Cardiovascular Risk Factors Among Preventive Cardiovascular Nurses
The cornerstone of the prevention of cardiovascular disease (CVD) is the identification and reduction of cardiovascular risk factors. While genetic factors may contribute to the development of CVD, most research has found that environmental and behavioral factors play an equally important role. Behaviors such as consuming a healthy diet (low in saturated fat, high in fiber, fruits, and vegetables), performing regular exercise, maintaining a normal weight, avoiding cigarette smoke, reducing stress, and maintaining desirable levels of blood pressure and cholesterol have all been linked to reduced risk for CVD.1
A recent survey of cardiologists compared their self-reported risk factors to an age-matched sample drawn from the national Behavioral Risk Factor Surveillance System and found lower rates of risk factors among the cardiologists.2 So how do cardiac prevention nurses compare?
Because cardiovascular nurses provide much of the counseling and education for CVD risk reduction, they likely serve as role models for behavior change. It can be expected that nurses who know their risk factors and who follow healthy lifestyle behaviors will be more effective in these counseling roles.
Preventive Cardiovascular Nurses Association (PCNA) investigators designed a Web-based survey based on the Cardiologists' Lifestyle Survey to help answer that question. Thanks to the support of the past and current nurse members of PCNA, more than 1,300 surveys that self-reported cardiac risk profiles were completed. Data analyses are being performed by the study investigators and will be compared to risk factor rates from national databases using age-matched samples. Stay tuned for the first results to be announced at the PCNA Annual Symposium.
References:
1. Pearson TA, Bazzarre TL, Daniels SR, et al. American Heart Association guide for improving cardiovascular health at the community level: a statement for public health practitioners, healthcare providers, and health policy makers from the American Heart Association Expert Panel on Population and Prevention Science. Circulation. 2003;107:645-651.
2. Abuissa H, Lavie C, Spertus J, O'Keefe J Jr. Personal health habits of American cardiologists. Am J Cardiol. 2006;97:1093-1096.
Plant Stanols and Sterols: Functional Foods for Cholesterol Control
March is nutrition month-a time for nurses to gain more information about the role that plant sterols and stanols play in overall heart health. Also called phytosterols, they are essential components of plant membranes, are similar in structure to animal cholesterol, and carry out similar cellular functions in plants. Sterols and stanols are naturally found in many fruits, vegetables, nuts, seeds, cereals, legumes, and other vegetable sources. When added to the diet, these phytosterols may help reduce cholesterol levels by blocking its absorption. The intestine absorbs cholesterol from dietary and biliary sources. Cholesterol that is reabsorbed circulates throughout the body, contributing to the development of atherosclerotic plaque. When enough plant sterols and stanols are consumed in the diet, they will compete with cholesterol in the digestive tract, resulting in a reduction in the amount of cholesterol that is reabsorbed into the body and returned to the liver.
Plant sterols and stanols found naturally in food exist in small amounts, generally not enough to significantly lower cholesterol levels. The challenge of incorporating larger amounts of plant phytosterols into the diet has been overcome in many countries by fortifying foods with sterols and stanols. Margarines, salad dressings, cereals, yogurt, and orange juice are some of the products available that are fortified with phytosterols. Plant sterols and stanols are also available in a softgel capsule. Food products and dietary supplements that contain plant sterols or stanols may qualify for a health claim for reduced coronary heart disease risk when consumed as part of a low-fat, low-cholesterol diet. The Food and Drug Administration allows products to carry the health claim provided that the product also meets the requirements for being low in saturated and total fat.1
In its 2006 Diet and Lifestyle Recommendations, the American Heart Association (AHA) stated that individuals should consume plant sterols and stanols daily from a wide variety of foods and beverages. The AHA also notes that maximum effects are achieved at sterol and stanol intakes of approximately 2 g/d.2 This is consistent with the evidence statement made by the National Cholesterol Education Program's Adult Treatment Panel III that states: "Daily intake of two to three grams per day of plant sterol and stanol esters will reduce LDL cholesterol by 6 to 15 percent."3
Individuals on statin drug therapy may achieve further reductions in their blood cholesterol levels when consuming a diet rich in plant sterol and stanol. A 10% to 15% reduction in LDL cholesterol levels has been seen in some studies when statins were combined with a higher intake of plant sterols.
The Preventive Cardiovascular Nurses Association (PCNA) has developed a Plant Stanol/Sterol Esters worksheet in its online resource: PCNA Forms: Practical Information for Your Cardiovascular Risk Reduction Clinic: Medical Evaluation Forms, Assessment Tools, and Educational Materials. This worksheet includes general information on plant stanol and sterol esters, how they are packaged, and the difference between stanols and sterols and a chart detailing the dietary information of some of the most popular products containing plant stanols and sterols. To view this worksheet and more than 90 other forms, please visit http://www.pcna.net/members/exams/forms_guide_intro.
For more reading about nutrition month activities and nutritional information, visit the American Dietetic Association's Web site at http://www.eatright.org.
References:
1. FDA authorizes new coronary heart disease health claim for plant sterol and plant stanol esters. FDA Talk Paper. http://www.cfsan.fda.gov/~lrd/tpsterol.html.
2. Lichtenstein, AH, Appel, L J Brands, M, et al. Diet and lifestyle recommendations revision 2006: a scientific statement for the American Heart Association Nutrition Committee. Circulation. 2006;114.
3. National Cholesterol Education Program. NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III). Final report. September 2002. NIH Publication No. 02-5215.
Highlights from Stroke Nursing Symposium
The State-of-the Art Stroke Nursing Symposium is an important preconference to the International Stroke Conference, held in New Orleans, Louisiana, February 19, 2008.
Each year, the conference provides an essential update of valuable and easily transferable information, as well as networking opportunities for nurses and other healthcare professionals.
Several highlights of the symposium included reports of advances in ischemic and hemorrhagic stroke management, presentations of innovative best clinical practices across the care continuum, discussions of lessons learned from the recertified Primary Stroke Centers, descriptions of creative models of care that improve care delivery, and evidence-based recommendations regarding how rehabilitative care can assist patients and families to more effectively make that important transition from the hospital to home.
The symposium speakers represented a blend of internationally known experts from nursing, medicine, and other disciplines that provide valuable knowledge applicable to diverse practice settings.
This event was sponsored by the American Heart Association's Stroke Nursing Committee of the Council of Cardiovascular Nursing and cosponsored by the Preventive Cardiovascular Nurses Association.
For more information about the 2009 State-of-the-Art Stroke Nursing Symposium or for information on submitting an abstract, visit http://www.strokeconference.org.
Preventive Cardiovascular Nurses Association Supports Certification Program in Clinical Lipidology
The Accreditation Council for Clinical Lipidology (ACCL) is the first and only independent certifying organization that has developed standards and an examination in the field of clinical lipidology for the growing number of mid- and advanced-level allied healthcare professionals who manage and treat patients with lipid disorders.
Certification by the ACCL demonstrates professional commitment to the prevention of cardiovascular disease and documents expertise in lipid management for patients, professionals, and colleagues. It also correlates with the Preventive Cardiovascular Nurses Association (PCNA) mission of promoting nurses as leaders in the prevention of cardiovascular disease.
To become credentialed, candidates must meet the basic eligibility criteria and training requirements of the ACCL, which require applicants to demonstrate that they have earned 200 credit-hour equivalents or "points" to qualify for the examination. Points can be earned in a variety of ways, including primary and subspecialty certifications, relevant academic practice, and involvement in relevant clinical research and participation in lipid-focused continuing medical education activities.
The PCNA has been a part of this initiative from the very beginning and is pleased to announce that since the inception of the ACCL in November 2007, a total of 62 allied health professionals have been awarded the designation of "clinical lipid specialist." Of these 62 credentialed specialists, 24 are registered nurses.
The ACCL will administer 5 examinations in 2008. The dates and venues are as follows:
* Saturday, February 23, 2008, Philadelphia, Pennsylvania
* Friday, May30, or Saturday, May 31, 2008, Seattle, Washington
* Saturday, July 19, 2008, Denver, Colorado
* Saturday, August 23, 2008, Hilton Head, South Carolina
* Saturday, September 27, 2008, Chicago, Illinois
For more information about the ACCL, to obtain an application, or to review eligibility requirements, please visit the ACCL Web site at http://www.lipidspecialist.org.
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.