Have a heart? Keep it healthy

Arkansas has the highest death rates for heart attack and stroke in the nation – 64% higher than the national average, according to the Centers for Disease Control and Prevention (CDC). Cardiovascular disease (CVD) continues to be the leading cause of death and disability in Arkansas.

The major modifiable risk factors for heart disease and stroke have increased in Arkansas over the past 20 years: high blood pressure, high cholesterol, diabetes, obesity, and inadequate physical activity and consumption of fruits and vegetables. One key risk factor, smoking, has declined very slightly.

Another factor causing Arkansas’ high rates of CVD, heart attacks and strokes is health disparities in terms of race, gender, age and socioeconomic status. Disparities are clearly evident in CVD’s risk factors, incidence, diagnosis, treatment and death rates. Social determinants such as poverty, unemployment, limited education and poor nutrition disproportionately affect racial minorities, especially in rural Arkansas. African American and Hispanic Arkansans have a higher prevalence than Caucasians for high blood pressure, diabetes and obesity. Approximately 18% of Arkansans’ have an income below poverty.

Arkansas could save $518.6 million annually in direct medical care expenditures, plus wider use of preventive services and chronic disease management, by eliminating health disparities, according to the Minority Health Commission.

AFMC and the Arkansas health care community are attacking the root causes of heart disease with initiatives to improve heart health, reduce health disparities, enhance prevention measures and help communities increase healthy activities.

The national “Million Hearts 2022” campaign uses innovative strategies to reach minority populations and people with mental or substance abuse disorders. The campaign educates people in their communities and places of religious worship, using interventions such as public blood pressure monitors, “Health Hubs” in libraries, smoking cessation campaigns, and heart health promotions in barbershops, beauty salons, fitness centers and retail outlets. Cities were encouraged to promote community fitness challenges, local farmers’ markets and walking trails.

AFMC developed and distributed “Bless Your Heart” toolkits to churches and faith-based organizations to develop health ministries and enhance heart-healthy outreach efforts at church and community events. Support groups facilitate peer-to-peer training on healthy eating and cooking demonstrations, home blood pressure monitoring and exercise programs. AFMC’s quality specialists assist health ministries in planning monthly health topics, events, trainings and educational materials.

AFMC provides technical assistance to doctors who serve high-risk populations. Using electronic health records, providers can identify where they can have the greatest impact on patients’ heart health, allowing AFMC’s analysts to identify the most at-risk patients and population disparities.

AFMC provides speakers who promote the American Heart Association’s (AHA) national initiative to control high blood pressure using the “Check. Change. Control.” method. It encourages individuals to regularly monitor and track their blood pressure – both habits significantly improve blood pressure control.

The free tools available on AFMC’s website (afmc.org) help people actively manage their heart disease and stroke risks by:

• Monitoring and tracking blood pressure
• Managing cholesterol
• Quitting smoking
• Improving diet by following either the Mediterranean or DASH diets
• Achieving and maintaining a healthy weight, ideally BMI of less than 25
• Moderating alcohol to no more than two drinks a day for men; one drink for women
• Increasing physical activity strengthens the heart muscle to work more efficiently, enhances the immune system, longevity, mood and functional status, while reducing risks for osteoporosis, certain cancers and diabetes.

Another best practice is to “dial, don’t drive.” If you suspect heart attack symptoms, call 9-1-1 immediately. About half of patients experiencing a heart attack drive themselves to the hospital, not realizing the potential harms of cardiac arrest with no one to perform CPR, causing an accident or not going to the appropriate hospital. Emergency medical services (EMS) are essential to the chain of survival for heart attack patients. They begin treatment at the patient’s location, and can alert the most appropriate hospital that a heart attack patient is en route, letting patients bypass the emergency room and go straight to life-saving treatment.

When communities use evidence-based treatments, embrace quality improvement initiatives and focus on improving heart-healthy behaviors, CVD and stroke hospitalization and death rates drop significantly. National statistics over the past decade are impressive:

• 38% fewer heart attacks
• 34% fewer ischemic strokes
• 30% less heart failure
• 84% less unstable angina (often leads to heart attack)
• 23% fewer deaths within one year of hospitalization
• 31% fewer deaths for patients who participate in cardiac rehab after a heart attack

At AFMC, we believe Arkansas can achieve these same results. Hypertension is the easiest chronic health condition to treat. Universal treatment would pay enormous dividends in terms of lives saved, quality of life, enhanced productivity and reduced health care costs.

Get involved during heart month in February. Regular blood pressure checks are an inexpensive and highly effective way to monitor risk of future heart disease. Does your business offer employees regular, free blood pressure checks?

Editor’s note: Ray Hanley is president and CEO of the Arkansas Foundation for Medical Care (AFMC), a nonprofit health care improvement organization. The opinions expressed are those of the author.