Cardiovascular Risks For Heart Failure Essay

Cardiovascular Risks For Heart Failure Essay

Cardiovascular Risks For Heart Failure Essay

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Older adults present with various chronic illnesses that affect both their physical health and mental health. This means that as psychiatric and mental health nurse practitioners deal with older adults, group therapy may be an effective way of making sure that mental health services are accessible to this growing population. However, there are various factors which may make it difficult to provide effective mental and psychiatric health services to this patient population through group therapy. Taking note of such challenges and addressing them as early as possible during the initial stages of the group formation and processes is an important way of making sure that group therapy actually works for older adults.Cardiovascular Risks For Heart Failure Essay


The group therapy that shall be described here focused on a particular population of older patients. These are patients that are being rehabilitated due to complications associated with heart failure or those that have been diagnosed with congestive heart failure and other cardiovascular risks for heart failure. These patients were also diagnosed with depression and this is why the group therapy was started. Research has established that there is close relationship between heart failure and depression, in that the two conditions exacerbate each other in elderly patients (Liguori et al., 2018). Therefore, while the older patients were taking part in a cardiac rehabilitation program in the nursing home, the services of the therapist were procured to help them in dealing with depression and associated disturbances in order to improve their physical and mental health. This is why the group therapy was considered necessary.Cardiovascular Risks For Heart Failure Essay

After the formation of the group through the identification of the older patients that actually presented with depression, based on the geriatric depression scale as well as the DSM-5 criteria for major depressive disorder, the next session fell under the storming. This is the stage where power and control issues are established. It is also where differences can be seen before they actually lead to conflicts. Issues pertaining to hierarchy also come out in this stage (Malhotra & Baker, 2019). In this particular group, it was evident that since the members were living together in the nursing home, they had already developed hierarchies, associations and conflicts. Such issues however manifested themselves in a clear manner once they were put together in the group therapy. For instance, members started describing how a different resident made life hard for them in the nursing home because of various reasons. Others had the perception that a different resident simply did not like them because of how they looked at them. One member said that she felt uneasy and uncomfortable in the home and in the group because she felt like everyone else was avoiding her. All these issues were revealed during the storming stage and it was clear that the facilitator had so much on his hands when it comes to solving the conflicts.Cardiovascular Risks For Heart Failure Essay

Conflicts in a group therapy may prevent members of the group from being able to offer or receive the curative factors that come from being part of a group therapy. For example, low self esteem as was noted in one of the members from the description above can prevent the member from sharing her insight that may benefit the others. She may also be distracted with how others perceive her, hence preventing her from benefiting from what the rest have to say. In dealing with this issue, the facilitator ensured that an atmosphere of open communication was developed and that members of the group could freely discuss their fears and others were allowed to freely give their insight without judging or vilifying each other. This was effective especially because imparting of advice assigns power to the person being advised (Bonhote, Romano & Cornwell, 1999). The facilitator maximized on open communication to bring the best out of each member. However, more challenges are expected because of old age such as short attention span and the need to meet individual needs specific to each member due to their multiple chronic illnesses.Cardiovascular Risks For Heart Failure Essay

The purpose of this paper is to thoroughly analyze Heart disease in the world today and how it has and currently affecting adults. Heart disease in America kills around 610,000 people each year nationwide as it is the leading cause of death in adults. But what is Heart disease? Coronary heart disease, which is often also called heart disease is the main form of heart disease. It is a disorder of the blood vessels within the heart that can lead to heart attack. When a heart attack occurs, the artery becomes blocked which prevents nutrients and oxygen from getting to the heart. Heart disease is just one of several cardiovascular diseases all of which are diseases of the blood vessel and heart system. There are other cardiovascular diseases including, high blood pressure, stroke, rheumatic heart disease, chest pain. Heart disease is a lifelong condition so unfortunately once an individual is diagnosed with it, they will have it forever in their system.Cardiovascular Risks For Heart Failure Essay

Anatomy of the Heart

The heart in an individual is one of the body’s most important organs. Essentially the heart is a pump and a muscle that is made up of four chambers separated by valves and divided into two halves. Each one of the half contains one chamber called a ventricle and one called an atrium. The atria collects the blood, and the ventricles contract in and out to push blood out of the heart. The right half of the heart pumps oxygen-poor blood which is blood that has a low amount of oxygen. This then travels to the lungs where the blood cells can obtain more oxygen. Therefore, the newly oxygenated blood travels from the lungs and into the left atrium, lastly entering the left ventricle of the heart. The left ventricle pumps the now oxygen rich blood to the organs and tissues of the body. This oxygen provides the patient’s body with energy and is essential to keep the body healthy. The general term used to determine the malfunctions of the heart is Heart Disease, or sometimes Cardiac Disease. Though there are multiple forms of heart disease, the two common forms of heart disease are a Heart Attack and Heart Failure. As both of these diseases are to some extent avoidable, there are ways and methods that an individual can take to decrease their chances of having to deal with heart disease, or to at least minimize the negative effects of existing heart disease. There are recent procedures that have been evolved such as bypass surgery and percutaneous coronary intervention this can help blood and oxygen flow to the heart more easily. But even with these procedures, the arteries still remain damaged. This most acceptably means that those individuals are more likely to have a heart attack. What’s more, the condition of someone’s blood vessels will steadily worsen unless they make changes in their daily habits. Many men and women in America have died of complications from heart disease and heart related problems and still to that day, the number is still growing. Cardiovascular Risks For Heart Failure Essay That’s why it is so vital for this nation to take action to prevent and control this disease. According to the US national Library of Medicine, “Half of adults have at least one cardiovascular risk factor. Not even 1% of the population attains ideal cardiovascular health. Despite falling coronary death rates for decades, coronary heart disease (CHD) death rates in US women 35 to 54 years of age may now be increasing because of the obesity epidemic.” People around the nation unfortunately has just become to accustom to the standards around us that Adults are often putting a “want” before a “need” when it comes to their health.Cardiovascular Risks For Heart Failure Essay


Symptoms of heart disease

Learning about how heart disease affects an individual has a high importance as different symptoms can relate to different heart related issues but knowing what to do in any heart situation is beneficial and valuable. Here are some of the symptoms an individual may notice if they have a heart related issue. The most common symptom of coronary artery disease is angina, or also known as chest pain. Angina is a medical term which can be described as a having discomfort, heaviness, aching, pressure, burning, squeezing, fullness, or painful feeling in a person’s chest. It can be mistaken for indigestion and or heartburn. Angina may also be felt in the shoulders, neck, arms, back throat, or jaw. Other symptoms of coronary artery disease include Shortness of breath, a faster heartbeat, palpitations, weakness or dizziness, sweating, and nausea. Unfortunately there is not much of a difference from the symptoms of heart disease, and the feeling of a heart attack. However; when a heart attack is occurring it typically will last 30 minutes or longer and have no sense of releasement of pain even when using oral medications. Initial symptoms may start as a mild discomfort in the chest and throat but will eventually progresses to significant pain that can be described as unbearable. Some people have a heart attack without having any symptoms at all, which is known as a silent myocardial infarction. While this is not a very common to interaction with the heart, more often than not it happens to people with diabetes.Cardiovascular Risks For Heart Failure Essay

Heart Disease affecting the population

The United States population in particular, among the older age groups is continuing to expand daily at an alarming rate. Because of the incidence of heart failure increasing with age, largely due to the development of heart failure risk factors such as coronary artery disease and hypertension, the epidemic of heart failure is likely to grow further into the upcoming decades. While some assert that the life expectancy is approaching its natural limit and heart related mortality’s are slowing life expectancy gains, the steady increase in Heart disease has been observed over the past century and yet in recent years it has not waived this increase in the aging population having implications with heart failure. According to Impact on Heart Failure , “Over the next two decades, the proportional increase in the generality of heart failure will likely exceed cardiovascular diseases and is likely going to be driven by the aging of the population nationally”. Certain minority groups also face a greater risk than others. These differences have appeared to come from an increased amount of high blood pressure, obesity, and diabetes seen in some populations that are in contrast with that of Caucasian Americans. Still, Genetic differences do exist.Cardiovascular Risks For Heart Failure Essay But diversity within different ethnic and racial groups means that genetic traits common to some groups can’t be rationalized to an entire race. For example, according to the Office of Minority Health, “while six percent of Caucasian American and African American adults are living with heart disease, African American men are thirty percent more likely to die from heart disease, as compared to Caucasian American men”. Alaska Natives and American Indians, on average are more likely to be diagnosed with heart disease and heart failure than their Caucasian counterparts. For people of all ethnicities, knowing and properly managing their biometric numbers such as cholesterol levels, blood pressure, and weight can prevent or delay heart disease and its complications in an individual.Cardiovascular Risks For Heart Failure Essay

Recent Advancements in Heart Disease

With Heart disease as one of the leading deaths in America researchers are always looking for recent advancements and ways to continue to better prevents heart disease in adults. Recently, Physicians and Researchers have created remarkable advancements in treating heart disease. The future has not become even more positive for adults with 200 new heart disease and stroke medications in development. Among, these medicines is a treatment for patients with coronary heart disease and low levels of high density lipoprotein. This medicine is an inhibiter of the bromodomain an extra terminal protein. It is thought the protein can reproduce specific biological effects than will be able to provide health benefits to these patients and reduce the prevalence of adverse cardiac events. Another possible treatments is a non-viral gene therapy that targets tissue repair and regeneration in the body. So many adults rely on the multiple forms of medications in the market of the nation today, this is including Beta blockers such as, Bisoprolol as well as, angiotensin-converting enzyme inhibitors Captopril and Enalapril. The majority of these medications work by blocking the effects of hormones that are released by the body during heart failure. These medications happen to work relatively well in the early to mid-stages of heart failure, but unfortunately once the patient reaches the later stages of heart failure, the effectiveness of the drops significantly. They also come with serious side effects of which includes worsening kidney function and hypotension. There are however Pacemakers, which are also known as cardiac resynchronization therapy, these devices have been around for more than half a century.Cardiovascular Risks For Heart Failure Essay These small devices consist of electrodes that are implanted into the heart and deliver electrical impulses to regulate the heartbeat within the individual. Two other main classes of devices are implantable cardiac defibrillators and ventricular assistance devices. Both of which work similar to pacemakers, using electricity to correct irregular heartbeats and supply supplementary pumps of pressure that help the heart pump blood in and out of the ventricles. Within the past decade there have been major breakthroughs in sensor and nanotechnology have made cardiac resynchronization therapy and implantable cardiac defibrillators. Now most patients now have a single device that does both the job of a CRT and ICD safer and more reliable for the patient. Previously, these devices were imprecise, occasionally causing violent hiccups. Doctors are now able to position multiple sensors more precisely on different chambers of the heart this allows for more coordination. Physicians are able to take patients who had poor responses to cardiac resynchronization therapy and allow them to have positive responses, this is all due to miniaturization technology which is the trend to manufacture smaller electronic, optical and mechanical products and devices.Cardiovascular Risks For Heart Failure Essay

Social and economic factors

Heart disease is a compound condition that is a leading cause of death worldwide. It is often seen as a disease of overflow, yet is strongly associated with a socio-economic status. It’s highly complex causality means that many different factors of social and economic life are compromised in its cause of disease, these factors are determined through such as workplace hierarchy and agricultural policy combined with other factors to together result in a pass for an individual lifestyle. The untangling of causes for heart disease thus automatically raises moral, political, and, social issues. These include the accepted role of the individual and of larger social efforts in its prevention’s and treatment. The construction of risk factors for heart disease likewise is embedded with questions of organized justice in the responsible direction of those at risk for heart disease, a debate within the medical literature that has received much attention, but less intriguing within the ethical literature. For example, prevention strategies may raise composite issues of responsibility and of judgements of what it is to exactly live well. After all if there was a true way to live well, who is to say what that definition entails? More than twenty three million adults worldwide have heart failure, an astounding number to a millennial such as myself. Even though over time the survival of life after the diagnosis of heart disease or heart related issues has improved, ephemerality from heart failure still remains high today. Approximately fifty percent of people diagnosed with heart failure will die within five years. Many of these patients will progress to advanced heart failure, this is characterized by symptoms at leisure despite the maximum medical therapy.Cardiovascular Risks For Heart Failure Essay These patients are considered obstinate, both the patient and the physician upon reaching this form of state are faced with ethical issues that can be very difficult to determine what is best for the patient. There has been consideration over advanced therapies including, left ventricular assist devices or a transplant, involvement of palliative care, transitioning into hospice care, as well as end of life issues such as advance directives and implantable cardioverter-defibrillator deactivation that have the need to be conveyed. Now, may advance therapies such as LVADs and cardiac resynchronization therapy have become more readily available to patients who are older as well as more obstinate. Expanding the indications for device therapy in heart failure are based on expert opinion regarding their effects and clinical trials in a beneficial way. However, careful consideration must come into perspective and be given to the cost to the general public, the potential to reduce the quality of life, the possibility of doing harm to the individual, and disparities in the care of acute heart failure patients.Cardiovascular Risks For Heart Failure Essay

Cardiovascular disease is a major cause of disability and premature death throughout the
world, and contributes substantially to the escalating costs of health care. The underlying
pathology is atherosclerosis, which develops over many years and is usually advanced by
the time symptoms occur, generally in middle age. Acute coronary and cerebrovascular
events frequently occur suddenly, and are often fatal before medical care can be given.
Modifi cation of risk factors has been shown to reduce mortality and morbidity in people
with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from
coronary heart disease, cerebrovascular disease and peripheral vascular disease in people
at high risk, who have not yet experienced a cardiovascular event. People with established
cardiovascular disease are at very high risk of recurrent events and are not the subject of
these guidelines. They have been addressed in previous WHO guidelines.a
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events.
Decisions about whether to initiate specifi c preventive action, and with what degree of
intensity, should be guided by estimation of the risk of any such vascular event. The risk
prediction charts that accompany these guidelinesb allow treatment to be targeted according to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through
changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework
for the development of national guidance on prevention of cardiovascular disease that
takes into account the particular political, economic, social and medical circumstances.Cardiovascular Risks For Heart Failure Essay

Of an estimated 58 million deaths globally from all causes in 2005, cardiovascular disease (CVD)
accounted for 30%. This proportion is equal to that due to infectious diseases, nutritional defi ciencies,
and maternal and perinatal conditions combined (1). It is important to recognize that a substantial proportion of these deaths (46%) were of people under 70 years of age, in the more productive period of
life; in addition, 79% of the disease burden attributed to cardiovascular disease is in this age group (2).
Between 2006 and 2015, deaths due to noncommunicable diseases (half of which will be due to
cardiovascular disease) are expected to increase by 17%, while deaths from infectious diseases,
nutritional defi ciencies, and maternal and perinatal conditions combined are projected to decline
by 3% (1). Almost half the disease burden in low- and middle-income countries is already due to
noncommunicable diseases (3).
A signifi cant proportion of this morbidity and mortality could be prevented through populationbased strategies, and by making cost-effective interventions accessible and affordable, both for
people with established disease and for those at high risk of developing disease (3–5).Cardiovascular Risks For Heart Failure Essay
To address the rising burden of noncommunicable diseases, in May 2000 the 53rd World Health
Assembly adopted the WHO Global Strategy for the Prevention and Control of Noncommunicable
Diseases (6). In doing so, it placed noncommunicable diseases on the global public health agenda.
Since then, WHO has strengthened its efforts to promote population-wide primary prevention
of noncommunicable diseases, through the Framework Convention on Tobacco Control (7) and
the Global Strategy for Diet, Physical Activity and Health (8). These activities target common
risk factors that are shared by CVD, cancer, diabetes and chronic respiratory disease, and their
implementation is critical if the growing burden of noncommunicable diseases is to be controlled.
These measures should make it easier for healthy people to remain healthy, and for those with
established CVD or at high cardiovascular risk to change their behaviour. However, populationwide public health approaches alone will not have an immediate tangible impact on cardiovascular
morbidity and mortality, and will have only a modest absolute impact on the disease burden (3,
4). By themselves they cannot help the millions of individuals at high risk of developing CVD
(Table 1) or with an established CVD. A combination of population-wide strategies and strategies
targeted at high risk individuals is needed to reduce the cardiovascular disease burden. The extent
to which one strategy should be emphasized over the other depends on achievable effectiveness,Cardiovascular Risks For Heart Failure Essay
as well as cost-effectiveness and availability of resources (1–4).
Although CVD already places a signifi cant economic burden on low- and middle-income countries (9), the resources available for its management in these countries are limited because of
competing health priorities. It is, nevertheless, essential to recognize that the transition to lower
levels of infectious diseases and higher levels of noncommunicable diseases is already under way;
failure to act now will result in large increases in avoidable CVD, placing serious pressures on the
national economies (10–12). In this context, it is imperative to target the limited resources on
those who are most likely to benefit. Cardiovascular Risks For Heart Failure Essay


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