Tag: CVD Prevention

The Economic Burden of Cardiovascular Disease

Despite the extensive literature and research that indicates the preventability of cardiovascular disease, it remains a primary and leading cause of not only mortality & morbidity, but also a tremendous health care cost and economic burden. A Vital Signs report recently released by the Centers for Disease Control and Prevention cited that in 2016 alone, myocardial infarction, strokes, heart failure, and other largely preventable cardiovascular conditions caused 2.2 million hospitalizations, 415,000 deaths, and $32.7 billion in costs.

The researchers that conducted the findings estimated that “without preventative interventions, approximately 16.3 million events and $173.7 billion in hospitalization costs could occur during 2017–2021.” Moreover, a second Vital Signs report pulled data from the National Health and Nutrition Examination Survey, the National Survey on Drug Use and Health, and the National Health Interview Survey to assess and analyze the pervasiveness and prevalence of critical, key cardiovascular disease risk factors. Researchers found that 54 million adults are smokers, and could likely benefit from smoking cessation interventions. 71 million adults are not engaging in physical activity, and thus more prone to cardiovascular disease. Furthermore, millions of adults are not taking aspirin as recommended; 39 million adults are not managing their cardiovascular disease risk through suggested statin use; and 40 million adults are living with uncontrolled hypertension.

Quoted in an article published in the American College of Cardiology, Janet S. Wright, MD, FACC—executive director of Million Hearts, a national initiative co-led by the CDC and the Centers for Medicare & Medicaid Services, initially designed as a preventive measure to combat one million heart attacks and strokes by the year 2022—”Small changes–the right changes, sustained over time–can produce huge improvements in cardiovascular health.”

The report specifically explains that health care professionals & practitioners, in conjunction with systems and institutions, can focus on various aspects of heart health, including the use of aspirin when appropriate, management of blood pressure, cholesterol control, and smoking cessation. The report further recommends the utilization of a team approach through technological application, coupled with standard process and pooling skills in order to find and treat patients at higher risk for myocardial infarction and stroke. The researchers advocate follow-up care for patients who have previously had a myocardial infarction or stroke, in order to properly recover and therefore reduce future risk of another event. Finally, the report endorses the continuous promotion of physical activity and healthy eating among both patients and employees.

While there are enormous challenges associated with achieving the Million Hearts 2022 goal, and tackling the health and economic burdens of cardiovascular disease, there are ample opportunities to improve the nation’s cardiovascular health. In a related viewpoint recently published in JAMA, Wright and co-authors discuss small steps needed for cardiovascular disease prevention, and focus on the critical need for “individuals and families, health care and public health professionals, and communities to begin doing what works, one small step at a time.”


Limit Screen Time to Reduce Risk of Cardiovascular Disease

Recent advice from the American Heart Association indicates that children should have limited screen time, as it may contribute to future cardiovascular disease. The AHA has emphasized existing recommendations, which suggest limiting screen time for children & teens to no more than 1-2 hours each day. Pediatric cardiologist Dr. Stephen Daniels, a spokesman for the American Heart Association, states: “Screen time is associated with being overweight and obese which is associated with high cholesterol and high blood pressure…Once those risk factors, such as obesity, are in play in childhood, they tend to continue into adulthood.”

The recommendations stem from a review of two decades of science, conducted by an AHA expert panel, regarding the correlation between CVD, stroke, and self-reported screen time by children and teens. The surveyed findings found that the use of mobile screens is up, which has resulted in an overall net increase of screen time. Kids and teens today, between the ages of 8 and 18, are estimated to spend more than 7 hours each day on ‘smartphones, tablets, video games, and other screen-based recreational devices, including television.’

Sedentary behavior is inevitably linked to higher risks for obesity; obesity is intricately linked to heart disease. Dr. David Hill, chairman of the Council on Communication and Media for the American Academy of Pediatrics, confirms, “There are strong data that relate childhood TV time to obesity in children.” The scientific statement published by the AHA further states that the upward increasing trends of screen time are particularly concerning given the accessibility and portability of screen-based devices, coupled with the access to unlimited programming and online content–which could lead to “new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health.”

Tracie Barnett, a researcher at the INRS-Institut Armand Frappier and Sainte-Justine University Hospital Research Center in Montreal, said in a statement that “There are real concerns that screens influence eating behaviors, possibly because children ‘tune out’ and don’t notice when they are full when eating in front of a screen.” Barnett added that screens can disrupt sleep quality, further increasing the risk of obesity.

Overall, the American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth, and their overall effects and impacts on obesity and cardiometabolic health. While the panel agreed that there is little research regarding the longterm repercussions of screen use on children’s health, parents must improve childhood physical activity. Hill noted, “Heart health starts during childhood, so I think it’s very appropriate that the American Heart Association looks at every issue that can contribute to heart disease.”

Ideas cited in an article published by CNN include encouraging family physical activity, scheduling movement/exercise each day, eliminating any TV and/or mobile screen devices from bedrooms, and planning TV viewing in advance. The AHA statement suggests that parents and guardians sholud be supported to not only ‘devise and enforce appropriate screen time regulations,’ but also to effectively model healthy screen-based behaviors.

Experts conclude by clarifying that not all technology is inherently harmful; the American Academy of Pediatrics has created an interactive tool that has the capability to create a personalized media use plan for entire families. “There are ways to leverage technology to improve health,” said Hill. “My youngest got his first fitness tracker at 11, and comes to me every day to tell me how many steps he’s taken.”