New Year’s Resolutions & Your Heart

by Misty Kevech, RN Project Coordinator, HHQI

A little over a month ago, many people made New Year’s resolutions such as losing weight, exercising more, and trying to quit smoking. Have you started down the slippery slope of forgetting or giving up on your resolutions? Time to relook at some of your resolutions for your HEART!

clockFebruary is American Heart Month. Why is heart disease still important? Heart disease is the leading cause of death for both men and women resulting in 1 in every 4 deaths in the U.S. each year. Every 40 seconds someone in the U.S. has a heart attack, and each minute someone dies from heart-disease related death. (CDC, 2016)

Clinicians and many patients know the risk factors, but heart disease remains the leading cause of death. According to the CDC (2011) almost half of Americans have one of these key heart disease risk factors:

  • High blood pressure
  • High LDL cholesterol
  • Smoking

How are clinicians working on reducing the incidence and consequences of heart disease?  Educating patients and their families to know the risk factors and which ones can be modified with lifestyle changes or medical interventions. Engaging  patients into their care and assisting with developing a reasonable plan to make changes. Start with small changes. The World Heart Federation® states that CVH diseases can be prevented with behavioral risk factor modifications including:

  • Eat healthy and control weight
  • Exercise and get active
  • Improve hours of sleep
  • Manage cholesterol
  • Monitor blood pressure
  • Reduce diabetes
  • Reduce tobacco use
  • Take essential medications

Making behavioral modifications can be difficult. A simple clinical approach with changes are the 3 A’s.

Ask_Advise_Act

ASK the patient which of the modifications they might be able to work on. Listen to what they are telling and not telling you. Allowing the patient to select the area will begin to engage the patient into their care planning.

ADVISE the patient on different interventions that could be used with the modification topic selected by the patient. This allows the patient to hear options and make a selection of something they feel they could and are willing to try.

ACT or ASSIST allows you to provide small steps the patient could work on building upon successes towards a bigger goal.  Assist patients with tools or tips to be successful or to remember concepts.

This cycle is repeatable as the patient progresses. Always give positive feedback and encouragement. Create change in small obtainable goals will assist with putting new behavior into action. To learn more about the 5 A’s and 3 A’s see the Cardiovascular Health: Part 2 Best Practice Intervention Package (BPIP) pages 71-73.

Research continues to modify guidelines and protocols to improve cardiovascular health. The American College of Cardiology & American Heart Association (ACC/AHA) recently updated their blood pressure management guidelines. The update also provided changes in the classifications of blood pressure.

Categories of BP in Adults*

BP table_HHQI

**Individuals with SBP and DBP in 2 categories should be designated to the higher BP category. BP indicates blood pressure (based on an average of ≥2 careful readings obtained on ≥2 occasions, as detailed in Section 4); DBP, diastolic blood pressure; and SBP systolic blood pressure. (Whelton, et al., 2017)

The updated blood pressure guidelines for ACC/AHA and the American Diabetes Association (ADA) are included in HHQI’s Cardiovascular Health Part 1 – 2018 Update BPIP.

One of HHQI’s focus areas over the past five years has been improving cardiovascular health (CVH) of home health patients. We have created several CVH BPIPs to provide the evidence, information, and resources for home health and other community setting providers. Additionally, HHQI has created many other supporting resources including patient and clinician education materials (e.g., tools, videos, puzzles, etc.); all of which are free and can be used to promote heart disease awareness. Below are some examples that you may want to share with staff, colleagues, and patients to promote heart disease awareness this month.

  • HHQI CVH patient and clinician videos (10 total)
    • 8-12 minutes in length
    • Available to download and saved
      • Complete Resource Library – select the following filters:
        • Topic: Cardiovascular Health (any/all topics) and then Material Type: Video
        • MP4 files can be downloaded and saved on laptops or tablets
      • Or can be viewed from YouTube
      • HHQI materials and information
        • Complete Resource Library – select the following filters:
          • Topic: Cardiovascular Health (any/all topics) and then Audience: Patient OR Nurse, OR Therapist…
        • HHQI University’s Cardiovascular Health Course Catalog offers free courses that include free nursing CEs and a few have PT CCUs
          • Blood Pressure Control and Smoking Cessation (1.5 hr)
          • Cardiovascular Health for At-Risk Populations (2.5 hr)
          • Cholesterol Management: The Good, the Bad & the Ugly (1.25 hr)
          • It’s HHQuitting Time – Help Your Patient Quit Smoking (1 hr)
          • Lifestyle Management for Cardiovascular Health (1 hr)
          • Master the Maze if Blood Pressure Medication (1 hr)
          • Tobacco Effects and Cessation Medications (1 hr)
        • HHQI University’s Home Health Aides Course Catalog offers a CVH course geared to home health aides:
          • Heart Attach & Stroke Risk Factors, Signs & Symptoms (Aides; 1 hr and no CEs)

Make a fresh resolution this month to engage patients, caregivers, your family and friends, and yourself in reducing heart disease risk factors!

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