Community Nursing: NUR 3634
Coronary heart disease affects a disproportionate amount of African Americans (CDC, 2010a), yet there are modifiable risk factors that can reduce the risk of this disease. These modifiable risk factors include high blood pressure and high cholesterol. This health promotion plan involves a community-based strategy that targets African Americans by offering primary and secondary prevention measures directly accessible at local community churches in Titusville, FL to decrease the prevalence and incidence of coronary heart disease in the African American community.
Health Promotion Plan for African American Adults at Risk for Coronary Heart Disease
Part I: Community Diagnosis
Risk of complications, including death, of hypertension and hyperlipidemia among African American adults related to poor eating habits, poor primary prevention measures, and poor medication compliance as evidenced by data that show prevalence of cardiovascular disease among African Americans to be 44.6 percent for males and 46.9 percent for females (FDH, 2008), and Healthy People 2010 National Health Objective 12-9, which is to reduce the proportion of adults with high blood pressure (USDHHS, 2000), and National Health Objective 12-14, which is to reduce the proportion of adults with high total blood cholesterol levels (USDHHS, 2000). Part II: Review of Literature
What is Coronary Heart Disease and how does blood pressure and cholesterol affect it? According to the CDC (2010b), cardiovascular disease is the leading cause of death for both men and women (34.3 percent of all deaths), and is estimated to affect over 81 million people in the United States (AHA, 2010). Cardiovascular disease includes several conditions (AHA, 2010): high blood pressure, coronary heart disease, stroke, and heart failure. Coronary heart disease is the most common type of cardiovascular disease and accounts for the majority of these deaths (AHA, 2010). Coronary heart disease, also known as coronary artery disease, refers to a condition in which atherosclerotic plaque collects in the arteries and obstructs the flow of blood to the myocardium (Lewis, Heitkemper, Dirkson, O’Brien, & Bucher, 2007). The plaques consist of deposits of cholesterol and lipids, which progressively decrease the diameter of the blood vessel though which blood flows. The stress of a constantly elevated blood pressure increases the rate of atherosclerotic development (Lewis, Heitkemper, Dirkson, O’Brien, & Bucher, 2007). Coronary heart disease is associated with multiple risk factors, some of which are modifiable (e.g., high cholesterol, high blood pressure, diabetes, smoking, and dietary factors) and other risk factors that are not modifiable (e.g., age, sex, heredity) (CDC 2010b; Lewis, Heitkemper, Dirkson, O’Brien, & Bucher, 2007). Why is high cholesterol & high blood pressure a problem for African American Adults? Data from the CDC (2010a) suggest that although African Americans are less likely to be diagnosed with coronary heart disease, which is due to disparities in health care access and delivery, they are more likely to die from it. In fact, the prevalence of cardiovascular disease among African Americans is 44.6 percent for males and 46.9 percent for females (FDH, 2008). Related to this are estimates that African American males and females over the age of 20 are more likely to have hypertension than non-Hispanic whites (CDC, 2010a). Although percentage of African American adults over the age of 20 with high cholesterol is less than non-Hispanic whites, high cholesterol is still a problem for approximately 10 percent of African American females and 13 percent of males (CDC, 2010a). Current Nursing Interventions
Primary prevention measures generally consist of patient education, behavioral counseling, and support....