World Heart Day 2018

Today, September 29, marks World Heart Day (WHD) around the world. World Heart Day brings awareness to the prevention and control of cardiovascular diseases (CVDs) which plays a significant role in our daily lives contributing to our overall health and wellness.

What are Cardiovascular diseases?

Cardiovascular diseases are a group of disorders of the heart and blood vessels and they include:

  • Coronary heart disease – disease of the blood vessels supplying the heart muscle;
  • Cerebrovascular disease – disease of the blood vessels supplying the brain;
  • Peripheral arterial disease – disease of blood vessels supplying the arms and legs;
  • Rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;
  • Congenital heart disease – malformations of heart structure existing at birth;
  • Deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.

According to the World Health Organization (WHO), cardiovascular diseases take the lives of 17.7 million people every year, and accounts for 31% of all global deaths. Of these deaths, 85% are due to heart attack and stroke.

Projects around the world

The global fight against CVDs is happening throughout the world. Some examples include:

– Through the HEARTS project based in Manila, Philippines, WHO and partners like the United States Centers for Disease Control and Prevention (CDC), are supporting ways to fight cardiovascular disease through training, planning and implemention.

– A two-year Standardized Hypertension Treatment project launched in 2015 by the Pan American Health Organization (PAHO) and CDC on the Caribbean island of Barbados, enacted a mission to improve hypertension treatment and control among Barbadians with raised blood pressure through standardizing care for hypertensive patients, prescribing and making available the most effective medicines for treating each person’s condition. The principal investigator of the project highlighted, “It was also encouraging to see the cultural and behavioural change in the clinics among health workers who had to deliver a more focused form of care.” It is important to also note how cultural and social factors play a vital role to behavioral change when it came to seeing patients achieving satisfactory blood pressure control.

Specific intervention activities included: (1) Developing salt reduction and tobacco control plans, (2) Implementing simplified and standardized management protocols, (3) Improving access to medicines and technologies, and (4) Building capacities of health and other providers.

http://www.who.int/news-room/feature-stories/detail/treating-cardiovascular-disease-in-barbados

http://www.who.int/news-room/feature-stories/detail/philippines-embraces-efforts-to-step-up-cardiovascular-disease-care

Key messages to protect heart health

There are small, yet very impactful ways to make “heart health at the heart of all health”. Here are some facts/tips!

  • Tobacco use, an unhealthy diet, and physical inativity increase the risk of heart attacks and strokes.
  • Engaging in physical activity for at least 30 minutes every day of the week will help to prevent heart attacks and strokes.
  • Eating at least five servings of fruit and vegetables a day, and limiting your salt intake to less than one teaspoon a day, also helps to prevent heart attacks and strokes.

When it comes to reducing cardiovascular diseases and improving heart health, it is pivotal to identify those individuals with or at highest risk of CVDs due to risk factors such as hypertension, diabetes, hyperlipidaemia or an already established disease to ensure they receive appropriate treatment in order to prevent premature deaths. During 2015, 17 million premature deaths occurred from noncommunicable diseases (under the age of 70) with 82% of deaths reported in low- and middle-income countries, and 37% caused by CVDs (WHO, 2017). Although there has been great strides toward the prevention of cardiovascular diseases, inequalities including access to noncommunicable disease medicines, and basic health technologies in all primary health care facilities is essential to those in need of receiving treatment and education.

The epidemic of cardiovascular diseases has also impacted my life with my grandmother,mother, and all 4 of my aunts and uncles suffering from hypertension. In March 2018, my cousin at the age of 35 suffered from a massive stroke and is successfully recovering. I spent bringing awareness to this day by cooking popular caribbean dishes with a healthy spin and educating family and friends across the United States and Caribbean on the importance of having and maintaining a healthy heart. In addition, I took a 2 mile walk through my neighborhood taking in the beautiful Florida scenery and cool breeze.

How did you celebrate World Heart Day?

 

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World No Tobacco Day 2018

The focus of this year’s World No Tobacco Day on May 31st is the impact of tobacco on cardiovascular health. In 1967 the Surgeon General’s report definitively linked smoking to lung cancer and presented evidence that it causes cardiovascular problems. Despite all the evidence and outcry from health professionals, it was not until the 1990s when many countries around the world banned smoking in public places. There have been several policies including those deterring tobacco companies from advertising to younger age groups and forcing them to add warning labels on tobacco products. Despite all these efforts, tobacco still kills 7 million people each year and tobacco use (and secondhand smoke) is responsible for nearly 12% of all deaths globally due to cardiovascular diseases (CVDs).

Tobacco1

Tobacco smoke contains more than 7000 chemicals and is divided into a) a particulate phase which contains nicotine and total aerosol residue or tar and b) gas phase which contains carbon monoxide and other gases. The image below depicts how chemicals in tobacco cause CVDs.

Tobacco2

While the effects of tobacco on heart health are well known, knowledge among the public that tobacco is one of the leading causes of CVD is very low. The figure below from WHO’s brochure shows the percentage of adults who do not believe or do not know that smoking causes stroke and heart attacks.

Tobacco3

The goals of World No Tobacco Day 2018 are to:

  • Emphasize the links between use of tobacco products and CVDs
  • Increase awareness among the broader public about the impact of tobacco and exposure to secondhand smoke on heart health
  • Provide opportunities to make commitments to promote heart health
  • Encourage countries to strengthen implementation of MPOWER

WHO and the US Centers for Disease Control and Prevention launched the Global Hearts initiative in September 2016. The initiative aims to support governments in bolstering prevention and control of CVD. Global Hearts comprises of three technical packages: a) MPOWER for tobacco control b) SHAKE for salt reduction and c) HEARTS to strengthen management of CVD in primary health care settings.

Hopefully, on this World No Tobacco Day, the governments will commit to protect their citizens from tobacco use. The truth of the matter remains: prevention and control are not sole responsibilities of governments. Health care professionals, public health agencies/staff, national/state/local governments, educational institutions, business leaders/businesses, community based organizations and community leaders all have a role in making everyday a “No Tobacco Day”.

Beat Diabetes: WHO call to action

It’s World Health Day today and the WHO has issued a call to action to “Beat Diabetes”.

World Health Day 2016 poster: Halt the rise in diabetes

Source: World health day

Diabetes is  a set of diseases that result in excessive amounts of sugar in the blood a.k.a high blood glucose. Type 2 diabetes is among the most common types of diabetes and it occurs when the body stops using insulin properly ultimately leading to “insulin resistance”. The other common types are

  1. Type 1 diabetes
  • occurs due to lack of insulin production
  • poorly understood form of diabetes

2. Gestational diabetes

  • occurs during pregnancy
  • risk factor for pregnancy related complications
  • increased risk of Type 2 diabetes for both the mothers and their children.

Diabetes is a metabolic disorder and its long term complications include heart disease, strokes, diabetic retinopathies, kidney failure  and poor blood flow to the limbs that could result in amputations. It is also among the leading cause of death. In 2012 nearly 1.5 million deaths were directly attributed to diabetes. Early diagnosis, management of blood glucose levels through diet, physical activity and medication when necessary and routine screenings are not only cost-effective but are effective interventions to prevent diabetes-related complications from occurring or worsening.

A new study published in The Lancet this month has raised the alarm by showing that there has been quadrupling of the number of people with diabetes since 1980. The pooled analysis of 751 population-based studies involving nearly 4.4 million participants from 146 countries shows increasing burden of diabetes, more so in low and middle income countries than in high-income countries. This number is startling and is  a wake up call to public health and health care professionals.

World Health Day 2016 banner

Image Source: World health day

 

Diabetes is a treatable disease and efforts to prevent/treat it, will help achieve MDG 3 target of preventing premature mortality from noncommunicable diseases by one-third by 2030. We should be working together to raise awareness about diabetes with a particular focus on low and middle income countries, scale up prevention strategies that are specific, effective and affordable.

For this campaign, WHO has created a quiz-take it to test your knowledge!

Together we can Beat Diabetes!

Note: This was cross-posted to my blog

PRI’s The World: Mysterious Kidney Disease Now Found in South Asia

I found this story particularly interesting, since I did a one-year fellowship with CDC-NIOSH on pesticide poisoning surveillance. The story examines a high incidence of kidney disease in Sri Lanka and discusses how farmers, medical professionals and government authorities have been dealing with it. The full story can be viewed here; a summary of the story, and a video, can be found below.


A form of chronic kidney disease (CKD), similar to one that has been killing sugarcane field workers in Central America, has now been observed in South Asia. The World‘s Rhitu Chatterjee reports from Sri Lanka, where thousands of rice farmers and their families are affected. Her story is part of a series, Mystery in the Fields, produced in collaboration with The Center for Public Integrity.

The afflicted show no signs of high blood pressure or diabetes – the most common causes of CKD elsewhere in the world – and yet their kidneys are failing. There is no known cure. Authorities are trying to find a cause, but their preliminary findings have not reached the people whose lives are threatened.

A new study by the World Health Organization and the Sri Lankan Ministry of Health suggests that Sri Lanka’s CKD sufferers may have been poisoned by chronic, low-level exposure to the heavy metals cadmium and arsenic. Researchers think the toxins may be coming from farm chemicals, such as pesticides and fertilizers. But while the study points to a possible cause, the study’s results have not been widely publicized.

Chatterjee speaks with rice farmers, doctors, government officials, and a representative from Sri Lanka’s farm chemicals industry. Her report examines the results of the WHO study, the secrecy that surrounds it, and the frustration of Sri Lankans who see little being done to prevent more people from falling ill.

The full report can be found here: http://bit.ly/Q9Gv1g

And we wonder at the growing obesity epidemic…

Global health advocates are becoming increasingly vocal about the growing international obesity epidemic, and all of the complications that come with it (e.g. cancer, diabetes, etc.). I have been traveling all across the state during the last few weeks for my day job (I coordinate a surveillance program at the  state health department), so I have been spending a lot of time in airports. Here is a shot of a drink vending machine at one of them.

Yep, that’s right: rows and rows of sodas and sugar-sweetened beverages, and no water. Next to this machine is a snack machine (naturally full of candy and salty snacks) and next to that was a coffee machine. There was no place in this tiny airport to buy a bottle of water.

And that, ladies and gentlemen, is why over a third (35.7%) of Americans are obese.