Nancy Brown: CVD cost will triple in next 20 years

The cost to treat heart disease in the United States will triple by 2030, according to an American Heart Association policy statement presented by Nancy Brown on Jan. 24 in Washington, D.C. The statement calls for effective prevention strategies to limit the growing cost burden, which accounts for 17 percent of national health expenditures.

The projected $545 billion increase is due in part to an aging population, according to the report. Cardiovascular disease is more prevalent in people older than 65. Another cost factor is an increase in risk factors such as obesity.

"If there's a silver lining in these figures, it is that they are projections," Brown said. "Unhealthy behaviors and unhealthy environments have contributed to a tidal wave of risk factors among many Americans. Early intervention and evidence-based public policies are absolute musts to significantly reduce alarming rates of obesity, hypertension, tobacco use and cholesterol levels."
According to the statement, 36.9 percent of Americans already have some form of cardiovascular disease, including high blood pressure, coronary heart disease, heart failure, stroke and other conditions. By 2030 this is expected to reach 40.5 percent.

Paul Heidenreich, M.D., chair of the AHA expert panel issuing the statement, said the study didn't double count costs for patients with multiple cardiovascular conditions. Heidenreich added that the study "didn't assume that we will continue to make new discoveries to reduce heart disease." If our ability to prevent and treat heart disease stays where we are right now, he said, the projected cost increase will occur just through demographic changes in the population.

Watch video clips from Nancy Brown's Natl. Press Club presentation.

American Heart Association Welcomes Sen. Richard Durbin as Co-Chair of Congressional Heart and Stroke Coalition

(Washington, January 20, 2011) — Illinois Senator Richard Durbin, Assistant Majority Leader in the Senate, has been named Senate Democratic co-chair of the Congressional Heart and Stroke Coalition. The American Heart Association congratulates him for taking on this important role and driving efforts to fight heart disease, stroke and other cardiovascular diseases—the nation’s leading health threats.

Sen. Durbin will fill the vacancy left by retired Senator Byron Dorgan (D-ND) and join Senator Michael Crapo (R-ID) and Representatives Lois Capps (D-CA) and Todd Platts (R-PA) as leaders of the coalition.

The Congressional Heart and Stroke Coalition works to raise awareness of the seriousness of cardiovascular diseases and acts as a resource center for issues including biomedical research, quality and availability of care and health promotion and disease prevention. The coalition and its more than 150 members also help advance public policies aimed at fighting cardiovascular diseases.

“I am honored to join my colleagues as co-chair of the Congressional Heart and Stroke Coalition. I look forward to working with them and the American Heart Association to raise awareness and secure resources in the fight against heart disease and stroke,” said Durbin.

“Sen. Durbin has been a staunch supporter of the association’s goals to reduce American death and disability rates from heart disease and stroke,” said Ralph Sacco, MD, American Heart Association President. “We look forward to continuing our work with the Senator to educate congressional Members and staff, improve research, treatment and awareness and advance lifesaving policies.”

Sen. Durbin’s record as a heart and stroke champion in Congress includes his leadership role in ensuring passage of the Family Smoking Prevention and Tobacco Control Act and as the lead sponsor of the Congenital Heart Futures Act, both of which were enacted into law in the last Congress. He also was the lead author of the law that banned smoking on airplanes more than 20 years ago. He has been a strong advocate for increased heart and stroke research funding for the National Institutes for Health and has co-sponsored numerous bills supported by the association, including the HEART for Women Act and the Genetic Information Non-discrimination Act.

Secondary students should be required to receive CPR training

DALLAS, Jan. 10, 2011 — All secondary school students should be required to be trained in cardiopulmonary resuscitation (CPR) and receive an overview of automated external defibrillators (AEDs), according to an American Heart Association science advisory.

The advisory, published in Circulation: Journal of the American Heart Association, calls for state legislatures to mandate that CPR and AED training be required for graduation, and to provide funding and other support to ensure the educational standard is met.

Last school year, 36 states had a law or curriculum standard encouraging CPR training in schools, according to the advisory. School districts have developed various models for providing and paying for the training and equipment, including using volunteer instructors or video-based programs, and drawing support from businesses, foundations, civic organizations and public agencies.

Challenges include finding time in the curriculum to teach the courses and providing and maintaining CPR manikins, which are vital for training. Schools can keep reusable manikins, replacing key parts for sanitary reasons, or can work with a local agency that provides manikins and training. Some schools provide personal training kits that include DVD-based instructions and an inflatable, reusable manikin.

The statement authors report that the benefits far outweigh the costs. “Training of all secondary education students will add a million trained rescuers to the population every few years,” said Mary Fran Hazinski, R.N., M.S.N., co-author of the advisory and professor at Vanderbilt University School of Nursing in Nashville, Tenn. “Those students will be ready, willing and able to act for many years to come, whenever they witness an emergency within the community.”

Students trained as rescuers might help save lives at home, where most sudden cardiac arrests occur. Trained students could also respond to cardiac arrests at school and at public places such as malls, health clubs, or swimming pools, or at events such as family reunions.

Cardiac arrest is a leading cause of death in the United States. The American Heart Association reports that emergency medical personnel respond to nearly 300,000 out-of-hospital cardiac arrests in the United States annually, so CPR can help save many of these victims’ lives, the authors said.

Effective CPR circulates a small but vital amount of oxygen-rich blood to the heart and brain, which can help keep a victim alive until an AED is available. The AED can give an electric shock to the heart to stop the abnormal heart rhythm and allow a normal heart rhythm to return. AEDs are portable medical devices that can be used with minimal training and are often available in public places.

“Bystander CPR can double or triple survival from cardiac arrest. Currently, only about 30 percent of victims of out-of-hospital sudden cardiac arrest receive any type of CPR,” Hazinski said.

According to the statement, most untrained bystanders hesitate to help a cardiac arrest victim. Research has shown that when bystanders have CPR training, they are much more likely to take action.

Bystanders who phone 911 and begin CPR provide the first essential links in a strong, interdependent “chain of survival,” Hazinski said. “With activation of 911, early bystander CPR, rapid defibrillation, effective advanced life support and integrated post-resuscitation care, survival rates following sudden cardiac arrest can exceed 50 percent. That’s dramatically higher than the 7 percent to 9 percent average survival rate in the U.S. However, nothing is going to happen unless there’s a bystander who recognizes the arrest, phones 911 and begins CPR to start that chain of survival. Research has shown that any attempt at CPR can improve the odds of survival for someone who has a cardiac arrest,” she said.

CPR training in schools should cover several key areas, including how to recognize an emergency, an emphasis on high-quality chest compressions and skills practice, according to the advisory. At a minimum, AED training should cover the purpose, simplicity and safety of the devices.

“Many schools have overcome barriers to training and begun teaching CPR,” Hazinski said. “But I think a legislative mandate and support for training in schools would go a long way.”

Co-authors are: Diana Cave, R.N., M.S.N.; Tom P. Aufderheide, M.D.; Jeff Beeson, M.D.; Alison Ellison, B.S.N.; Andrew Gregory, M.D.; Loren F. Hiratzka, M.D.; Keith Lurie, M.D.; Laurie J. Morrison, M.D., M.Sc.; Vincent N. Mosesso, Jr., M.D.; Vinay Nadkarni, M.D.; Jerry Potts, Ph.D.; Ricardo A. Samson, M.D.; Michael Sayre, M.D.; and Stephen M. Schexnayder, M.D. Author disclosures and sources of funding are on the manuscript.

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