CDC Aims to Prevent Heart Disease from Midlife Onward
Aldrich, Nancy, Aging Today
"Too many people think that dying from heart disease means passing away in their sleep when they are 90 years old, but that is not the reality," stated Nancy B. Watkins, the team leader for program services at the Centers for Disease Control and Prevention's (CDC) Cardiovascular Health Branch. She added, "We are trying to put a face on premature heart disease and stroke, and on the amount of disability and loss of quality of life that comes with these diseases." Heart disease affects 70 million Americans.
Heart disease is largely preventable, she said, and most people know they should manage their blood pressure and cholesterol, avoid tobacco, stay physically active, and eat a healthy diet low in fat and salt to maintain good heart health. Yet, despite decades of public education, heart disease continues to be the numberone cause of all deaths for both women and men in the United States-it is also a leading cause of premature, permanent disability in the workplace. Heart disease alone accounts for 19% of Social security Administration disability allowances, the American Heart Association reports.
Watkins, who spoke last spring at the 2005 Joint Conference of the American Society on Aging and National Council on the Aging, noted that CDC and statelevel heart disease and stroke prevention programs are encouraging communities to create environments where it is easier for individuals to make heart-healthy choices. That means changing both the physical and the social environment to be more supportive of the positive health choices that individuals can make every day.
Health policy experts now recognize that depending on individual health behaviors alone may not lead to improved health and quality of life, she said. As important as preventing people from dying of heart attacks in old age is avoiding the lingering disability that can lower the quality of life for middle-aged and older adults, Watkins stressed.
CDC urges communities and states to take action to ensure more smoke-free areas, better parks and walking courses, free blood-pressure screenings, more vending machines and cafeterias offering heart-healthy options, health insurance plans that focus on preventive care, and education programs targeting all ages. CDC and other publichealth agencies are increasingly emphasizing the need to educate the public to recognize and respond to heart attacks, and are urging communities to shore up their emergency response system via expanded and better-trained 9-1-1 emergency services.
In addition, Watkins said, many of the health disparities between racial and ethnic groups can be attributed to heart disease, a concern examined in CDC's Morbidity and Mortality Weekly Report (MMWR) of Sept. 14, 2001. CDC attributes one-third of the life-expectancy gap between African Americans and whites to heart disease. In 2002, age-adjusted death rates were 30% higher for blacks than for whites.
Moreover, the age-adjusted rate of heart disease deaths per 100,000 population in 2002 was 371 for African American men, 294 for white men, 263 for African American women, and 192 for white women, according to CDC. These disparities are partly attributable to the higher prevalence of lifestyle risk factors, high blood pressure, obesity and diabetes among nonwhite racial and ethnic groups, according to CDC's National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). The latest data from the NCCDPHP, covering 1999-2002 (reported in MMWR, Jan. 14, 2005), show that only 29% of U.S. adults with hypertension had their blood pressure under control. The proportion with controlled blood pressure was substantially lower among Mexican Americans (17.3%) than among other groups.
Researchers are studying reasons for heart disease disparities among population groups. For example, African Americans may be at higher risk for death from cardiovascular disease because they have a greater risk for strokes and a higher incidence of blood pressure elevation. …