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Developing competencies that address societal impacts on cardiovascular health

March 9, 2022
March 9, 2022
Care provider checking a patient with stethoscope - HealthStream

This blog post is taken from a recent webinar moderated by Luther Cale, Vice President, Clinical Programs and featuring Maria Flowers, Director of Health Equity and Belonging, Bo Latham, Senior Product Manager and Andrea Zalewski, Clinical Programs Manager. The panelists shared updates and insights on the common causes of heart disease, the impact of disparities in healthcare (including mental health) on cardiovascular health, the importance of having an advanced resuscitation program and how to best use technology and education to help patients and providers manage cardiac health.

Disparities in Cardiovascular Health

Heart disease remains the leading cause of death in the United States. It also leaves sufferers of poor cardiovascular health more vulnerable to other illnesses including an increased risk of severe illness from COVID-19. However, the burden of cardiovascular disease is not shared equally across the population. Flowers shared that African Americans are 30% more likely to die from cardiovascular disease than their white counterparts with risk factors such as hypertension and diabetes occurring at higher rates with earlier ages of onset.

When asked about the causes for the disparities, Flowers pointed to the 2020 declaration by the American Medical Association that defined systemic racism as a public health threat. “Systemic racism directly impacts the social determinants of health. The environmental conditions of both home and work, education, economics, access to healthy food as well as access to quality healthcare can contribute to these disparities,” said Flowers.

Flowers also addressed gender disparities, pointing out that cardiovascular disease is very prevalent among women with as many as 90% of women having at least one risk factor and as many as 1 in 3 women have cardiovascular disease. Flowers points out that women of color are particularly susceptible to cardiovascular disease citing uncontrolled risk factors and a lack of awareness of personal risk for the disease.

Fighting the Progression of Cardiovascular Disease

Given the prevalence of heart disease, fighting its progression has become an area of significant focus for healthcare providers. Zalewski points out that interventions focusing on pharmacology, lifestyle changes and consistent monitoring are the best ways to fight progression of cardiovascular disease. “These are the kinds of interventions that keep people out of the hospital and protect them from myocardial infarctions and heart failure,” said Zalewski.

Zalewski also points to mental health factors as being contributory. Stress and fatigue can cause the kinds of physiological symptoms that can contribute to cardiovascular disease and may also cause people to self-medicate resulting in overeating, smoking or the use of drugs and alcohol.

Fighting the progression of this disease is important to the millions of Americans that suffer from it, but also to the healthcare system in general. “By 2035, about 45% of Americans are projected to have some form of cardiovascular disease and total costs for this disease are expected to reach $1.1 trillion – roughly one-third of all healthcare expenditures in the US,” said Zalewski.

Fighting Cardiovascular Disease – The Role of Technology and Education

While it is hard to find the upside of COVID-19, the emergence of telehealth, has helped to improve the kinds of access that may help patients better manage their disease. Zalewski pointed out that successful disease management relies on regular surveillance to monitor potential negative trends and prevent progression. However, barriers to in-office visits can interrupt that process. “Telehealth can bridge the accessibility gap, improving patient awareness and engagement in the maintenance of their own conditions,” said Zalewski.

Technology can also improve the quality of CPR and CPR education. While Latham points out that “CPR is inherently inefficient, providing just 10%-30% of normal perfusion to the heart and 30%-40% to the brain when performed at guidelines, it is also the best weapon we have in our fight to improve survival rates and return the patient to normal function.”

Latham recommends adaptive learning to ensure that staff is ready to respond to in-hospital cardiac arrests. “Adaptive learning can help reduce seat time (allowing more time for patient care), but it also allows for the delivery of an individualized learning plan that is specific to that user with content that is focused on their specialty,” said Latham. He went on to say “It is important for new learners to be shown how to properly do skills in a real environment while leveraging the kinds of technology that ensures compliance while tracking performance and capturing the kinds of data that help evaluate and improve performance.”