The main causes of heart disease and the cost associated with its care - Research Paper Example

Heart Disease Heart disease is a major cause of concern all around the world as vast numbers of people are affected by this condition every year. Heart disease appears to be indirectly caused by an unhealthy lifestyle which includes a diet rich in fats, getting no exercise, smoking and stress. These factors can lead to high levels of cholesterol build-up or an increased blood pressure, both of which have been implicated as major risk factors for heart disease. The care of people who are suffering from heart disease places a huge strain on the healthcare resources. There has been a trend of the mortality due to heart disease falling, and this has been attributable to an increasingly healthy diet adopted by people once diagnosed and advances in medical care. It is important to identify the reasons for this reduction in mortality as it will enable prevention strategies to be implemented at the population level. This paper will take a look at the main causes of heart disease, the cost associated with its care, recent trends in the disease and finally at prevention and management strategies. It has been recognized that while heart disease is a worldwide problem, it is more prevalent in industrialised nations and this may be attributable the consumption of rich food, a lack of exercise, smoking cigarettes and even mental stress. In fact, in the United States, it has been estimated that about 40% of deaths are related to sedentary lifestyle (Turpeinen, 1979; Hayden et al, 2010). The fact that heart disease is more prone to affect industrialized nations is especially apparent in China, where heart disease is showing an increase gradually with increased urbanisation. It is now the second leading cause of death in China (Zhang et al, 2008). The two fundamental reasons for the risk of heart disease increasing are high levels of cholesterol (Turpeinen, 1979) and high blood pressure or hypertension (Georgiopolou et al, 2010). The idea that cholesterol from fats in the diet may be a reason due of heart disease was demonstrated during World War II in Norway and Finland. During the war, there was a major drop in the consumption of milk, eggs and butter and the number of heart disease cases dropped dramatically only to increase again after the war (Strom and Jenson, 1951; Malmros,1950; Vartiainen, 1947 from Turpeinen, 1979). Conversely, in the United States, the levels of heart disease stayed constant both before and throughout the war as food supply was unaffected (Malmros, 1950 from Turpeinen, 1979). On looking at international statistics related to heart disease, there is a very clear correlation between the intake of saturated fats and an increasing death rate due to heart disease (Turpeinen, 1979). It must be noted that there is a significant variation in mortality from heart disease with regards to what fat is consumed in the diet. Fats can be broken down into vegetable fats, animal fats and dairy fats. Vegetable fats are unsaturated and contain polyunsaturated fatty acids, in particular linoleic acid. On the other hand, meat fats and dairy fats are saturated and have little linoleic acid (Turpeinen, 1979). In countries where the consumption of vegetable fats is prevalent, such as in Italy, Portugal or Japan, the mortality from heart disease is much lower than in countries, like the United States, United Kingdom or Ireland, where mainly animal and dairy fats are consumed (Turpeinen, 1979). In fact, in an experiment conducted where there was a replacement of animal and dairy fats completely in Finnish hospitals over the years 1956-1971, there was a major drop in mortality due to coronary heart disease. This clearly indicated the quality of fats that are consumed that is of importance to health (Turpeinen, 1979). In addition to the quality of fats, the quantity consumed is also of importance. Jakobsen et al (2004) demonstrated using a 16 year study involving both men and women, that it was an increasing quantity of fats also contributed to heart disease. The second major cause of heart disease is an increased blood pressure which leads to hypertensive heart disease (HHD). It was reported by the World Health Organisation Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) project that hypertension is present in populations of all industrialised countries in a range varying between 20-50 %.( Wolf-Maier et al, 2003 from Georgiopolou et al, 2010). An increased blood pressure results in structural changes to the walls of the cardiac wall and also changes in composition of myocardial structure which can result in HHD and its clinical manifestations such as ventricular or atrial arrhythmias, heart failure or coronary artery disease (Georgiopolou et al, 2010). In light of the increasing numbers of people affected by healthcare, it is unarguably the case that the care of these patients uses up a lot of resources in the healthcare system. It has been estimated that the care of patients with heart disease in the United States adds up to over 500 billion dollars (Kearney et al, 2005 from Hayden et al, 2010). A comparison between sufferers of heart disease and healthy individuals in Denmark between 2002-2005 showed startling results as to resources spent on people suffering from heart disease in a given year. After adjusting for factors such as age, gender, lifestyle, education and socioeconomic group, the cost for people with heart disease was 3409 Euros/year where as for the control group of healthy individuals, the cost was 876 Euros/year. This indicated that as much as 5 times more is being sent on people suffering from heart disease as is spent on people who are healthy (Kruse et al, 2008). The results of this study point clearly to the need for prevention strategies to manage heart disease in the future. While the costs of heart disease are undoubtedly strain the healthcare resources, it must be made note of that the number of deaths resulting from coronary heart disease have fallen considerably in the last 30 years. It is important to understand the reason for this so as to improve medical care and prevention methods (Ford et al, 2007 from Wijeysundara et al, 2010). It has been reported that in Canada, there have been improvements in lifestyle habits as people become more aware of the dangers of heart disease. There was a marked improvement in cholesterol levels and in blood pressure, both of which as previously described are major factors in determining the severity of heart disease. Unfortunately, with these improvements came an unforeseen issue which was overconsumption which may be the factor responsible for the increasing numbers of people affected by obesity and diabetes mellitus increased. Also the decrease in coronary heart disease reduction was attributed to better medical facilities (Wijeysundera et al. 2010). Wijeysundera et al (2010) have concluded that the reduction in the number of coronary heart disease deaths can be attributed in half to the advances in medicine and in half to improvements in lifestyle and eating habits. To continue with these improvements in the number of people affected by heart disease, prevention measures need to be firmly in place for future generations. Prevention methods that target the root of the problem which is an unhealthy lifestyle would possibly be the best action to prevent heart disease. A population-wide approach to encourage people to exercise more and eat healthier meals, in addition to giving up other unhealthy habits would go a long way in prevention (Georgiopoloue t al, 2010). In cases where medication has already been prescribed for heart disease or in people with pre-disposing factors to it, such as high blood pressure or high cholesterol, it is essential to encourage people to adopt a healthier lifestyle in addition to taking medication (Georgiopolou et al, 2010). This refers to effective self-management of the disease which has been defined as “the individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and lifestyle changes inherent in living with a chronic condition.” (Barlow et al, 2004 from Hayden et al, 2010). Effective self-management in the case of heart disease generally involves dietary improvements, regular aerobic exercise, weight loss in addition to taking medications (Georgiopolou et al, 2010). In conclusion, it can be said that heart disease is a huge problem worldwide. It is the leading cause of death in many countries. With an increase in industrialised nations, there has been seen to be an increase in unhealthy lifestyles such as improper diet, a lack of exercise, an increase in smoking and an increase in stress levels. These have increased the numbers of people who suffer from high levels of cholesterol and from high blood pressure, both factors that are directly related to heart disease. It is clear that the changing lifestyles are to blame for heart disease as is apparent from China recently. While many countries in the west had dealt with heart disease for many years; it is only recently becoming very common in China amongst its urban population. Heart disease burdens the healthcare system of a country greatly. Countries have been known to spend as much as 5 times on patients suffering from heart disease as on healthy patients and this is a major cause for concern while in general, the number of people suffering from heart disease is very high, it must be said that there is a trend towards a reduction in mortality from heart disease and id possibly as a result of people improving their lifestyle choices once diagnosed and due to advances in medical treatment. Prevention and effective management of care is extremely important in any condition and heart disease is no exception. Prevention strategies should target the general population and aim towards encouragement towards healthier living. Effective management includes providing accurate information to people who are already affected so as not to aggravate the condition further. Annotated Bibliography Georgiopolou, Vasiliki V et al. Prevention, Diagnosis, and Treatment of Hypertensive Heart Disease. Cardiology Clinics. 28: 675–691. 2010. Takes an intensive look into the prevention, diagnosis and treatment options for heart disease caused by hypertension. Hayden, B. Bosworth, Benjamin J. Powers and Eugene Z. Odone. Patient Self-Management Support: Novel Strategies in Hypertension and Heart Disease. Cardiology Clinics. 28: 655-663. 2010. An intensive look into how a patient can use self-management techniques to manage the conditions of hypertension and heart disease. Jakobsen, Marianne U. et al. Dietary Fat and Risk of Coronary Heart Disease: Possible Effect Modification by Gender and Age. American Journal of Epidemiology. 160( 2): 141–149 141–149. 2004. This paper looks at how the risk of coronary heart disease is related to both the quantity and the quality of dietary fats. Kruse, Marie et al. Costs of heart disease and risk behaviour: Implications for expenditure on prevention. Scandinavian Journal of Public Health. 36: 850–856. 2008. This paper compared the average cost of healthcare per year for a person suffering from heart disease in Denmark and a person unaffected by this condition. Turpeinen,Osmo. Effect of cholesterol-lowering diet on mortality from coronary heart disease and other causes. Journal of the American Heart Association. 59(1):1-7. 1979. Shows a correlation between fats in diet and heart disease mortality, a brief discussion of the different types of fats described and how quality of fats significantly reduces heart disease mortality in an experimental population. Wijeysundera, Harindra C. et al. Association of Temporal Trends in Risk Factors and Treatment Uptake with Coronary Heart Disease Mortality, 1994-2005. Journal of the American Medical Association. 303(18):1841-1847. 2010. This article examines the data between the 1994-2005 to determine whether the decline in coronary heart disease mortality in Canada is due to trends in risk factors and medical advancements. Zhang, X-H, Z. L. Lu and L. Liu. Coronary heart disease in China. Heart. 94: 1126-1131. 2008. A look at the increasing proportion of the population who suffer from heart disease in China and the reasons for this increase. Read More