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Heart Disease and Stroke Prevention Strategies

Introduction

The policy issue under analysis is heart disease and stroke prevention. It analyzes various strategies and methods to reduce morbidity and mortality associated with different heart diseases. The purpose of this analysis is to identify the most efficacious policy strategies that can help prevent heart diseases and strokes, thereby increasing the survivability of patients with heart problems. This analysis targets the level of policy related to public and social health.

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The significance of the chosen issue is extremely high, as in the USA, in general, and in Florida, in particular, approximately 30% of all deaths are accounted for by various heart diseases. This staggering number of deaths is explained by the fact that more than half of the American population has at least one of the main risk factors for heart diseases, namely, smoking, high cholesterol, and high blood pressure. In 2014, in Florida, almost 43,000 people were hospitalized with a heart attack (Mozaffarian et al., 2016). Thus, the main question of this policy analysis is what methods are the most effective in eliminating these and other risk factors in order to reduce the mortality rates related to heart diseases.

Background

Heart diseases belong to cardiovascular diseases, a group of illnesses that involve blood vessels and heart. The most common heart diseases include Arrhythmia, Ischemic Stroke, Atherosclerosis, Heart failure, Heart Valve Problems, and Heart Attack. In the USA, the most widespread kind of cardiovascular disease is coronary artery disease (CAD) that can cause a stroke or heart attack (Sherwood, Smith, Hinderliter, Georgiades, & Blumenthal, 2017).

A stroke can cause brain damage and, in severe cases, death. It occurs when the brain or its part does not receive enough blood in order to function normally. It can happen when a blood vessel in the brain is clogged by a blood clot or simply bursts. Thus, if the brain does not receive enough oxygen that is transited by blood, the brain cells begin to die in several minutes. The type and degree of disability caused by a heart attack depend on the time without treatment and the intensity of the stroke (Gosmanova et al., 2016).

Heart diseases have been known to people since ancient times. However, only in the second half of the twentieth-century such treatment advances as stents, angioplasty, and bypass surgery were introduced, thereby making a diagnosis of heart diseases no longer a death sentence. Additionally, there is a great amount of literature that analyzes all types of heart diseases, along with the treatment and prevention strategies. There are also articles that provide the annual update of the statistics related to heart diseases (“Heart disease and stroke,” 2017).

As for the existing policies that address the chosen issue, there are several of them in the USA. In Florida, the main program regarding stroke and heart diseases is called “Heart Health+” and consists of several policies. Each County in Florida selected slightly different strategies to address these policies. Nevertheless, overall, they are similar and include Tobacco Cessation and Blood Pressure Self-Monitoring strategies and the programs that are called “Hypertension Control Champions” and “100 Congregations Million Hearts” (“Heart Health+,” 2017).

The main existing policy is Blood Pressure Self-Monitoring, which presupposes that patients measure blood pressure outside of hospitals. In this case, they have to have a device that measures blood pressure and measure it regularly. All the counties in Florida were instructed to carry out a program of Blood Pressure Self-Monitoring in their community and cooperate with the local Tobacco Free Florida Quit Counselor to integrate Tobacco Cessation strategies into the program (“Heart Health+,” 2017).

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The main strength of the identified policy lies in its efficacy, as fluctuations in blood pressure are a reliable indicator that demonstrates that there are some problems with a heart, and supporting the use of blood measuring devices can reduce the morbidity. As for the shortcomings, the most prominent of them is that it is impossible to observe everyone and know whether they are smoking and whether they measure blood pressure regularly or not.

The key stakeholders that are affected by this policy are people who have heart problems, as they have to frequently measure their blood pressure and if they smoke, they have to give it up, medical institutions, as they have to give these recommendations to all patients and control that they follow them, and various healthcare organization that promote these strategies and increase public awareness regarding heart diseases (“Heart disease and stroke,” 2017).

Analysis

In order to achieve the maximum result, in Florida, there are alternative policies that are used to address the problem of heart disease and stroke. Thus, the program called “Hypertension Control Challenge” is a competition introduced by the Million Hearts initiative that identifies practices, health systems, and clinicians that worked with patients in order to achieve the above 75% control rates of hypertension using innovations in electronic health records and health information technology, health care team, and patient communication. All the counties in Florida were instructed to cooperate with a health system in order to officially become a Hypertension Control Champion.

Their goal is to use standardized strategies to control high blood pressure and to promote the cessation of tobacco, and they will support the clinical decision at the point of care in order not to miss any opportunity to achieve full control. Additionally, they will assist the system of health by either implementing the Toolkit for the Undiagnosed or reporting on the clinical quality methods of the Million Hearts (“Heart Health+,” 2017).

Another alternative policy is called “100 Congregations for Million Hearts”. Its goal is to gain the support from various faith-based organizations in order to increase public awareness regarding the risks of stroke and heart disease and inform people about the prevention focusing on the control over high blood pressure. All the counties in Florida were instructed to cooperate with at least two faith-based organizations in the area and help them join “100 Congregations for Million Hearts”. They will help to develop various leadership messages concerning diabetes and heart health awareness. Additionally, they will partner with the organizations in order to host a couple of community events in each organization that focuses on the prevention of heart diseases (“Heart Health+,” 2017).

The criteria for the best policy are a wider scope of influence, fast operating speed, and efficaciousness. Each of the mentioned alternatives has even a greater impact on healthcare and patient outcomes than the main policy, as they are more extended. Thus, compared to the main policy, they engage more stakeholders in the process, provide more opportunities to control the patients’ state of health, and propose to use innovative technologies. All these significantly increase the quality of healthcare. As for the trade-offs between the alternatives, mostly, they complement each other, but overall the program called “Hypertension Control Challenge” is more promising (“Heart Health+,” 2017).

Recommendations

Overall, considering the policy situation in Florida and the current issue, the program entitled “Hypertension Control Challenge” is the best alternative. The rationale for such a selection is that this program comprises all the essential strategies from other alternatives and focuses on innovative technologies when addressing the prevention of the chosen policy issue.

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In order to implement the chosen alternative, it is crucial to consider certain strategies. First, it is important to engage all the stakeholders in the Million Hearts’ competition for the reduction of hypertension. The second strategy is to adopt methods to control the cessation of tobacco and high blood pressure. The third strategy is the implementation of the Toolkit for the Undiagnosed. Finally, it is essential to innovative technologies that can significantly ameliorate the situation.

Among the possible barriers to implementation of this alternative are the lack of financial support on the side of government and private organizations, people’s addiction to tobacco, and people’s resistance to new technologies (“Heart Health+,” 2017).

The best method to evaluate the chosen policy implementation is to conduct a survey in order to find out how the morbidity and mortality rates of heart diseases have changed. Additionally, it is important to conduct several interviews with patients and ask them how they use of new technologies has influenced their overall state of health and whether they are effective (DeFilippis et al., 2016).

Discussion

According to the analysis, one main policy and two alternative policies were identified in order to address the issue under analysis. Thus, one of the alternative programs entitled “Hypertension Control Challenge” proved to be the most effective as related to the main question identified, namely, to reduce the main risk factors for high blood pressure, high cholesterol, and smoking, thereby reducing morbidity and mortality rates from heart diseases. As for the recommendations, this program is chosen as primary. Also, it can help influence the level of policy it is intended to address, namely, it will significantly increase public and social health (“Heart Health+,” 2017).

As far as the limitations of the analysis are concerned, there are not many. The most prominent of them is that it is difficult to understand whether the proposed strategies have been successful or not, as people can often lie about smoking when they cannot control themselves or about measuring blood pressure when they simply forget about it (Gosmanova et al., 2016).

In terms of implications for practice, it is obvious that the analyzed policies relate directly to practice, as they consider purely practical issues that can help reduce the incidence of heart disease and stroke. Regarding the implications for education, it is crucial that people be aware of dangers of the cardiovascular illnesses and all possible strategies of their prevention. As for the implications for research, it is essential to conduct further studies in order to improve the existing strategies of treatment of heart diseases. Concerning the implications for policy-making, it is important to introduce policies and put into practice new methods and strategies aimed at dealing with heart disease and stroke (Sherwood et al., 2017).

Conclusion

In conclusion, it can be emphasized that three policies were analyzed in order to address the problem of heart disease and stroke in Florida. One of them called “Hypertension Control Challenge” proved to be the most promising, as it has a wider scope, involve more stakeholders in the process, and can be quickly and effectively implemented. In the future, it is recommended to consider questions about other less common risk factors for heart diseases such as atherosclerosis, various inborn pathologies, diabetes, obesity, angina pectoris, and so on. Additionally, in future studies, it is important to place a major focus on innovative technologies, as they are the key to successful treatment of heart disease and stroke.

Appendices

Appendix 1

Alternatives Effectiveness
Hypertension Control Challenge Most effective
Tobacco Cessation and Blood Pressure Self-Monitoring Average
100 Congregations for Million Hearts Least Effective

Appendix 2

The most common risk factors for heart disease and stroke
1. High blood pressure
2. Smoking
3. High cholesterol
4. Obesity
5. Diabetes
6. Inborn pathologies
7. Atherosclerosis
8. Angina pectoris

References

DeFilippis, A. P., Young, R., McEvoy, J. W., Michos, E. D., Sandfort, V., Kronmal, R. A.,… Blaha, M. J. (2016). Risk score overestimation: The impact of individual cardiovascular risk factors and preventive therapies on the performance of the American Heart Association-American College of Cardiology-Atherosclerotic Cardiovascular Disease risk score in a modern multi-ethnic cohort. European Heart Journal, 38(8), 598-608.

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Gosmanova, E. O., Mikkelsen, M. K., Molnar, M. Z., Lu, J. L., Yessayan, L. T., Kalantar-Zadeh, K., & Kovesdy, C. P. (2016). Association of systolic blood pressure variability with mortality, coronary heart disease, stroke, and renal disease. Journal of the American College of Cardiology, 68(13), 1375-1386.

Heart disease and stroke. (2017). Web.

Heart Health+. (2017).

Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M.,… Howard, V. J. (2016). Executive summary: Heart disease and stroke statistics –2016 update: A report from the American heart association. Circulation, 133(4), 447-454.

Sherwood, A., Smith, P. J., Hinderliter, A. L., Georgiades, A., & Blumenthal, J. A. (2017). Effects of exercise and stress management training on nighttime blood pressure dipping in patients with coronary heart disease: A randomized, controlled trial. American Heart Journal, 183(4), 85-90.

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