Program, and Community Intervention for Smoking Cessation (COMMIT), are the representatives of individual behavior change approach users (Virani et al., 2020). The projects recognize the multifactorial nature of the cardiovascular disease and consistently advocate approaches involving multiple strategies across multiple channels and across all sectors of the population. However, their main focus has been on interventions to encourage individual behavior change, on information and skill-building. Environmental and policy approaches have not received much attention in the projects in the United States. Given the limited perspectives, the projects could not achieve the greatest impact in comparison to the projects that used policy and environmental approaches. For example, in Stanford Five-City Project, the intervention conducted in the treatment cities was a 6-year multifactor risk reduction program including newspapers, television and radio, mass-distributed print media, classes, contents, and correspondence courses (Virani et al., 2020). The results showed that changes in risk factors were observed, but no evidence of a treatment-control difference in terms of combined-event rate of cardiovascular disease.

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Interventions for secondary prevention

Patients with established CVD constitute one of the highest risk groups. Secondary prevention involves identifying, treating and rehabilitating these patients to reduce their risk of recurrence, decrease their need for interventional procedures, improve their quality of life and extend their overall survival. Research has demonstrated the effectiveness of community-based secondary prevention interventions in the control of CVDs (Virani et al., 2020).

The quality of life should be a key objective of interventions for patients with CVD, not only to prevent or retard the progression of the underlying disease but also to alleviate symptoms and to improve the patients’ functional capabilities. However, few community-based interventions for patients with CVD address their impacts on patients’ quality of life. One reason is that a sensitive and valid tool for assessing of quality of life for CVD patients may not be available. Lack of assessment instruments makes it difficult for health service providers to identify the needs of patients, and less fitted interventions or services provide. Here I will briefly describe the existing quality of life assessment tools and indicators for testing the effectiveness of CVD interventions or treatments.

Evaluation of Teaching Plan

Prevention at the family level is essential because modifiable causal risk factors are deeply entrenched in the social and cultural framework of society. From the limited publications included in this paper, several experiences and evidence should be completely understood and emphasized (CDC, 2020). The primary intervention is directed to susceptible people before they develop cardiovascular disease. The key objective of primary prevention is to reduce the incidence of heart disease and, consequently, its sequelae. A key component of any public health strategy is to reduce the rising burden of CVD in low and middle-income countries. However, people should avoid completely using less cost-effective secondary interventions, such as high-tech methods to identify patients, and pharmacological methods to treat patients.

Conclusion

Cardiovascular risks often occur as a continuum throughout the population. Shifting population distributions of exposure can gain a large potential reduction in CVD morbidity and mortality. A combination of high-risk and population-based approaches is essential to shift the cardiovascular risk profile. Prevention through population-wide behavior modification will be more cost-effective than high-risk approach intervention. The changes in risk achieved in population-based studies are often small, but it should be realized that even small changes in the distribution of risk factors in the population will bring about sizable changes in CVD mortality as demonstrated in different countries. Individual-centered efforts are appropriate for the “early adopters” in the community to make positive health choices based mainly on new information. Most of the community intervention programs are limited to community residents aged 25 years and over. Family assessment or diagnosis should be included in the first phase of a family intervention program for CVD prevention and control. Such considerations will improve the overall family well-being and prevent the risk of health disease.

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References

Centers for Disease Control and Prevention. (2020). Underlying Cause of Death, 1999–2018. CDC WONDER Online Database. Atlanta, GA: Centers for Disease Control and Prevention.

Virani, S., Alonso, A., Benjamin, E., Bitten, M., Callaway, C., & Carson A. (2020). Heart disease and stroke statistics—2020 update: a report from the American Heart Association external icon. Circulation141(9): 139-596. Web.

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