The ABC's of preventing heart attacks and strokes

Posted: February 27, 2013

HOW DO WE prevent 1 million heart attacks and strokes in the next five years? The U.S. Department of Health and Human Services launched the Million Hearts initiative in 2012 to answer this question. And it's as simple as the ABC'S:

Aspirin for risk reduction.

Blood-pressure control.

Cholesterol-lowering.

Smoking cessation.

Since February is Heart Month, this is a great time for Philadelphia to start working on its share of the goal - preventing 5,000 heart attacks and strokes among city residents by 2017. The challenge is huge, as one Philadelphian dies every four hours from these diseases. The Philadelphia Department of Public Health and the American Heart Association are helping to coordinate the city's efforts, and everyone has a role to play.

Knowing your risk for heart disease and stroke is a critical first step. Two new tools are now available to help you. The first is Heart Health Mobile:

hearthealthmobile.com

It's a downloadable app that enables you to assess your personal risk for heart disease and find local sites for blood pressure and cholesterol screening. Philadelphia is one of five cities helping to launch the app.

For longer-term management, AHA has developed Heart360: heart360.org

That's a Web-based tool that allows you to track your heart health over time, including your blood pressure, physical activity, weight, and medications.

One of the most important medications is Aspirin. It's simple, cheap, readily available, and extremely effective. It can reduce the risk of a second heart attack or stroke by 20 percent, yet less than half of those who could benefit are taking aspirin regularly. Patients need to ask their doctors about whether aspirin is right for them.

And then there's Blood pressure and Cholesterol. More than one-third of Philadelphia adults and nearly half of African-Americans have high blood pressure, also known as hypertension. Effective treatments are available, but most people with hypertension do not have their blood pressure under control.

Cost remains a barrier to regular medication use, even for people with health insurance. The Philadelphia Department of Public Health and the Greater Philadelphia Business Coalition on Health are working with employers and insurers to reduce or remove copayments for blood pressure and cholesterol medications. Companies such as Pitney Bowes and Novartis have improved employees' health and decreased overall health-care spending using this approach.

Blood pressure can also be controlled by reducing the amount of salt (sodium) you eat in a day. Most people with high blood pressure are sensitive to the amount of sodium in their food, and should limit their daily salt intake to less than 1,500 mg per day, or just under a teaspoon. Unfortunately, many restaurant meals contain much more salt than this recommended limit. Philadelphia is the only city in the U.S. that requires chain sit-down restaurants to tell customers how much salt is in each menu item so that they can make healthier choices.

In addition, the city Health Department and Temple University's Center for Asian Health are working with 200 takeout Chinese restaurants to reduce salt use by changing ingredients and cooking techniques. Employers can also help with this effort by adopting healthy vending policies that make low-sodium snacks available in the workplace.

Smoking cessation is also key to reducing heart attacks and strokes. On average, smokers live 10 fewer years than nonsmokers, but quitting at any age can add years to one's life. Smokers are twice as likely to quit for good if they use assistance.

Philadelphians covered by Medicaid can now get nicotine patches, gum and lozenges for as little as $1 per month with a doctor's prescription. In addition, the PA Free Quitline, sponsored by the state Department of Health, is offering up to eight weeks of free nicotine patches and counseling via 1-800-QUIT-NOW (1-800-784- 8669). Through programs and policies such as the Clean Indoor Air Worker Protection Law, Philadelphia has seen a 15 percent decrease in adult smoking since 2008.

But much work remains: Philadelphia still has the highest smoking prevalence of the 10 largest U.S. cities. We need more smoke-free spaces, stronger youth smoking prevention, and better quit-smoking support for current smokers.

All Philadelphians have been touched by heart disease or stroke, whether they've struggled with illness themselves or helped a family member manage his or her disease. Together, we can prevent death and disability, create healthy communities, and live longer, more productive lives.

For more information, visit:

millionhearts.hhs.gov

phila.gov/gethealthyphilly


Donald F. Schwarz, M.D., is Philadelphia health commissioner. Paul J. Mather, M.D., is a Thomas Jefferson University professor.

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