Hypertension

A crisis in cardiovascular health: What to tell your patients

CME course: Nutrition facts

This e-learning module offers physicians guidance on how to discuss nutrition labels and healthy eating with patients.

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Earlier this year, Luke Perry, former star of “Beverly Hills, 90210,” and John Singleton, director of “Boyz N the Hood,” both died of a stroke before the age of 55. We’ve seen anti-smoking campaigns, medications to control blood pressure and cholesterol, and surgical advances that have extended millions of lives over the past century, but that progress has hit a roadblock. Now younger people, women and nonsmokers are falling victim to this crisis in cardiovascular health.

The AMA has developed online tools and resources created using the latest evidence-based information to support physicians to help manage their patients’ high blood pressure. These resources are available to all physicians and health systems as part of Target: BP™, a national initiative co-led by the AMA and American Heart Association (AHA).

In collaboration with the AHA, the AMA also created a national consumer awareness campaign to ensure patients are receiving the right preventive guidance. Patients can visit LowerYourHBP.org to better understand their numbers and to take the necessary steps to get their high blood pressure under control. Doing so will help patients reduce their risk of heart attack or stroke.

Since 2011, the death rate for cardiovascular disease has fallen 4%, after dropping more than 70% over six decades, according to the Centers for Disease Control and Prevention. This slowing progress has been attributed to the obesity epidemic and rise in prevalence of type 2 diabetes, which have been linked to high blood pressure and other conditions that increase a patient’s risk for heart attack, stroke and heart failure.

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Today’s cardiovascular disease patients differ from those of the past decades. Because physicians need to reach people while they are young, before obesity and diabetes develop, it is important to provide patients with education on cardiovascular disease prevention to improve health outcomes. Here are some preventive keys to share with your patients.

Eat a heart healthy diet. Encourage patients to follow a heart-healthy diet, such as plant-based and Mediterranean diets. They should choose more vegetables, fruits, legumes, nuts, whole grains and fish, while limiting salt, saturated fats, fried foods, processed meats and sweetened beverages.

Be physically active. Patients should exercise regularly, aiming for at least 150 minutes of moderate-intensity exercise each week. This includes brisk walking, swimming, dancing or cycling. If a patient is inactive, a little amount of activity is better than none. For those with busy schedules, small 10-minute bursts of activity throughout the day can add up.

Maintain a healthy weight. Excess weight can lead to conditions that increase a patient’s chances of heart disease, including high BP and cholesterol, and type 2 diabetes. Losing 5% to 10% of body weight can significantly reduce a patient with obesity’s risk of heart disease, stroke and other health issues.

Quit smoking. One in three deaths from cardiovascular disease can be attributed to smoking cigarettes, vaping or exposure to secondhand smoke. Counseling or approved smoking-cessation medications should be tailored to each individual patient.

Limit alcohol. Patients should avoid drinking too much alcohol because it can raise their blood pressure. Men should have no more than two drinks per day, while women should only have one.

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Check cholesterol. Blood levels of cholesterol should be tested at least once every five years. However, if a patient has a family history of high cholesterol, encourage them to get their blood levels checked more frequently. This can help prevent heart disease and other complications. And if a patient has high cholesterol, medications and lifestyle changes can help reduce their risk for heart disease.

Control blood pressure. Patients should have their blood pressure measured at least once every two years if they’ve had high BP or other risk factors for heart disease. If a patient has been diagnosed with hypertension, more frequent BP measurements will be needed to ensure control. Self-measured blood pressure can also help with control.

Manage type 2 diabetes. Patients with prediabetes should adopt lifestyle changes to reverse their condition. However, if they have been diagnosed with type 2 diabetes, patients should monitor their blood glucose levels and follow proper treatment, such as lifestyle changes or medications, to reduce their risk for heart disease.