We're #2 in heart disease! Now I've got something else to worry about, great!

Our Melting HeartIt's amazing the things you find on the Internet. In the disturbingly titled Morbidity and Mortality Weekly Report I ran into from the Centers for Disease Control and Prevention, Puerto Rico has the second highest prevalence of myocardial infarction (MI) and angina/coronary heart disease (CHD) in all of the 50 states, the District of Columbia (DC), Puerto Rico, and the U.S. Virgin Islands (USVI). Only West Virginia had a higher prevalence. As the report states, heart disease has been the leading cause of death in the United States for the past 80 years and also results in substantial health-care expenditures; for example, coronary heart disease is projected to cost an estimated $151.6 billion in direct and indirect costs in 2007.

To obtain these results, the CDC analyzed self-reported data from the 2005 Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a state-based, random-digit--dialed telephone survey of the noninstitutionalized, U.S. civilian population aged >18 years and is administered by state health departments in collaboration with CDC. A total of 356,112 respondents from all 50 states, DC, Puerto Rico, and USVI participated in the survey. State (including DC) and territory sample sizes ranged from 2,422 (USVI) to 23,302 (Washington).

Many of the states with the highest prevalence were clustered in the lower Mississippi and Ohio River valleys, areas that have been documented previously as having high proportions of residents with heart-disease risk factors and high heart-disease mortality. A previous analysis suggested that states with a high prevalance of heart-disease mortality may be attributed to differences in cultural norms, lack of economic opportunity, poverty, and social isolation. Additional studies that include small-area analyses, in-depth interviews, and more precise race/ethnicity prevalence estimates, quality-of-care assessments, and health outcomes might further define these differences and lead to effective interventions.

What you can do?

Well first, you need to assess yourself against the list of high risk factors. Modifiable risk factors, including high blood pressure, high cholesterol, diabetes, tobacco use, obesity, and lack of exercise, are the main targets for primary and secondary prevention of heart disease and stroke. In principle, all people can take steps to lower their risk for heart disease and heart attack by:

  • Prevent and control high blood cholesterol - High blood cholesterol is a major risk factor for heart disease. Preventing and treating high blood cholesterol includes eating a diet low in saturated fat and cholesterol and high in fiber, keeping a healthy weight, and getting regular exercise.
  • Prevent and control high blood pressure - Lifestyle actions such as healthy diet, regular physical activity, not smoking, and healthy weight will help you to keep normal blood pressure levels and all adults should have their blood pressure checked on a regular basis.
  • Prevent and control diabetes -People with diabetes have an increased risk of heart disease but can reduce their risk. Also, people can take steps to reduce their risk for diabetes in the first place, through weight loss and regular physical activity.
  • No tobacco - Smoking increases the risk of high blood pressure, heart disease, and stroke. Never smoking is one of the best things a person can do to lower their risk. And, quitting smoking will also help lower a person’s risk of heart disease. A person's risk of heart attack decreases soon after quitting. If you smoke, your doctor can suggest programs to help you quit smoking.
  • Moderate alcohol use -Excessive alcohol use increases the risk of high blood pressure, heart attack, and stroke. People who drink should do so only in moderation and always responsibly.
  • Maintain a healthy weight -Healthy weight status in adults is usually assessed by using weight and height to compute a number called the "body mass index" (BMI). BMI usually indicates the amount of body fat.
  • Regular physical activity - Adults should engage in moderate level physical activities for at least 30 minutes on most days of the week. For more information, see CDC's nutrition and physical activity program Web site.
  • Diet and nutrition - Along with healthy weight and regular physical activity, an overall healthy diet can help to lower blood pressure and cholesterol levels and prevent obesity, diabetes, heart disease, and stroke. This includes eating lots of fresh fruits and vegetables, lowering or cutting out added salt or sodium, and eating less saturated fat and cholesterol to lower these risks.
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