February is American Heart Month. Being aware of heart disease and its prevention strategies is a primary message given during the month and repeated throughout the year. Many people and organizations will celebrate National Wear Red Day on February 3, 2017, sponsored by the American Heart Association (AHA), in which special attention is given to heart disease in women. Heart disease is the number one cause of death in the United States, claiming 614,348 lives in 2014.
Approximately 27.6 million adults (11.5%) had a diagnosis of heart disease in 2014 and accounted for 12 million visits to providers' offices and 1.9 million visits to hospital outpatient departments.1 It is safe to say that every healthcare provider has patients with heart disease (including children) because heart disease includes heart failure, dysrhythmias, cardiomyopathy, heart valve disease, pericarditis, and congenital heart defects.
Advances in research
Every December since 1996, the AHA announces the top 10 advances in heart and stroke research for the year aimed at fighting cardiovascular disease (CVD) and improving health outcomes for all Americans whether they are immediately affected or not. The list for 2016 includes the following:
* For some high-risk groups, additional therapies help prevent a second stroke
* New possibilities for treating women with myocardial infarction
* More options for valve replacement in older adults
* A long-term study validates less invasive treatment for carotid artery stenosis
* Better together: managing BP and cholesterol simultaneously helps lower heart risk
* Evidence suggests we might be able to outsmart our genes
* Disparity in counseling women and minorities with heart failure
* Syncope could be a sign of pulmonary embolism in some patients
* Advancing the treatment of severe strokes
* Two studies moved the needle toward better prevention of heart disease.2
Key findings from research reports published in well-known medical journals are summarized, and a link to the citation, abstract, or article for each report is provided. Access to the full text for some articles, however, requires a subscription or other permission. The information is written in lay terms for the general public.
The HOPE-3 trial
Participants in the Heart Outcomes Prevention Evaluation (HOPE)-3 trial were followed for a median of 5.6 years. HOPE-3 was a multicenter, international (228 centers in 21 countries), long-term, double-blind, randomized, placebo-controlled trial. Over 12,000 male and female participants (46.2% were women) with intermediate risk of CVD and an average age of 65.7, were randomized to one of four groups with different combinations of a statin, antihypertensive, and placebo medications.
The researchers looked at two coprimary outcomes: the composite of death from CVD, nonfatal myocardial infarction, or nonfatal stroke and heart failure, cardiac arrest, or revascularization. Results demonstrated the group that received the combination of a statin and two antihypertensive agents had a significantly lower rate of cardiovascular events than the dual placebo group for individuals without CVD.3
In other terms, "the number needed to treat for 5.6 years to prevent one event of the first co-primary outcome was 72, and the number needed to treat to prevent one event of the second co-primary outcome was 63."3 The authors suggested that with minimal screening, providers are able to identify those who might benefit from low doses of combination therapy.
Combating heart disease
NPs and other providers continue the uphill battle against heart disease by encouraging healthy lifestyle behaviors and emphasizing the improved long-term health outcomes.
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, DPNAP
EDITOR-IN-CHIEF [email protected]
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