The CDC calls on patients and their doctors to
boost prevention efforts
by Kathleen
Fifield, AARP,
September 7, 2018
The
Centers for Disease Control and Prevention (CDC) released new numbers on heart attacks and strokes this week, showing that in a
single year, there were 2.2 million related hospitalizations and 415,000
deaths.
What
really stands out among those seriously big numbers? That 80 percent of such
costly or deadly outcomes could have been prevented with lifestyle tweaks or
relatively inexpensive and widely available medications. In fact, according to
the agency’s data, the missed opportunities for treating cardiovascular disease
include things like not taking aspirin when you should (9 million American
adults), not using statins as directed to manage cholesterol (39 million
adults), continuing to smoke (54 million) or, weighing in as the largest
contender for potential improvement, not being physically active (71 million).
The
numbers also introduce a new chapter in what had been a major and somewhat rare
success story in preventive medicine: the steady, long-running improvement in
Americans’ cardiovascular health. “There’s no question
that in the last 20 years we’ve made great strides in this area, but now we’re
plateauing,” says Ragavendra Baliga, a cardiologist at the Ohio State
University Wexner Medical Center who stressed that many of the medications,
such as statins, to treat the “eminently preventable” causes of cardiovascular
disease, are now “generic and low cost.”
Specifically,
he says, beyond helping smokers quit, low-cost therapies to control cholesterol
or blood pressure should be “top priority” in the effort to get the overall
numbers back on their positive trajectory. (While aspirin therapy is also part
of the solution, Baliga notes that recent research shows it's more key to
preventing a second heart attack and not always worth the risk of internal
bleeding for those without a history of cardiovascular events.) The challenge
in getting people to take such medications, he says, comes from the fact that
they may feel perfectly fine without them. As he puts it, “Even if they
need blood-pressure-reducing agents, the patient can appear completely
asymptomatic … then they have stroke or heart failure.”
One
possible motivator might be knowing that every 20 millimeter increase in your
systolic blood pressure — say, going from 120 to 140 — “doubles your risk of
mortality from stroke, heart disease or vascular disease.” What’s
more, warning signs of cardiac events often are overlooked, particularly in
African Americans and women, putting them at even greater risk.
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