Parkosewich Honored With Excellence in Cardiovascular Nursing Clinical Practice Award
During the Cardiovascular Nursing Dinner, held on November 6 in conjunction with the American Heart Association's Scientific Sessions, Janet Parkosewich, MSN, RN, was presented with the Excellence in Cardiovascular Nursing Clinical Practice Award. This award is sponsored by the Preventive Cardiovascular Nurses Association (PCNA) and the American Heart Association's Council on Cardiovascular Nursing.
This award recognizes and encourages excellence in cardiovascular nursing clinical practice. Award nominees must have spent at least three-fourths of their career in cardiovascular nursing, with a minimum of 10 to 15 years in cardiovascular nursing practice. In addition, the candidate must demonstrate delivery of outstanding patient care by contributing above and beyond basic job requirements in 1 or more of the following areas: cardiac rehabilitation; lipid, hypertensive management; case management; patient and family counseling/education; acute care and delivery; outpatient care delivery.
Ms Parkosewich is currently a cardiac clinical nurse specialist at Yale-New Haven Hospital and serves on the clinical faculty at Yale University School of Nursing, both in New Haven, CT. Parkosewich is a student of Yale University School of Nursing's Doctor of Nursing Science program with a focus in Management of Health and Illness and expects to complete the program in 2008.
Congratulations to Janet Parkosewich on her past, current, and future achievements! PCNA is proud to honor her with the Excellence in Cardiovascular Nursing Clinical Practice Award.
Preventive Cardiovascular Nurses Association Members Contribute to Scientific Sessions
Preventive Cardiovascular Nurses Association was well represented by many members who made important contributions to the science presented at the American Heart Association Scientific Sessions held November 2007 in Orlando.
In a session that highlighted nursing interventions, Preventive Cardiovascular Nurses Association (PCNA) Board Member Jerilyn Allen, ScD, RN, FAAN, gave a state-of-the-science address on the effectiveness of nursing interventions for secondary prevention in patients with coronary heart disease. Dr Allen's systematic review of randomized controlled trials published between 2000 and 2007 identified 43 articles reporting on nurse-led risk factor management (n = 15) and disease management (n = 28). On the basis of this review, she concluded the following: (1) Nursing interventions for secondary prevention in patients with coronary heart disease/heart failure have a beneficial impact; (2) the optimal combination of intervention components, including strategy, mode of delivery, frequency, and duration, is unclear; (3) there was great variability in intervention effect on outcomes across studies; (4) women and ethnic minorities were underrepresented in trials; and (5) few studies reported cost-effectiveness analyses. The review identifies a need to translate effective nursing interventions into clinical practice.
Some new research findings reported at the Scientific Sessions that may be of interest to PCNA members are summarized below.
High Prevalence of Cardiovascular Risk Factor Clustering and Suboptimal Treatment Among Poor Urban Patients With Diabetes
Dennison and colleagues reported on cardiovascular (CV) risk factor clustering and quality of CV risk factor management among patients with diabetes in urban community clinics. The sample of primary care patients with diabetes (n = 138) was predominantly female (74%) and black (89%) with a mean age of 55+/-11 years. HgA1C was 7% or greater for 75% of the participants and 9% or greater for 36% of the participants. Only 50% were on an ACE-I or ARB, and only 50% were on ASA or other antiplatelet medications. Current smoking was reported by 30% of the participants, with none reporting smoking cessation medications. Body mass index (BMI) was 30 kg/m2 or greater for 73% of the participants. Blood pressure (BP) was uncontrolled (>=130/80 mm Hg) for 69% of the participants. Of those with uncontrolled BP, 19% were not on antihypertensive medications. Low-density lipoprotein was 100 mg/dL or greater for 58% of the participants. Of those with low-density lipoprotein 100 mg/dL or greater, 57% were not on lipid-lowering medications. More than 1 CV risk factor was uncontrolled for 22% of the participants. Despite being in care, this sample of predominantly black female patients with diabetes had a high prevalence of CV risk factor clustering, and management of CV risk factors, including diabetes, was suboptimal. This study has important practice implications.
Waist Circumference, BMI, and Their Association With Cardiometabolic and Global Risk Among Whites and Racial/Ethnic Minorities
Christian and Mosca conducted a study to determine if waist circumference (WC) or BMI was more strongly associated with cardiometabolic risk factors among family members of patients hospitalized for cardiac disease, overall and by race/ethnicity. The study included 472 participants who had a mean age of 48+/-14 years; 67% were women, and 36% were nonwhite. The most common correlate of increased WC and BMI was increased hs-CRP level. Overall, increased WC was the strongest correlate of glucose level 100 or greater and hs-CRP level 3.0 or greater. A BMI of 25 kg/m2 or greater was the strongest predictor of BP 140/90 mm Hg or greater, low high-density lipoprotein (HDL), triglyceride level 150 or greater, and global CV risk of 10% or greater. Among nonwhites, increased WC did not identify those with BP 140/90 mm Hg or greater, glucose level 100 or greater, or global risk of 10% or greater, and a BMI of 25 kg/m2 or greater did not identify those with low HDL or glucose level 100 or greater. There was a significant interaction between race/ethnicity and increased BMI in predicting low HDL (P <0.01), with a stronger correlation in whites than nonwhites. The prevalence of cardiometabolic risk factors and their correlation with WC and BMI varied by race/ethnicity. The authors concluded that these data support the inclusion of both WC and BMI in screening guidelines for diverse populations to identify individuals at increased cardiometabolic and global risk.
Energy Drinks May Pose Risks for People With High BP and Heart Disease
In a small study conducted by Kalus et al, 15 healthy young adult participants (53% female; average age, 26 years) drank 2 cans of an energy drink that contained 80 mg of caffeine and 1,000 mg of taurine (they abstained from other forms of caffeine for 2 days before and throughout each day of the study). For 7 days, BP, heart rate, and electrocardiogram were measured before and again at 30 minutes and 1, 2, 3 and 4 hours after consumption. Within 4 hours of energy drink consumption, maximum systolic BP increased by 7.9% on day 1 and by 9.6% on day 7; diastolic BP increased by 7% and 7.8%, respectively, within 2 hours of energy drink consumption. Heart rate increased by 7.8% on day 1 and by 11% on day 7. Over the duration of the study, heart rates increased by 5 to 7 beats per minute and systolic BP increased by 10 mm Hg after energy drink consumption. No significant electrocardiogram changes were observed. The authors note that although the increases did not reach dangerous levels in these healthy volunteers, the increases in BP and heart rate could prove to be clinically significant in patients with heart disease or in those who consume energy drinks often. Kalus et al suggested that, until further studies are conducted, individuals with high BP and heart disease should be advised to avoid these drinks.
Preventive Cardiovascular Nurses Association Joins the Fight Against Heart Failure
Preventive Cardiovascular Nurses Association has partnered with the American Association of Heart Failure Nurses and the Society of Chest Pain Centers to develop a patient education handbook, "Fight Against Heart Failure, Four Ways Every Day." The focus of the handbook is to empower patients to take control of heart failure by eating a heart-healthy diet, exercising regularly, monitoring their weight and symptoms, and taking prescribed medications regularly. The colorful 17-page handbook includes several journal pages that allow patients to track their symptoms, weight, and dietary sodium intake. Also included are helpful notes pages and places to keep an up-to-date list of medications and provider names and telephone numbers.
In the near future, the Fight Against Heart Failure project, sponsored by Scios, Inc, will include a public awareness campaign. This campaign will educate the general public about the signs and symptoms of heart failure as well as heart failure prevention strategies. For more information about this campaign and to order a supply of free handbooks, visit http://www.fightheartfailure.com or call 866-626-6636.
Valentine's Day and Women's Heart Health Awareness
February is Heart Month, a perfect opportunity for both healthcare professionals and the public to reflect on how vital it is to protect a woman's heart. Cardiovascular disease kills 1 woman every minute.
The National Heart, Lung, and Blood Institute's "Heart Truth" campaign reminds us that 1 in 3 American women die of heart disease, not cancer, and it can strike at a younger age than most of us expect. Eight million women are living with some form of heart and blood vessel disease. Nurses need to be aware of how heart disease presents and is treated so these statistics can be improved. In contrast to men presenting with sudden death, in women, angina subsequent presentation of coronary heart disease. However, their angina has been characterized as "atypical," although the reverse may be more accurate-that the atypical symptoms that men present with are the "typical" symptoms for women. Therefore, raising awareness about women and heart disease is a key step in stemming the tide of premature death. Women need to "know their numbers" related to their individual risk factors.
Several tools are available for calculating and assisting women to understand their risk. The American Heart Association (AHA) offers the "Go Red Heart CheckUp," an online tool for calculating 10-year risk (http://www.americanheart.org). Another risk tool recently developed specifically for women is the Reynolds Risk Score (http://www.reynoldsriskscore.org). Finally, the AHA Guidelines for Heart Disease Prevention in Women 2007 Update offers both a classification system that places women as high risk, at risk, and optimal risk and evidenced-based recommendations for preventive therapies and action plans. During Heart Month, encourage the women in your life to check their numbers.
Preventive Cardiovascular Nurses Association (PCNA) has its own campaign to raise awareness about women and heart disease, "Tell a Friend About Women and Heart Disease." This campaign asks each nurse who participates to reach out to 10 women, with the goal of delivering our message to more than 10,000 women. We ask you to join in our efforts by finding an audience with whom you can speak about women and heart disease. This can be an informal meeting or given as a slide presentation. On the PCNA Web site, you will find a slide presentation and a script that has already been prepared for you. Be creative in finding ways to get involved: at a brown bag lunch at work, having a pot luck dinner party sharing a low-fat dish, at your health club or community center, or at a book club or place of worship. We hope that you share our passion and move out to influence others whose lives may be saved through YOU.
Section Description
The Journal of Cardiovascular Nursing is the official journal of the Preventive Cardiovascular Nurses Association. PCNA is the leading nursing organization dedicated to preventing cardiovascular disease through assessing risk, facilitating lifestyle changes, and guiding individuals to achieve treatment goals.