Disadvantages of Cardiovascular Disease Prevention Methods

Diet and exercise have been proven to help prevent cardiovascular disease, yet according to the American Heart Association (AHA) it continues to be the leading cause of death in the United States (American Heart Association, 2008). There are 79.4 million adults currently living in the U.S. with one or more forms of cardiovascular disease including angina pectoris, myocardial infarction, and heart failure (Parkosewich, 2008). It is important that action be taken to help reverse the prevalence of cardiovascular disease. Patients need to be taught how to eat right, how to create an exercise plan that is manageable for them, and what healthcare actions can be taken to detect and prevent the disease. Because preventive care activities reduce the incidence of cardiovascular disease nurses must educate patients on the importance of diet and exercise.
Nation-wide, obesity is becoming an increasing problem. AHA recommends that disease prevention begin by age 20, however younger and younger patients are presenting with signs and symptoms of cardiovascular disease (American Heart Association, 2008). There are many factors that come together to contribute to one’s risk of developing the disease such as lifestyle, age, sex, race, and genetics (Berra, Miller, Fair, 2006). Unfortunately many of these factors are out of the patient’s hands.
Because many of the reasons that lead to an increased risk of cardiac disease are unable to be controlled it is important for nurses to emphasize what can be controlled. Nurses can collaborate with patients to develop an exercise regimen that will fit into their lifestyle and is tailored to meet their level of ability. Exercise plans need to be individualized for each patient and it is important that nurses pay close attention to what is available to the patient and their perception of the need for intervention. Ideally, the



U.S. Surgeon General recommends 30 minutes of moderate-intensity exercise most days of the week to prevent diseases associated with a sedentary lifestyle such as cardiovascular disease, cancer, and diabetes (Swain, 2006). Although moderate-intensity exercise is beneficial, it is not as beneficial as vigorous-intensity exercise (exercise that can be maintained for no longer than 5 minutes) and if possible, vigorous-intensity exercise should be recommended to patients (Swain, 2006). However, not all patients are capable of such intense exercise and therefore, it is important that exercise plans are suitable for each patient.
Along with exercise, diet is another contributor to cardiovascular disease that can be controlled. There are many effective dietary modifications that can be made. The modifications include eating foods that are low in cholesterol, saturated fat, and trans-fat, foods that decrease the body’s absorption of cholesterol, and foods that are high in fiber (Scott, 2005). It is important for nurses to teach patients to avoid foods that are greasy like fried foods and instead eat more lean meat and fish, fruits, vegetables, nuts, and healthy carbohydrates like oatmeal (Scott, 2005). It is also important to tell patients that they can still enjoy the foods they like, but caution needs to be taken in regards to portion size, as moderation is key.
Although eating healthy and getting adequate exercise are extremely important in maintaining a healthy lifestyle, they do not guarantee the prevention of developing heart disease. Preventive care and the early detection of cardiovascular disease are equally crucial. Stress tests, cholesterol tests, and regular physical exams are all ways that one’s risk for the development of cardiovascular disease or the presence of existing disease can be assessed. These methods help in the avoidance ever having a cardiac event or the
recurrence of additional events by determining whether education and treatment need to focus on preventing disease in the future or managing the disease that has already taken place and avoiding worsening. Monitoring and reporting progress toward a healthy lifestyle is a key to success in cardiovascular health (Flynn, Cafarelli, Petrakos, and Christophersen, 2007). Nurses need to stress the importance of preventive care to patients and encourage them to take the initiative to keep on top of their health maintenance. Everyone has the potential to develop cardiovascular disease; therefore preventive methods and nursing education need to be aimed at every patient regardless of current level of wellness.
The incidence of cardiovascular disease is an increasing problem and is occurring in younger and younger people all the time. Poor nutrition and sedentary lifestyles are leading to shorter life spans and a decreased quality of life in millions of people. Prevention of cardiovascular disease is extremely important and it is crucial for nurses to educate patients on the value of eating a proper diet and getting adequate amounts of exercise. The three primary components to cardiovascular disease prevention are participating in an individualized exercise regimen, eating a healthy diet that consists of foods low in fat and cholesterol, and having regular health screenings that include a close examination of cardiovascular health. Through nurse-patient collaboration and encouragement of a healthy lifestyle, patients can live longer, more enjoyable lives.


Intervention 1 - Diet in Relation to Cardiovascular Disease

Disadvantage 1 – Difficulty in Making Lifelong Dietary Changes

While cutting down on the intake of saturated fats, trans fats, and cholesterol can reduce the risk of developing cardiovascular disease (CVD) many people have difficulty making the necessary dietary modifications. When viewing the recommended dietary changes, patients may feel overwhelmed as changes in eating habits need to become a lifelong way of living. Patients may also have misconceptions regarding what foods can be included in a heart-healthy diet. The perceived inability to make this lifestyle change can make patients feel discouraged and unwilling to comply, therefore doing nothing to lower the risk of CVD development. To make dietary changes feel more manageable and realistic to patients, emphasis should focus on the accomplishment of small goals such as eating a piece of fruit rather than potato chips for lunch, and healthy fat consumption like those in olive oil and fish. Better education needs to be provided to patients on what foods should be eaten and how to make “healthy foods” better tasting so that patients will want to eat them. By setting and meeting small goals, patients may gain a sense of accomplishment and have better success at making healthy eating a way of life.

Jefferson, A. (2008). Nutritional management of coronary heart disease. Journal of Community Nursing, 22(5), 28-30.

Disadvantage 2 – Cultural Factors Leading to Obesity

High consumption of high calorie food and sedentary lifestyle is the overall cause of the obesity epidemic that is occurring. There are many reasons fast foods have become a way of life for so many people including convenience and inexpensiveness. Such a high level of fat consumption with so little physical activity is causing the prevalence of CVD to increase quickly. In addition to peoples’ ever-expanding waistline is portion size. Opportunities to “super-size” are available at most fast food restaurants and the readiness of people to order “super-sized” meals can be attributed to wanting the best value for the money spent. To overcome this issue of overeating high calorie foods without adequate energy expenditure, cultural modifications need to be made. Consumer education on the reduction of portion size needs to be made a focus as well as providing healthier, less expensive options for on-the-go eating.

Hill, J., & Peters, J. (1998). Environmental contributions to the obesity epidemic. Science, 280(5368), 1371-1374.


Intervention 2 – Health Prevention in Relation to Cardiovascular Disease

Disadvantage 1 – The Uninsured Population

Preventive health care is extremely important in detecting and reducing the development of CVD, however preventive care is unobtainable to many due to the lack of health care insurance. Although the knowledge of the need for medical management may be present, many people simply cannot afford to receive care. Because many people do not seek prevention and treatment for CVD, the occurrence of complications and premature death that results from CVD is much higher. The cost of health insurance continues to rise which causes employers to take larger and larger amounts of money out of employee paychecks or discontinue the benefit of health care altogether, and according to the Association of Operating Room Nurses (AORN), nearly 45 million Americans were uninsured for all of 2005. With better health care coverage, less people would forego or delay treatment, and therefore better patient outcomes would be achieved.

Thompson, J. (2007), The effect of health insurance disparities on the health care system. AORN Journal, 86(5), 745-764.




Disadvantage 2 – Complications with Prevention

Patient education by health care workers is of huge importance to CVD prevention. It is necessary for healthcare workers to provide information to at risk patients on the importance of issues such as diet, exercise, smoking cessation, and medical management of CVD. However, increased demands being placed on health care employees and the health care provider shortage are causing the amount and quality of patient education to be compromised. Because the workload placed on health care staff has increased, they are forced act more as problem focused care providers rather than holistic, preventive providers. Without adequate time to spend with each patient, education falls away from what is considered priority. In order to correct this problem, the importance of providing patient education needs to be emphasized to employees and re-implemented as a responsibility to providing overall quality patient care.

Anonymous. (2008). Practice nurse barriers to prevention. Australian Nursing Journal, 15(8), 6.
References



Berra, K., Miller, N., & Fair, J. (2006). Cardiovascular disease prevention and disease management: a critical role for nursing. Journal of Cardiopulmonary Rehabilitation, 26(4), 197-206.

Flynn, F., Cafarelli, M., Petrakos, K. & Christophersen, P. (2007). Improving outcomes for acute coronary syndrome patients in the hospital setting: successful implementation of the American heart association “get with the guideline” program phase I cardiac rehabilitation nurses. Journal of Cardiovascular Health, 22(3), 166-176.

Hill, J., & Peters, J. (1998). Environmental contributions to the obesity epidemic. Science, 280(5368), 1371-1374.

Jefferson, A. (2008). Nutritional management of coronary heart disease. Journal of Community Nursing, 22(5), 28-30.

Parkosewich, J. (2008). Cardiac rehabilitation barriers and opportunities among women with cardiovascular disease. Cardiology in Review, 16(1), 36-52.

Scott, S. (2005). Medical report: preventing coronary artery disease. American College of Sports Medicine, 9(6), 27-29.

Swain, D. (2006). Moderate- or vigorous-intensity exercise: what should we prescribe?. American College of Sports Medicine 10(5), 7-11.

Thompson, J. (2007), The effect of health insurance disparities on the health care system. AORN Journal, 86(5), 745-764.