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The Cardiovascular Disease: Crucial Issues

Introduction

Cardiovascular disease (CVD) is a leading cause of mortality in the developed nations. The condition has been the single largest cause of death for a long period in the United States of America. According to Lakic, Tasic, and Kos (2014), CVD is a large burden to the society in terms of mortality and morbidity. Large amounts of resources are also directed to the prevention and control of this health problem. This expense has direct negative effects on the economy of any society. CVD also poses a significant problem in society as it deals with transience and morbidity.

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The burden of CVD is high in the United States. The available statistical findings show that nearly 2,400 Americans succumb to the condition each day to make an average of one death after every 37 seconds (American Heart Association, 2012). The burden of a disease that is associated with CVD is evaluated through the measurement of the resources used in the prevention, treatment, rehabilitation, and other effects of the condition on the society. However, the economic burden of any condition can be classified according to the direct and indirect costs (Lakic, Tasic, & Kos 2014, p. 138). Therefore, the sum of the costs for CVD is high. The following report looks at cardiovascular disease in the United States, its etiology, risk factors, and other political and social issues associated with the condition.

Problem Description

Cardiovascular disease is a group of conditions that affect the cardiovascular system. Some of the diseases in this group include coronary heart disease (heart attack), cerebrovascular disease, peripheral artery disease, congenital heart disease, heart failure, rheumatic heart disease, and hypertension (Kelly, Narula, & Fuster, 2012). In most of the cases where CVD is used, it refers to heart disease and stroke. The condition is mostly associated with the elderly population. Several factors are recognized as predisposing the individuals. Physical inactivity, unhealthy diet, and tobacco use are the main causes of cardiovascular disease (World Health Organization, 2012). Although the condition is not the leading cause of death in the low and middle-income countries, most of the global deaths associated with CVDs are from these regions (World Health Organization, 2012).

The complications of heart disease include heart failure where the heart is unable to pump blood to all other parts of the body (Kelly, Narula, & Fuster, 2012). Coronary artery disease often results from the formation of a clot in the coronary artery. It can lead to sudden death in patients if the clot dislodges. The condition is equally distributed in both sexes in many parts of the world. The World Health Organization puts CVD as a global leading cause of death, with this status being projected to remain the same for a long time in the future (World Health Organization, 2012). An estimated 17 million people died of the direct and indirect effects of CVD in 2008. This figure was 30% of all the deaths recorded globally in the same year (World Health Organization, 2012). Heart attacks and stroke were the leaders in mortality from cardiovascular disease in the same year, representing 12% and 5% respectively (World Health Organization, 2012).

Extent of the Problem

As indicated above, cardiovascular disease is a global leader in mortality and morbidity. Millions of people die each year. In the national and local setting, the condition continues to cause significant damage to the economy in the loss of income and labor. This section looks at the extent of the problem in the USA and the State of Texas.

Nationally

The United States is among the countries that have a high burden of CVD. More people are dying from the condition. In 2008, the number of male people in the population who died from cardiovascular diseases was 392,210, with that of female patients being 419,730 (American Heart Association, 2012). The condition was the leading cause of mortality in the nation. All cancer cases come a distant second (American Heart Association, 2012). The prevalence of stroke in the same year was 14.5% of the male population and 14.8% of their female counterparts (American Heart Association, 2012). The distribution of CVD according to races and ethnicities showed that the black population was more predisposed, with the age adjusted death rates for stroke among this population being 57.6 per 100,000 (American Heart Association, 2012).

The condition is also a significant economic problem. In 2008, the amount of money spent directly and indirectly in the management of heart disease was 190.3 billion dollars (American Heart Association, 2012). Hypertension costs were $50.6 billion, with stroke and other CVDs costing 56.8 billion dollars for the same year (American Heart Association, 2012). The projection of the costs related to CVDs on the national economy shows that more money has to be spent in their management. It is projected that $564 billion will be spent in 2015, $704.7 billion in 2020, $886.2 billion in 2025, and $1117.6 billion in 2030 (American Heart Association, 2012).

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Locally

The burden of cardiovascular disease in Texas is also as high as the national one. Heart disease is the single largest killer in this region. The average in Texas is significantly higher than the United States’ average (American Heart Association, 2012). In 2010 alone, the number of people who succumbed to heart disease is 38,253 (23% of all deaths) (American Heart Association, 2012). The conditions that are categorized as cardiovascular diseases were also independently common in the state of Texas. Stroke ranked the fourth largest cause of death in this state (American Heart Association, 2012). There were 9,180 deaths associated with stroke alone in 2010 (American Heart Association, 2012).

Billions of dollars were also spent in this state to prevent, treat, and deal with the effects of CVDs. The state spent the most amount of money on treatment of the condition. The elderly population was the most affected (American Heart Association, 2012). The region is also high in the rates of obesity and other predisposing factors of cardiovascular diseases such as smoking and alcoholism compared to other states (American Heart Association, 2012).

Etiology and Risk Factors

Cardiovascular diseases are non-communicable. They are caused by the interaction of genetic and environmental factors (Kelly, Narula, & Fuster, 2012). Research shows that the causes of CVDs are either modifiable or non-modifiable, with the major attributable modifiable risk factors being smoking, unhealthy diet, and physical inactivity (World Health Organization, 2012). The modifiable factors are within the control and prevention of the susceptible population while the non-modifiable factors such as genetics are not easily controlled (World Health Organization, 2012). The condition has a peak in the elderly because of the cumulative effects of the predisposing factors.

One of the recognized risk factors is obesity, which predisposes individuals mainly to stroke and heart attacks (Lakic, Tasic, & Kos 2014). Diabetes is also another recognized risk factor, with physical inactivity, smoking, and low socioeconomic status being the other factors (World Health Organization, 2012). The genetic predispositions to the condition reveal the disparity in the prevalence between ethnicities and races in the same geographic region such as the United States (He Hernandez, Fonarow, Liang, Al-Khatib, Curtis, La Bresh Hernandez et al., 2007). The control and prevention of cardiovascular diseases has to target these recognized risk factors.

Impact on Population

The impact of CVD on the population can be grouped into social and economic effects. The economic effects of the diseases include direct loss of income from the treatment of the condition and the loss of labor because of deaths from CVD (Kelly, Narula, & Fuster, 2012). When a person succumbs to A CVD or its complication, the dependents are unable to fill the space that the individual previously occupied. The families may experience financial insecurity. Families and insurance companies also have to pay large sums of money to the health institutions that manage the condition. This means that money that could be used in some important activities is lost.

The deaths from CVD lead to increase in the number of orphans. Many single families exist because of loss of spouses (Kelly, Narula, & Fuster, 2012). However, this effect is not largely felt, as most of people suffering from the conditions are mainly the elderly. The population is forced to take care of the patients of CVD. Time and resources are spent in the process. However, the biggest loser in the event of mortality and morbidity from CVD is the national economy (Kelly, Narula, & Fuster, 2012).

Preventive Approaches

The cost of preventing non-communicable diseases such as CVD is far less than what is spent in their management. Research into the causes of CVD has led to the development of simple strategies and measures that may be applied in the prevention of the condition (World Health Organization, 2012). The World Health Organization (2012) estimates that over 80% of premature mortality from stroke and heart disease can be avoided through cessation of smoking, healthy diet, and regular physical activity.

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The prevention of CVD can simply be done through physical activity for at least 30 minutes in a day (World Health Organization, 2012). Healthy eating entails eating fruits and vegetables as part of the daily meal, limiting the amount of salt taken in a day, and avoiding fast foods (World Health Organization, 2012). The daily intake of salt should be reduced to less than a teaspoon. This strategy is likely to reduce the prevalence of CVD (Lakic, Tasic, & Kos 2014). Smoking tobacco is a recognized cause of CVD. It is estimated that more than one quarter of the CVDs can be reduced through the cessation of smoking (Hernandez et al., 2007). The mortalities from CVDs can be prevented through adequate and timely treatment of conditions.

Available Resources to solve the Problem in the Community

The resources available to solve the problem of CVD in the community can be put to use in the management of CVD. The financial resources available are mainly applied in the treatment of the CVDs, with little proportion of this money going to preventive measures. There is the need to put more finance into preventive measures of CVD compared to the treatment. Some of the interventions that can be applied in financial funding include funding of education and production of education materials.

The other resource that is available at the community level is the community health workers who are used to the prevention of CVDs at the community level through educating the general public on how to stay healthy and disease free (Lakic, Tasic, & Kos 2014). The media is also a resource in the prevention of CVDs. Although it is associated with a sedentary lifestyle and obesity, this tool can be used to prevent CDVs by acting as an avenue of education.

Ethical/Political Issues related to the Problem’s Resolution

The resolution of CVD as a problem affecting the American public has often been associated with several political and ethical issues, as with other health conditions. The prevalence of CVDs in the USA is said to be higher in the Blacks and other minority populations (Hernandez et al., 2007). Despite the rapid growth of the minority populations in the USA, the services accorded to these groups are significantly lower in quality compared to their white counterparts (Hernandez et al., 2007). The level of care for CVDs is one of the factors that have disparity in the population, with insurance companies providing lesser support to the minority populations (Hernandez et al., 2007).

There is progress in primary care for CVDs. However, an ethnic and racial disparity in cardiovascular care is still a significant problem (Hernandez et al., 2007). One of the latest developments in the care of CVD patients is the provision of ICD therapy (Hernandez et al., 2007). However, Black and women CVD patients are less likely to get this therapy in the USA even in the presence of guidelines and indications compared to white men (Hernandez et al., 2007). This observation is a major issue in the management and prevention of CVDs locally and in the USA.

Pertinent Legislation

Legislation is an important part in the control of any health problem. The authorities have a role in the development of policies for prevention and treatment. This section looks at the laws pertaining to the incidence, prevention, management, and control of cardiovascular disease.

International

Internationally, the main body that is tasked with the development of policies on health is the World Health Organization. This body has been in the forefront of developing policies that are aimed at preventing the increased use of tobacco in different parts of the world. Laws have been passed by which each member countries must abide. The WHO has also held a number of conventions that are aimed at developing policies to control hypertension, stroke, diabetes, and other forms of cardiovascular diseases. Smoking and the sale of other commodities listed as illegal drugs are subject to international control. The international laws prohibit the sale of some chemicals that are associated with the etiology of CVD combined with other conditions such as cancer (World Health Organization, 2012).

National

It is vital to investigate the policies that countries have put in place in dealing with health issues in an effort of gauging whether their citizens are safe or not. In the United States, much legislation is dedicated to the prevention of cardiovascular diseases and their management. The main laws in the United States that are related to the prevention of CVDs include the laws on smoking and the insurance policies. Companies that make alcoholic beverage and tobacco products also have to respect the existing policies such as not selling to minors and smoking in public since these acts are prohibited in most states. The Food and Drug Agency is the body that is charged with the security of the nationally available drugs. Some of the commodities that it controls are alcoholic and tobacco products. Therefore, there is adequate legislation at the national level. However, there is still room for more preventive measures.

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Local

In the state of Texas, the prevention and management of cardiovascular diseases is supported by policies and legislation. Some of the significant policies include the use of electronic health records in the improvement of care for the CVD patients (Rossi, & Every, 1997). Collaborative services in the care of these patients are also encouraged using pharmacists in collaborative drug therapy (Kinn, Marek, O’Toole, Rowley, & Bufalino, 2002). The legislation used in the state is in line with the international and national guidelines, including the monitoring of progress for the CVD patients. The state of Texas is also in the process of ensuring that smoking becomes controlled. Smoking in public places is prohibited. Tobacco and alcohol companies have to abide by advertising and marketing policies in place where they are not allowed to sell to minors.

Conclusion

Cardiovascular disease is a significant global, national, and local health problem. Thousands of deaths that are witnessed every year are associated with the disease. CVD is a non-communicable condition that is prevalent in all parts of the world, mostly in the low and middle-income countries. The main problem associated with the condition is the loss of economic resources in a community where many hours are spent in the treatment of the condition. The report indicates that CVD is the leading cause of death in the United States. The prevalence is likely to increase over the next few years. The economic burden from CVD is also likely to increase over the next few decades if no interventions are put in place. The main interventions recognized as preventing CVD include cessation of smoking, eating a healthy diet, and engaging in regular physical exercises.

Summary

The burden of cardiovascular disease is large. It is ever increasing in different parts of the world. This report has looked at the definition of CVD and conditions that are witnessed in this group are states, with the most prevalent being heart failure and stroke. The main risk factors stated in the report include smoking, unhealthy diet, and lack of physical activity. The report has looked at the international, national, and local implications of CVD, with these implications being classified into direct and indirect effects. The suggested approaches in prevention include cessation of smoking, exercise regimes, and fruit and vegetables in the diet. The political and ethical issue in the condition management is the racial and ethnic disparities in the USA. Policies at the international, national, and local levels have been discussed to be related to CVD in the report. The conclusion is that more effort needs to be put in the management of CVD since it is a social and economic health problem.

Reference List

American Heart Association. (2012). Heart and Stroke Statistics-2012 Update. Dallas, TX: American Heart Association.

Hernandez, A., Fonarow, G., Liang, L., Al-Khatib, S., Curtis, L., La Bresh, K., Yancey, C., Albert, N., & Peterson, E. (2007). Sex and Racial Differences in the Use of Implantable Cardioverter-Defibrillators Among Patients Hospitalized with Heart Failure. JAMA, 298(13), 1525 –1532.

Kelly, B., Narula, J., & Fuster, V. (2012). Recognizing Global Burden of Cardiovascular Disease and Related Chronic Diseases. Mount Sinai Journal of Medicine, 79(1), 632–640.

Kinn, J., Marek, J., O’Toole, M., Rowley, M., & Bufalino, J. (2002). Effectiveness of the electronic medical record in improving the management of hypertension. Journal of Clinical Hypertension, 4(6), 415–9.

Lakic, D., Tasic, L., & Kos, M. (2014). Economic burden of cardiovascular diseases in Serbia. Vojnosanit Pregl, 71(2), 137–143.

Rossi, R., & Every, N. (1997). A computerized intervention to decrease the use of calcium channel blockers in hypertension. Journal of General Internal Medicine, 12(1), 672–8.

World Health Organization. (2012). World health statistics, 2012. Geneva: World Health Organization.

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