By Keith C. Ferdinand, MD FACC, FAHA
Professor, Tulane University Heart and Vascular Institute
Every 43 seconds someone in the U.S. has a heart attack and many of them are fatal. On average, someone in the United State dies from a stroke every 4 minutes. Heart attacks or strokes together are the number one cause of death in the United States with millions of these events each year. Fortunately although they are the leading cause of death, heart attacks and strokes are often preventable. The Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services co-lead the Million Hearts initiative on behalf of the U.S. Department of Health and Human Services. Million Hearts is a national initiative to prevent one million heart attacks or strokes by 2017. The focus of this program is to use current scientific evidence to help patients focus on the ABCS.
The A indicates aspirin which when used when appropriately in people who have already had heart disease or stroke may help prevent a reoccurrence.
The B is for blood pressure control. Elevated blood pressure known as hypertension is found commonly in people over 50 and is one of the most important causes of death related to heart disease especially in African Americans. Hypertension is the leading cause of decreased life expectancy especially in Blacks and appropriate blood pressure control can reduce heart attacks, strokes, and chronic kidney disease. Along with appropriate anti-hypertensive medication, reducing sodium intake can do an excellent job of lowering blood pressure and reducing its risk.
The C indicates cholesterol management. Elevated cholesterol is a prominent cause of heart attacks and strokes and can be controlled with a combination of low saturated fat diet and cholesterol medication when appropriate especially statins such as atorvastatin, simvastatin, rosuvastatin, and others have been shown to greatly diminish early death and disability from heart attacks and stroke. This is especially true in persons who have diabetes or a family history of premature heart disease.
The S indicates smoking cessation. Tobacco use not only causes heart disease and strokes but is associated with a wide range of cancers and lung disease. Smoking cessation utilizing counseling and/or medications can assist patients with avoiding the ravages of heart attacks and strokes. Efforts for a smoke-free society, including the City of New Orleans, can greatly add to the benefits of blood pressure and cholesterol management.
Each individual should ensure adequate access to effective care to decrease their cardiac risk factors and referral to a cardiologist when needed to avoid the unnecessary death and disability from heart attacks and strokes. Prevention includes not only a heart healthy lifestyle but also adherence to prescriptions for medications that address the ABCS. Black men and women are more likely to die from heart disease and stroke than whites and remain at high risk. Although health, life expectancy, and medical care have improved dramatically for all, the benefits of cardiac prevention have not occurred equitably. There remains unfortunately a death gap between blacks and whites driven primarily by heart disease and strokes. Knowing your ABCS and taking appropriate steps can help all patients achieve optimal cardiac health regardless of race, ethnicity, gender, or socioeconomic status. For more information, a public website where materials can be downloaded at no cost is www.millionhearts.hhs.gov.
Everyone should practice eating a healthy diet, maintaining a healthy weight, being active on most days, not smoking or using tobacco, and limiting alcohol use.