Final Health Paper - heart disease

Running Head: Cardiovascular Disease 1
Cardiovascular Disease:
A World Health Issue
Andrew Blumenreich
Professor Christine Connolly, PhD
HEA 470
18 June 2014

Cardiovascular Disease: A World Health Issue
Across the world, there aren’t many things that have a larger scale and are more
prominent than the health industry. The health industry is important whether you are examining
it from a country-to-country level or you look deeper and examine a small community. For
example, in Westchester County, New York, the health industry is tied into: politics, the
economy, and both social and cultural events. The health industry rapidly changes and grows all
the time; this is why the health industry plays a vital role in each and every one of the lives of the
residents of Westchester County. Having a health industry that residents can rely on to protect
them and keep them safe is what every person expects and deserves. Unfortunately, health
awareness is still not where it needs to be and there are many diseases that have an affect on
people’s lives on a daily basis. One of those diseases is heart disease. Heart disease is one of the
leading causes of death in America. Based on studies it has been shown that heart disease kills
one American every 39 seconds (WP Hospital, 2014). As a result many steps are being taken to
prevent and slow down the rate of death caused by heart disease in Westchester County.
There are many social and cultural events that take place in Westchester County. The
main goal of these events is to try to raise the average persons knowledge of heart disease. Most
people are aware of what heart disease is but they do not understand how to take steps to prevent
heart disease. Since heart disease can affect everyone, there are events that take place all over
Westchester for all different types of people. One of the events that took place was at The
Westchester, in White Plains. This event was designed to teach senior citizens about the
symptoms of heart disease, and also how to check for signs of heart disease daily using a new
self-monitoring blood pressure system (Med, 2014). The event was also fantastic because it
offered people an opportunity to be a part of a healthy walking initiative. This program allows its

members to walk around the mall, which is great exercise. Another event that takes place around
the Hudson Valley area is called Go Red for Women. This event strives to teach women about
the signs of heart disease, by having teaching seminars. A lot of people believe heart disease is
more prominent in men, but heart disease is actually the number one killer of women. In fact
heart disease kills more women than all forms of cancer combined (HV Heart, 2014). An event
like Go Red for Women is important because it teaches women that with minor changes to their
lifestyle eighty-three percent of coronary events can be prevented (HV Heart, 2014). With more
and more events taking place around Westchester County, people are beginning to understand
the severity of this disease. Events like these are crucial to prevent heart disease going forward.
To prevent future cases of heart disease, there is a lot of lobbying that goes on to make
sure that hospitals have the greatest opportunities to treat patients. That’s why the Westchester
area has some of the best hospitals and some of the newest technology that’s used for treating
patients. An example of this is White Plains Hospital, which received Echocardiography
accreditation by the IAC (WP Hospital, 2014). This type of accreditation is really hard to receive
and only goes to the best hospitals that demonstrate a high ability to meet and satisfy specific
regulations. Another great local hospital, which has shown and proven to have a great ability to
treat patients that are diagnosed with heart disease and symptoms of heart disease, is Northern
Westchester Hospital. Northern Westchester hospital follows all of the regulations set by the
American Heart Association and American Stroke Association (NW Hospital, 2014). Hospitals
in Westchester are also using state of the art technology, which makes treating patients who have
had strokes and other cases of heart disease much easier than in the past. This has all happened
because of the demands of the people over the 20th and 21st century, to put the best equipment
and best doctors available into these hospitals.

One problem that some people are facing in Westchester County is finding a way to pay
for their prescription drugs. The way that the economy is today, it is very hard for people living
in Westchester County to afford their medication. Westchester County is one of the most
expensive places to reside in, in the United States of America; with average property taxes
costing $9,647 per year. While the average property taxes for sixty percent of counties in the
United States is $500 to $1,500 per year (Sahadi, 2013). It is even harder for residents of
Westchester County who have no insurance to come up with enough money to be able to afford
the pills that they need to maintain a healthy lifestyle. It gets even worse when you realize that
people suffering from heart disease; need to take so many different pills ranging from high blood
pressure pills, to high cholesterol pills, to diabetes pills and many others. With all of the costs
that it takes to keep heart disease in check many people are making difficult decisions to pay for
other things and put their health aside.
With hospitals and health insurance becoming more costly all the time, a condition like
heart disease is becoming harder to treat, because of the costs for care. Today we have some
tools that aid in the prevention of heart disease but it is still killing way too many people. There
are many things that are known about heart disease that weren’t known in the past and places
like the Colombia Doctors of Hudson Valley are giving great guidelines to prevent heart disease.
If the residents that live in Westchester County take the steps to prevent heart disease that are
given to them like being active every day, eating healthier and reducing stress by laughing and
talking to family and friends they will have increased odds of reducing their chance of heart
disease (Glibicky, 2014).
With all of the efforts taken by the Westchester County community and hospitals to
prevent heart disease, the area is on a great path towards helping New York eradicate heart

disease. Unlike most diseases, heart disease is not contagious, but heart disease makes up for that
by being extremely fatal, with many people experiencing no signs of heart disease until death.
While heart disease can have sudden and devastating effects; like a stroke or high blood pressure,
the effects usually take their time to build up and reach their deadliest stage. This is when they
can kill the individual within moments. Heart disease causes plaque to build up in the veins and
arteries within the heart, which eventually will constrict the flow of blood. This stops the heart
from beating within seconds. Heart disease is the leading killer of all residents living in New
York State; and nearly 40 percent of all deaths in New York were due to Cardiovascular Disease
in 2008 (Cardiovascular Disease Mortality, 2008). Since heart disease is so deadly there are
many actions being taken to limit the dangers.
There are many political happenings in New York State to attempt to minimize the effect
that heart disease is having on the inhabitants of the state. One thing that politicians and activist
groups around the country and especially in New York are doing is joining the National Salt
Reduction Initiative or NSRI for short. Since salt is one of the leading factors in the increase of
high blood pressure, which is one of the foremost causes of Heart Disease, the NYC Health
Department is enforcing a public and private partnership to reduce the amount of salt in food
packaging and also the amount of salt used in restaurant food (National Salt, n.d.). This is a
gigantic first step in tackling Heart Disease in New York and it shows that lobbying in the state
has gotten through to the politicians, because they are choosing to enforce this completely
voluntary standard that is set by the NSRI. In addition to that the NYC Health Department is also
planning on observing the changes in sodium intake of New Yorker’s through a 24-hour urinary
sodium analysis, which is part of the Heart Follow-Up Study (National Salt, n.d.). On another
note the American Heart Association asked Gov. Andrew Cuomo to motivate New Yorker’s to

improve their cardiovascular health. The American Heart Association wants Gov. Cuomo to
make CPR training a requirement for all high school graduates. Also the group is lobbying to
ban all artificial trans fats from restaurant menus, mandatory screenings for heart defects in
babies and further funding for heart disease prevention, obesity prevention and tobacco control
(Bakeman, 2013). This could lead to more knowledge of ways to prevent heart disease and if
Gov. Andrew Cuomo does make it mandatory for high school graduates to know CPR, the
American Heart Association says that onlookers who know CPR can double or triple the survival
rate of heart disease (Bakeman, 2013). Anyway you look at having a Governor who is involved
and committed to preventing heart disease can only lead to positive things down the road for the
residents of New York State.
A cultural undertaking going on in New York State to prevent heart disease is the
Healthy Heart Program. The New York State Healthy Heart Program is attempting to reduce
deaths caused by heart disease by making sure people are staying fit, eating healthier foods and
are receiving the best health care advice that is possible. The messages of the Healthy Heart
Program have reached across all of New York and they key messages are: be tobacco free, eat
more fruits and veggies, do light exercise for at least 150 minutes a week or intense exercise for
75 minutes a week and for all residents to make sure their blood pressure and cholesterol are in
check with normal blood pressure and cholesterol levels (Cardiovascular Disease, 2012). The
Healthy Heart Program is doing this by creating environments that entice people to be more
active. Examples of this are the Healthy Heart Program creating side walks for people to walk or
bike on, and opening schools after hours for community use. The Healthy Heart Program also
understands that 60 percent of adults are at work all day and may not have time for working out,
so the Healthy Heart Program is funding agencies to implement programs at work like stretching

classes, exercise room on site and access to healthier food in vending machines (New York State,
2013). The same is being done with children in school who need more physical activity and
more information about eating healthier. If people living in New York follow the regiment and
ideas of the Healthy Heart Program, it would lead New York to be one of the healthiest states in
the country not only for heart disease but also for many other illnesses. In addition to that being
healthier leads to less depression and less stress. This would lead many individual’s to feel better
their lives.
Since heart disease is such a huge problem in New York it plays a vital role in the
economy. An example of just how large a role heart disease plays on the economy is in 2009
alone heart disease cost the state an estimated $34.7 billion in medical costs and lost productivity
(Million Hearts, n.d.). With outstandingly grotesque numbers like this the economy truly suffers
because most of these are charges are unplanned for and can not be made up for because the
person who suffers a heart attack or stroke usually either dies or suffers irreversible damage to
their body. This causes problems where that person was working and also makes it harder for
companies to stay afloat.
New York seems to be a front-runner in creating new and exciting plans to prevent heart
disease across the United States of America. Heart disease is still the leading killer of males and
females in America, with nearly one in every three deaths being related to stroke or coronary
failure (Vital Signs, 2014). The worst thing about heart disease is that it is totally preventable in
most cases. In fact, according to the CDC at least two hundred thousand deaths from stroke and
heart disease each year are preventable (Vital Signs, 2014). In addition to that, more than half of
preventable deaths that are caused by heart disease and stroke happen to people under the age of
sixty-five (Vital Signs, 2014).

Heart disease is such a common disease in the United States that it is having severe
consequences to the economy. To put into perspective just how costly heart disease is to our
nation, Coronary heart disease alone costs $108.9 billion annually (Heart Disease, 2014). This
cost includes health care services, medications, and lost productivity. When you add in strokes
and other forms of heart disease that number balloons to an outrageous $312.6 billion annually
(Frequently Asked, 2013). High medical costs are a major reason why the CDC created and is
funding the State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity
and Associated Risk Factors and Promote School Health grant. This grant is designed to be a
national program that provides a base level of funding to all 50 states and Washington DC
(CDC’s State, 2014). As a result of this program all states are required to put into effect new
initiatives that are expected to lower the effects of all of the diseases mentioned in the grant. Two
examples of the initiatives are, promote the adoption of food service guidelines and nutrition
standards, which include sodium and to promote awareness of high blood pressure among
patients (CDC’s State Public, 2014). A grant as complex as this one can quickly become very
expensive but in the long run the CDC and the government believe that the positive outcomes
will greatly outweigh the negatives ones. Heart disease is one of numerous diseases that weigh
heavily on the economy of the United States. If you were to add up the amount of money that
diseases cost the United States annually in medical related costs the number would be well over a
trillion dollars. This is part of the reason why President Obama introduced the Affordable Care
Act to attempt to subdue the rising costs associated to heart disease and the hundreds of other
diseases plaguing the United States.
In the United States there are many social and cultural start-ups to combat heart disease.
These programs are important because they help to spread the word in many communities of the

effects of heart disease and how people can prepare for the worst such as severe cardiac trauma
like a heart attack. One such program is the WISEWOMAN program. This program is important
because it provides low-income, under-insured or uninsured woman with chronic disease risk
factor screening, lifestyle programs, and referral services in an attempt to stymie heart disease
(WISEWOMAN, 2013). The WISEWOMAN program saves many lives because it gives woman
learning tools and treatment that they normally wouldn’t receive. Another program that aids in
the prevention of heart disease in the United States is the Paul Coverdell National Acute Stroke
Registry. The National Acute Stroke Registry program is important because it keeps track of
strokes on a state-to-state level. The data that is collected is then used to attempt to provide
stroke victims with the best care available, while also having a long term goal of diminishing the
amount of strokes in the United States by preventing strokes in the first place through scientific
study and research. The National Acute Stroke Registry was put into motion by the U.S.
congress in the year 2001, this is a perfect example of how the government is trying to
implement certain programs to decrease heart disease numbers across the United States (CDC
State Heart, 2013). One other program that can have a vital role in lessening the amount of
deaths related to heart disease in the United States is the Million Hearts Program. This program
is intended to prevent one million heart attacks and strokes by the year 2017. The Million Hearts
program believes that it can lower the rates of heart disease by bring together campaigns, such as
better education and implementing policies such as the teaching of the “ABCS” of clinical
prevention. The “ABCS” are appropriate aspirin therapy, blood pressure control, cholesterol
management and smoking cessation (Million Hearts, 2014). This program is ambitious but with a
rising support across the nation saving one million lives doesn’t seem like such an unattainable
number. Finally, May is high blood pressure month across the nation, so people are encouraged

to get screened by their doctor (Power Down, 2014). This is important because high blood
pressure is a silent killer and should not be taken lightly.
With the combined efforts of the people who live in the United States and even more
attention than ever before from the United States government to halt heart disease, it finally feels
like the United States is on the path to success. An example of this strong effort are heavy
sanctions of tobacco and cigarettes brought down by the government to attempt to decrease heart
disease deaths related to first and second hand smoke (Smoking Bans, 2014). This is important
because the government knows that if they can successfully cut a large chunk of deaths caused
by heart disease it will relieve some of the economic stress and tension that has been created due
to rising health care costs. The United States has always been one of the leaders in the
development and implementation of strategies to fight any threats facing our country, near or far.
While people have been focused on wars for many decades it’s about time that the focus shifted
to saving the lives of the citizens of the United States, and only time will tell if we are successful
as a nation.
One thing is for sure, the United States will never give up until the prevention and
treatment of heart disease is above and beyond where it is now and it meets or matches the
efforts of other countries across the world. Whether you live in a developed country or an
undeveloped country there is a high chance that heart disease has altered the life of someone you
have had personal relations with. In fact, according to the WHO, sixty percent of the global
burden of coronary heart disease occurs in developed nations (Global burden, 2014). Therefor,
you can see that even with the education and resources of developed countries, there is still a
tremendous amount of effort that needs to be taken to strengthen the knowledge of people on
ways to tackle heart disease across the world. Since science and medicine are always getting

better, our understanding of heart disease is changing all the time. We will not be able to stop the
loss of life from heart disease unless there are positive political influences. In addition to that,
there must be an agenda to increase social awareness of heart disease especially in
underdeveloped countries. Plus, economics come into play when you’re dealing with such a
costly and straining disease that has an effect on all different types of demographics.
There are many political movements across the world to stop the spread of coronary heart
disease. These movements are designed by the government to protect the lives of the people of
their respective countries. Many of these policies and procedures have had a positive impact on
the prevention of coronary heart disease. An example of one of these regulations is the banning
of smoking in workplaces. Some countries that have banned smoking in workplaces across the
world are Brazil, the Russian Federation, and India. Countries like the United States, China and
Australia have smoking restrictions in workplaces (Policies and Legislation, 2014). This is
important because smoking is one of the leading causes of coronary heart disease across the
world. In addition to that, another political movement is the WHO Framework Convention on
Tobacco Control, this is the first international convention that relates specifically to heart
disease. Once 40 countries ratify the convention it will become a legally binding treaty among
those countries. The convention includes clauses on advertising bans, smoke-free areas, health
warnings and smuggling. Additionally there are many countries that have national plans to deal
with cardiovascular disease prevention (Policies and legislation, 2014). Fifty percent of
European countries have plans, which is among the highest across the world. Especially when
compared to Africa, where only eight percent of countries have a national plan. This shows that
there is much work that still needs to be done in underdeveloped countries to protect against
heart disease. Finally, most regions of the world have tobacco, and food and nutrition legislation.

In South-East Asia eighty-nine percent of countries have food and nutrition legislation, while in
the Americas only sixty-six percent of countries have food and nutrition legislation. This shows
that there can still be a lot of improvement when it comes to legislating food and nutrition to
prevent cardiovascular disease. Once again Africa is the lowest region with only twenty-two
percent tobacco legislation and only forty-three percent food and nutrition legislation (Policies
and legislation, 2014). Legislation is necessary to stop heart disease but in places like Africa it is
harder to create laws because of corrupt governments and a poor economic structure. This is why
the WHO and other organizations are trying their best to bring knowledge of diseases like heart
disease to these types of countries
As far as demographics go coronary heart disease affects people of all different ages,
races and genders. That’s not to say there aren’t certain groups that have been shown to be
affected more through studies. Recent studies show that in developed countries people who have
lower incomes or a lower socioeconomic status are more likely to suffer from coronary heart
disease. This is also true for high blood pressure, smoking and diabetes. The reasons for this
could be due to stress, finding it harder to receive access to health care, and lifestyle (Risk factor,
2014). Studies also show that in countries like Trinidad and Tobago, there’s a correlation
between women aged twenty-four through eighty-five who have high blood pressure and
extremely low incomes (Risk factor, 2014). This shows that high blood pressure has the same
effect on people of lower socioeconomic status in Africa, which is an underdeveloped nation, as
it does on people living in the United States, which is a developed nation. Finally, in Canada,
children who come from low-income families are twice as likely to be obese when compared to
wealthy families (Risk factor, 2014). The fact that countries all across the world have similar
patterns and problems shows that having exposure to health care is necessary to preventing heart

disease. This is why governments have to make health care more accessible to people who have
all different types of socioeconomic status’s and not just wealth or middle class families.
Economics also play a gigantic role when it comes to cardiovascular disease. Globally
between four and five percent of all medical costs are spent on diabetes related illnesses
(Economic costs, 2014). Diabetes is of course one of the main contributing factors to heart
disease. In Singapore, the average hospital costs for stroke were $5,000 (Economic costs, 2014).
While in the United Kingdom they spend over four billion dollars annually to fight obesity
(Economic costs, 2014). No matter where you go in the world countries are struggling to fight
heart disease and closely related illnesses. This is why medical costs need to be lowered in order
to help people maintain their normal lives. Also more steps need to be taken to make sure future
generations don’t have the same health problems that current generations are fighting now. Only
eight percent of published cardiovascular research is from developing countries (Research,
2014). This is definitely not enough, since these are the countries that are expanding and
becoming developed countries in the near future.
At the end of the day there is still a ton of research that needs to be done. People need to
take the necessary steps to prevent the signs of heart disease, like diabetes, high blood pressure,
stress and high cholesterol. Their will most likely never be a flat out cure for heart disease, which
is why every government across the world has to rethink their stance on heart disease and think
about the future to protect their citizens. Governments need to look into more effective ways to
get their points across to make sure that people understand that heart disease is very deadly. In
the next twenty years it is definitely possible to cut the numbers of heart disease related deaths
by a substantial number if nations come together and work towards a common cause, which is to
stop cardiovascular disease.

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