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CardiovascularDisease

Epidemiology

Cardiovasculardiseases have been the major cause of death, with 30 percent of thepopulation worldwide suffering from the disorder. The death tolls arenormally higher in developing countries about 80 percent of totaldeaths caused. Projections indicate that over 23 million people willbe suffering from the disease by 2030[ CITATION Cla02 l 1033 ].

CardiovascularDiseases (CVD) disease is also known as heart disease. The disorderentails numerous problems related to atherosclerosis. The conditiondevelops as a result of build up of plaque around the walls of thearteries making it hard for blood to flow through. The CVD developsat differing rates in different people. The risk to CVD increasewith increase in smoking, heredity factors and abnormal cholesterollevels. Cardiovascular disease (CVD) is the term used to describeatherosclerosis, or hardening of the arteries, as it affects theheart. It is an expression of progressive damage to (or some thinknatural aging of) the blood vessels that nourish the heart. Theseblood vessels, or coronary arteries, start off, as do all arteries,with a smooth inner lining. Over time, material becomes imbedded inplaques, or deposits, under the inner lining. This material is amixture of cholesterol, fatty acids, and scar tissue ongoinginflammation is an active part of this process. Such risks damagearterial lining and enhance rapid development of the plaques[ CITATION Fri09 l 1033 ].

CVDcan be in form of heart failure, arrhythmia or heart valve problems.Heart failure results from improper pumping of the blood. Arrhythmiaresults from abnormal heart beats. The heart valve problems resultfrom constriction of the values making it hard for the blood toflow[ CITATION Gor13 l 1033 ].

  1. Major causes of CVDs

CDVbegins as early as during teenage. The body starts by resistinginsulin secreted by the pancreas leading to Type 2 diabetes andconstriction of the blood vessels. Insulin resistance can also leadto severity of cardiovascular disease leading to heart attack. Themajor causes of CVD include, smoking, increased cholesterol and fatsin the blood, high blood pressure, insulin resistance andinflammation of blood vessels[ CITATION Hof09 l 1033 ].

    1. Smoking

Thechemicals contained in tobacco harms the blood cells and affect thefunctioning of the heart. The damage to the blood cells and heartincrease the risk to atherosclerosis that causes the build up ofplaque. The build up and accumulation of plaque over time hardens andcauses narrowing of the blood arteries. This limits oxygen flow inthe circulatory system[ CITATION Mer06 l 1033 ].

    1. Increased cholesterol and fats in the blood

Increasedblood cholesterol refers to the condition when there is too muchcholesterol and fats in the blood. Too much cholesterol in the bloodaccumulates at the wall of the arteries and increases risks todevelopment of heart diseases[ CITATION Mer06 l 1033 ].

    1. Blood pressure

Bloodpressure refers force by the blood against arteries due to pumping ofthe blood by the heart. Increased pressure damages the body. High blood pressure increases vulnerability to heartattacks[ CITATION Hof09 l 1033 ].

    1. Insulin resistance

Insulinhormone is normally secreted in the pancreases and released to theblood by beta cells. The hormone enhances metabolism to avail energyto the body. Insulin resistance results when the produced insulin isnever put into effective use. This results in build up of glucose inthe blood rather than being absorbed by body cells. As a result,pancreas responds by producing more insulin. This exposes one todiabetes[ CITATION Rod04 l 1033 ].

  1. How to address the disease

    1. Avoid smoking

Carbonmonoxide from cigarette smoking reduces the amount of oxygen in theblood. This makes the heart to pump the blood harder to supply therequired oxygen. This increases the risks to heart attack. Inprevention of CVD, any amount of smoking is not recommended. Avoidingsmoking decreases the risks to heart diseases[ CITATION Cla02 l 1033 ].

    1. Physical exercise

Increasedphysical exercises reduce the risks to fatal heart diseases. Thishelp in controlling the body weight and reduces chances of developingother complications like high blood pressure, diabetes and highcholesterol levels.

    1. Eating healthy diet

Thisinvolves development of appropriate eating plan rich in fruits, wholegrains and proteins. Fats should be limited, especially the saturatedand trans fats such as red meat, margarines, crackers, coconutproducts and palm oils. A heart healthy diet should also keep offfrom alcohol. Various studies show that attention to modification oflifestyles can reduce progression of CVD progressively. Weight lessis effective in improving the cardio metabolic risk factors. Despiteabsence of controlled clinical trials on CDV weight loss events, thecardiometabolic risk factors decrease with improved physicalactivity[ CITATION Rod04 l 1033 ].

  1. Questions

  1. Why should the local health review the strategies used on cardiovascular disease?

Cardiovascularhas been considered as the leading cause of death, with people in lowsocioeconomic groups being the most adversely affected. Most of CVDis influenced by poor lifestyles, hence tackling the associated risksat population level saves the local health economy and ensuresachievement of various health outcomes.

  1. What information does the department require to mitigate the proliferation of the disease?

Thelocal health department must be aware of the CVD risk factors and themajor evidence-based approaches which have already been approved. Thelocal policies must ensure that people access healthy and affordablediet.

  1. What services does the department offer in their CVD prevention programme?

Helpingthe locals change their attitudes is critical part of CVD sinceindividualized prevention may not reduce overall prevalenceeffectively. Population based approaches tackles the economic, socialand environment factors which underpin the CVD risks and reduce thehealth inequalities.

  1. What is the estimated sustainability of the CVD prevention programmes?

Atpopulation level, the CVD programme must be effective, with a minimumefficiency duration of five years. The local health department musttherefore ensure complete funding and should be adequately staffed.

  1. How does the local authority include health when giving specifications for providers?

Theprimary care providers and local authorities must adopt practiceswhich prevent the prevalence of CVD. The local authority plays a keyrole by ensuring that the standards are included in all nutritionalcontent and tenders.

    1. Rudimentary protocol[ CITATION Gor13 l 1033 ]

Standard

Requirement

Strategy review

The department board must eliminate all the CVD associated risks and ensure health outcomes are achieved. This can be achieved by ensuring that the people are on appropriate diet, engage in physical activities and avoid smoking and alcohol. County and district councils should develop a coordinated approach towards reviewing the CVD.

Required Information

The department should seek all the information on CVD risk factors and the formulated policies should be favourable to the people to enhance accessibility of the services offered.

The department must formulate a comprehensive control strategy for tobacco to protect young people from smoking and young children from effects of second hand smoke.

Services offered by prevention programme

The management of the department must ensure that people are aware of the proper methods of preventing prevalence of the disease. Population based approaches should be used as opposed to individual based approaches to reduce the health inequalities.

The department must treat people with polypill and develop good practice criteria in execution of the population-wide initiatives.

Programme sustainability

The programme should be effective and must have a minimum duration of five years. The department should ensure enough staffing and funding of the programme for at least five years. The senior figures should be identified by primary health care organizations and local authorities towards prevention of CVD.

Specification for health providers

The department should ensure that all the standards are included in their tender documents to alert the providers on the measures to be put in place.

This should include:

  • Healthy meal specifications

  • Include nutritional content in tender documents

  • Include the health principles in specifications for the health suppliers

  • Impact assessments should be included in the specifications for the suppliers across the entire procurement stream

  1. Recommendations for prevention of proliferation of CVD

    1. Smoking cessation

Allnon smokers must be discouraged from smoking and non smokersencouraged to quit smoking and supported in their efforts. Thisnicotine replacement therapy and amfebutamone must be offered for theaddicted smokers[ CITATION Fri09 l 1033 ].

    1. Dietary changes

Theorganization should encourage the people to reduce the intake ofsaturated fats. They should advocate for a 30 percent reduction ofcalories and the intake of transfatty acids. People must beencouraged to reduce the intake of salts by a third. People should beencouraged to take at least 400gm of vegetables and fruits[ CITATION Fri09 l 1033 ].

    1. Antihypertensive drugs

Peoplewith blood pressure above 160/100mmHg must be supplied with drugs andadvised on specific lifestyle to lower the blood pressure andexposure to cardiovascular diseases. All people with less than160/100nmmHg blood pressure must be managed based on cardiovascularrisk. Also, the organization can invite the health physicians toadvice people on the steps that need to be taken towards protectionof the heart. This may include free check ups for blood pressure andbody mass index among others[ CITATION Rod04 l 1033 ].

    1. Physical activity

Allpeople must be encouraged o engage in physical exercises. Regularexercise strengthens the heart and increases the HDL cholesterol thatkeeps the arteries free of constriction. This also lowers the bloodpressure by burning the extra fats. The organization must ensure atleast 30 minute moderate exercise session regularly[ CITATION Rod04 l 1033 ].

    1. Weight control

Peoplewho are overweight must be encouraged to start the weight reducingprograms through use of reduced energy-diet and the increasedphysical activities. People should be taught on how to take rightfoods that normally lowers the cholesterol level and slashes therisks to heart attack. This can be achieved through proper educationon appropriate intake of all food proportions. Increased cholesterollevels lead to build up of plaque.If you already have coronary artery disease or diabetes mellitus andyour LDL is over 100, your doctor will probably recommend you takecholesterol-lowering drugs to get your LDL below the 100 mark[ CITATION Gor13 l 1033 ].

    1. Use of lipid lowering drugs

Peoplewith total cholesterol above 8mmol/l must be encouraged to startlipid lowering programme. They should be given the statin drug whichlowers the risk to cardiovascular disease. People with coronaryartery diseases must be encouraged to take cholesterol lowering drugsto lower the LDL level below 100[ CITATION Cla02 l 1033 ].

References

Clarke, R. (2002). Commentary: An Updated Review of the Published Studies of Homocysteine and . International Journal of Epidemiology 31(1), 70-71.

Friis, R., &amp Thomas, A. (2009). Epidemiology for Public Health Practice. Sudbury, MA: Jones and Bartlett.

Gordis, L. (2013). Epidemiology. Philadelphia, PA: Elsevier/Saunders.

Hofman, A. (2009). Recent Trends in Cardiovascular Epidemiology. European Journal of Epidemiology 24(12), 721-23.

Merrill, R., &amp Thomas, C. (2006). Introduction to Epidemiology. Sudbury, MA: Jones and Bartlett.

Rodriguez-Artalejo, F. (2004). Cardiovascular Epidemiology and Prevention. Journal of Epidemiology &amp Community Health 58(2), 116-19.