hypertension, diabetes,
RUNNING HEADER: Health Issue Analysis 1 Health Issue Analysis: Part I
Blue Group: John Blanchard, Malka Hayman, Arlly Regoso, Wayne Seare, and Allison White
Grand Canyon University NUR-508
April 6, 2016 Health Issue Analysis 2 Health Issue Analysis: Part I Cardiovascular disease (CVD) has been the leading cause of death in the United States
since the 1950’s and although improving healthcare has decreased the number of these deaths,
CVD remains at the top of the list. It is time individuals take responsibility for preventable
behaviors, and it is time for the healthcare community to reach out to everyone with education on
such preventable behaviors. The principal pathophysiology paradigm of heart disease, due to comorbidities such as hypertension, diabetes, hyperlipidemia, smoking and a sedentary lifestyle,
follow a similar precipitated path of myocardial damage. Consequently, this results in a reduction
of contractility which in certain instances such as hypertension left untreated the myocardium
compensates for years creating irreversible muscle damage (Hasenfuss & Mann, 2014).
Myocardial damage and dysfunction leads to activation of neurohormonal and cytokine
activation within the heart; creating a chain of events that leads to what is referred to as left
ventricle remodeling (Hasenfuss & Mann, 2014). The purpose of this paper is to explain in
further detail the ongoing issue of cardiovascular disease with a focus on risk factors from
human behaviors, past to present, and discuss the current status of this issue in the health of the
American people.
Influences of Health
There are numerous factors that can influence an individual’s well-being and ones
perspective of health. Social, personal, economic, and environmental factors are all determinants
of health and can play a major role in the life of an individual (Waitzkin, 2016). While biological
and genetic factors are a determinant of health that cannot be changed or altered, some people
are more susceptible to illness attributed to genetic composition. There are many human
behaviors that contribute to cardiovascular disease that can be controlled and considered
determinants for an individual outcome. An individual with a sustainable income has the ability Health Issue Analysis 3 to meet ones basic needs such as food, water, housing, and other necessary resources. An
adequate income status can allow the opportunity for a better living condition, avoiding physical
hazards; as well as decrease exposure to crime (Determinants of Health, 2016). Personal or
individual behavior refers to lifestyle choices including diet, physical activity, use of cigarettes,
alcohol or drug use. Healthcare today calls for lifestyle changes, as early prevention of disease
due to the fact that most chronic diseases are preventable. Diabetes Mellitus mellitus type 2 is an
example of preventable disease developed overtime due to personal lifestyle choices, as well as a
factor in cardiovascular disease.
Past and Present Initiatives
The National Institute of Health (NIH) began an initiative in 1991 to study preventable
factors for cardiovascular disease by the initiation of the Women’s Health Initiative (WHI)
focusing on cardiovascular diseases in post-menopausal women; with hopes of identifying
predicting factors (NIH, 2016). Increased awareness of CVD and the discovery of preventable
human behaviors to assist in prevention began a new initiative in 2010 in the United States to
establish goals for Healthy People 2020 to improve “cardiovascular health and quality of life
through prevention” (Heart Disease and Stroke, 2016, p. 1). In the year 2012, the Centers for
disease Disease control and prevention Prevention initiated the Million Hearts program to
“prevent 1 million heart attacks and strokes by 2017”; as CVD remains the top leading causes of
death since the 1950’s (Million Hearts, 2016, p.1).
Measured outcome Outcome & Outcome indicatorsIndicators
In the 1950’s, heart disease reached the number one cause of death in the United States,
and has remained the leading cause of death ever since. Public Health contributions of education,
preventative medicine and screenings, more accurate diagnoses, and public awareness of heart Health Issue Analysis 4 healthy diets and exercise has slowly decreased the number of people who die from heart
disease. According to The National Center for Health Statistics (2012), from 1969-2010, people
who died from heart disease hads decreased 41%, while also remaining the leading cause of
death.
Nationally, as well as local organizations, efforts have been made to instill healthy
choices in the youth, education on heart healthy diets, importance of physical activity, provide
treatments and management of diabetes, oral care, and anti-tobacco programs, have made a
tremendous effort towards decreasing heart disease and stroke (CDC, 2009). While these
strategies have been successful and America has come a long way, there are still hurdles to jump
and knowledge to spread in our ever-changing world of healthcare. According to DeNisco and
Barker (2013), science and technology will be our next evolution, as our healthcare system in the
21st century will be more focused on corporation of managed care, globalization with a foreign
investment in healthcare and information revolution with telemedicine. According to Hoyert
(2012), overall mortality is down 60% over the past 75 years and this number will only continue
to decrease with an increase in health insurance and access to healthcare, as well as public
awareness, and preventative screenings. Health Issue Analysis 5
References CDC. (2009). The Power of Prevention: Chronic disease…the The public health challenge of the
21st century. Retrieved from http://www.cdc.gov/chronicdisease/pdf/2009-Power-ofPrevention.pdf
DeNisco, S. & Barker, A. (2013). Advanced practice nursing: Evolving roles for the
transformation of the profession. (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
Determinants of Health. (2016). Healthy People 2020. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-ofHealth
Hasenfuss, G., & Mann, D. (2014). Pathophysiology of Heart Failure. Braunwald’s Heart
Disease: A Textbook of Cardiovascular Medicine. 10th ed. (pp. 454-472). Retrieved from
https://books.google.com/books?
hl=en&lr=&id=1R44BAAAQBAJ&oi=fnd&pg=PP1&dq=pathophysiology+of+heart+dis
ease&ots=dZaANWrbAK&sig=4HnWra3sANiJ4LmOcLn25ern0M#v=onepage&q=pathophysiology%20of%20heart
%20disease&f=false
Heart Disease and Stroke. (2016). Healthy People 2020. Retrieved from
https://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
Hoyert, D.L. (2012). National Center for Health Statistics. 75 years of mortality in the united
states, 1935-2010. Retrieved from http://www.cdc.gov/nchs/data/databriefs/db88.pdf
Million Hearts. (2016). About Million million Heartshearts. Retrieved from
http://millionhearts.hhs.gov/about-million-hearts/index.html Health Issue Analysis 6 NIH. (2016). Women’s Health health Initiativeinitiative: Background and overview. Retrieved
from https://www.nhlbi.nih.gov/whi/background.htm
Waitzkin, H. (2016). John D. Stoeckle and the Upstream upstream Vision vision of Social social
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