Transcript File - Sallie A. Alvarez, Registered Nurse

Hispanic
Women and
Heart Disease
Sallie Alvarez
March 12,2013
Demographics
 Hispanics
constitute one of the fastestgrowing racial/ethnic groups in the United
States
 By 2050, Hispanics are expected to number
97 million and account for nearly onequarter of the U.S. population.
(Morales, Lara, Kington, Valdez & Escarce, 2007)
Heart Disease
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About 600,000 people die of heart disease in the United
States every year–that’s 1 in every 4 deaths.
Heart disease is the leading cause of death for both men
and women.
Coronary heart disease is the most common type of heart
disease, killing more than 385,000 people annually.
Every year about 935,000 Americans have a heart attack.
Of these, 610,000 are a first heart attack. 325,000 happen in
people who have already had a heart attack.
Coronary heart disease alone costs the United States $108.9
billion each year. This total includes the cost of health
care services, medications, and lost productivity.
("Heart disease facts," 2012)
Heart Disease and Women

Heart disease causes 1 in 3 women’s deaths each year,
killing approximately one woman every minute.

90 percent of women have one or more risk factors for
developing heart disease.

Since 1984, more women than men have died each year
from heart disease and the gap between men and
women’s survival continues to widen.

While 1 in 31 American women dies from breast cancer
each year, 1 in 3 dies of heart disease.
(Go red for Women, 2012)
Heart Disease and Hispanic Women
Hispanic women are likely to develop heart
disease 10 years earlier than Caucasian women.
 Only 1 in 3 Hispanic women are aware that heart
disease is their No. 1 killer.
 Only 3 in 10 Hispanic women say they have been
informed that they are at a higher risk.
 Only 1 in 4 Hispanic women is aware of treatment
options.
 Hispanic women are more likely to take preventive
actions for their family when it comes to heart
health.
(Go Red for Women, 2012)
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Anatomical Differences
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Women are smaller in stature and have
smaller coronary arteries
Women deposit plaque differently causing
impairment in vasodilator response
Women’s resting heart rate is higher
Lower blood volume and lower oxygen
capacity
Greater percentage of fat in women
(Netce, 2011)
Risk Factors
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Age
Family history
High blood pressure
High cholesterol
Smoking
Overweight
Diabetes
Metabolic Syndrome
Lack of Physical Activity
Less than 5 servings of fruit and vegetable a
day
(Hintz, 2010)
Gender Specific Risks
 Employment
Role Conflict- higher stress at
the job increases risk comparable to men
 Oral Contraceptives increases MI risk
 Menopause causes lowered estrogen
levels which increases LDL levels
(Netce, 2011)
Prevalence of Risk Factors for Hispanic
Women in the U.S.
 Hypertension=
23.5%
 Hyperlipidemia= 36.9%
 Obesity= 42.6%
 Diabetes= 17.2%
 Smoking= 15.2%
(Daviglus, 2012)
Healthy People 2020 Goal
Improve cardiovascular health and quality
of life through prevention, detection, and
treatment of risk factors for heart attack
and stroke; early identification and
treatment of heart attacks and strokes; and
prevention of repeat cardiovascular events.
(CDC, 2012)
Social Factors
 Language
barriers leads to poor
outcomes
 Low education/cognition
 Lack knowledge to seek out resources to
get help
 Geographic location makes it difficult to
get to health care resources where
women sometimes do not drive.
(Morales, Lara, Kington, Valdez & Escarce, 2007
)
Political Factors
 High
levels of immigration from Latin
America have created a large foreignborn and Spanish-speaking Hispanic
population in the United States.
 Some illegal residents afraid to seek
medical care, fearing deportation.
 As many as 98 percent report speaking
primarily Spanish at home, while only 24
percent report speaking English very well.
(Morales, Lara, Kington, Valdez & Escarce, 2007)
Political Factors
Organizations making strides against
health disparities and promoting
Hispanic health awareness and
interventions.
 The
National Alliance for Hispanic Health
 National Council of La Raza
 The Hispanic Health Council
 The National Hispanic Health Foundation
 The Office of Minority Health
(Gillette, 2012)
Economic Factors
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A 2009 Gallup poll found that 41.7 percent of
Hispanics lacked health insurance (Gillette,
2012)
While the median family income for all
Americans was $42,299, the median income
for Hispanic families was $26,178 (Morales,
Lara, Kington, Valdez & Escarce, 2007)
No primary care physician- studies have
shown that Hispanics seek out less medical
care
Limited or no money for preventive care
Cultural Factors
 Woman
takes care of family and husband
but puts herself last
 Unhealthy cooking ingredients i.e. pork
and lard
 Communication barriers exist with healthcare workers since Spanish is primary
language
 Exercise is not seen as necessary to
improve health
Preventing Heart Disease
 Stop
smoking
 Monitor Blood pressure
 Exercise regularly
 Control Blood sugar
 Eat diet low in fat/salt/cholesterol
 Know your risk factors
 Debunk myths
Primary Prevention
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During office visits, check all risk factors and
educate patient on all parameters.
Health Fair in churches, neighborhoods to
target Hispanic women and nurses will check
blood pressures, blood sugars, weight, and risk
factors
Nurses will educate on diet choices to help
chose meals that help modify cultural favorite
foods into healthy meals.
Nurses will provide different alternatives to
incorporate exercises into participant’s
lifestyle.
Secondary Prevention
 Early
detection and knowledge of
symptoms.
 Review medication compliance if
applicable
 Knowing when to call physician/911. Early
intervention increases damage to heart
and or may help prevent death.
 Encourage follow up EKGs, stress test,
blood work to monitor any changes
Tertiary Prevention
 Cardiac
rehabilitation
 Home
health care to reinforce need to stay
on necessary medications
 Educate
patient on need for regular
physician nurse follow-up
Outcomes
 Education
critical for knowledge of
preventative measures
 Better
 Better
awareness of risk factors
awareness of symptoms and need
for early intervention
Resources
 American
Heart Association
 Centers of Disease Control
 Health Department
 Blood Pressure Screenings at
pharmacies
 Primary Care Physician
References
American Heart Association (2012). Heart disease statistics at a glance. Retrieved from
http://www.goredforwomen.org/about-heart-
disease/facts_about_heart_disease_in_women-sub-category/statistics-at-a-glance/
Centers for Disease Control and Prevention, Division For Heart Disease and Stroke
Prevention. (2012). Heart disease facts. Retrieved from
http://www.cdc.gov/heartdisease/facts.htm
Daviglus, M. L., Talavera, G. A., Avilés-Santa, M. L., Allison, M., Cai, J., Criqui, M. H.,
Stamler, J. (2012). Prevalence of major cardiovascular risk factors and cardiovascular
diseases among Hispanic/Latino individuals of diverse backgrounds in the united
states. JAMA: The Journal of the American Medical Association, 308(17), 1775-1784.
doi: 10.1001/jama.2012.14517
References
Gillette, H. (2012, July 5). Top 5 hispanic organizations in the u.s.. Retrieved from
http://www.voxxi.com/hispanic-health-organizations/
Gillette, H. (2012, August 2). What are the main issues affecting hispanics in the U.S.?.
Retrieved from http://www.voxxi.com/health-issues-hispanics/
Go Red for Women (2012). Causes and prevention of heart disease. Retrieved from
http://www.goredforwomen.org/about-heartdisease/facts_about_heart_disease_in_women-sub-category/causes-prevention/
Healthy People 2020 (2012). Heart disease and stroke. Retrieved from
http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid
=21#seven
Hintz, K. (2010, April 27). Ways to lower your blood pressure without medication.
Retrieved from
http://www.examiner.com/article/ways-to-lower-your-blood-pressure-without-medication
References
Morales, L. S., Lara, M., Kington, R. S., Valdez, R. O., & Escarce, J. J. (2007).
Socioeconomic, cultural, and behavioral factors affecting hispanic health outcomes.
National Institute of Health, 13(4), 477-503. doi: 10.1177/104920802237532
Netce Continuing Education for Healthcare Professionals (2011). Women and heart
disease. Retrieved from http://www.netce.com/coursecontent.php?courseid=698
Sherrod, M., McIntire. (2011). Hispanic women's symptoms of coronary heart
disease: Are they different? Hispanic Health Care International, 9(1), 5-12.
doi: http://dx.doi.org.ezproxy.lib.ucf.edu/10.1891/1540-4153.9.1.5