Chronic Illness and Living Healthy
Chamberlain College of Nursing
NR 351: Transition to Professional Nursing
Fall B, 2008
Chronic Illness and Living Healthy
The 2007 United States National Center for Health Statistics reports than an illness lasting longer than three months is considered to be chronic (National Center for Health Statistics, 2007). Healthy, the adjective form of the word health, is defined as a “…flourishing condition.” (Merriam-Webster Unabridged Dictionary, 2009). Coronary heart disease (CHD) affects 80.7 million Americans and accounts for, 36.3% of all deaths in the United States. Of those with CHD, 770,000 carry the often burdensome diagnosis of coronary heart disease (CHD). Burdensome as, “…CHD caused one of every five deaths in the United States in 2004…” (AHA, 2008). Yet with this chronic illness, all is not hopeless, as the modifiable risk factors of diabetes mellitus, hypertension, dyslipidemia, obesity, tobacco use, and physical inactivity are controllable, and can afford one with CAD a relative degree of health (Framingham Heart Study, 2009). Libby, Bonow, Mann, and Zipes delineate the modifiable CHD risk factors into three classes. Class I, risk factors that have an obvious causal relationship to the development of CHD are smoking, hypertension, and dyslipidemia. Class II risk factors are those that have strong causal relationship, and class III are risk factors currently being investigated (Libby, Bonow, Mann, & Zipes, 2007). This writing will examine the class I risk factors as they relate to chronic illness and modifications that can result in living healthy.
Coronary Heart Disease
As Americans began to shift from a predominantly agrarian society to an urban society, the death rates from CHD began to increase. From 1900 to 1955, the death rate from CHD increased from 5.5/100,000 population to 8.5/100,000 population, a rise of approximately 150%. Libby et al relates possible explanations for the mortality rate increase in the first half of the 20th century, asserting: By the middle of the 20th century, the United States was predominantly an urban, industrial economy, with 64 percent of the population living in urban and suburban settings. With continued mechanization and urbanization, activity levels declined considerably. The rise of suburbs meant that more and more people were driving to work or to shopping rather than walking or bicycling. Prevalence of smoking, one of the major contributors to premature mortality and chronic disease, hit its zenith among adult men at 57 percent in 1955 and among women 10 years later at 34 percent. Annual per capita consumption of cigarettes peaked in 1963 at 4,345, or more than half a pack per day for each American (Libby et al, 2007, Chapter 1, Page7, Para. 2). Since the 1960’s, America has been witness to a steady decline in mortality from CHD and the CAD subset, to the present levels (Cooper et al, 2000). A significant contributing factor in the mortality decline is the Framingham Heart Study (FHS).
In 1948, the National Heart Act was signed by President Harry S. Truman that created the National Heart Institute (NHI), now known as the National Heart Lung and Blood Institute (NHLBI) (NIH, 1999). That same year a research project, titled the Framingham Heart Study, under the direction of the NHI was launched. The objective of this study was to identify the common factors for CHD in 5,209 cohorts in Framingham, Massachusetts. In 2002 the FHS began enrolling the third generation of study subjects that are the grandchildren of the original 5,209. More than 1,800 articles have been published by the study group regarding research results, and those that identify CHD risk factors have been of invaluable benefit in the treatment of this chronic disease. Modifiable risk factors include diabetes mellitus, hypertension, hyperlipidemia, obesity, smoking,...