Heart Disease, Stroke, & Diabetes

Background

Heart disease and stroke can result in poor quality of life, disability, and death. Though both diseases are common, they can often be prevented by controlling risk factors like high blood pressure and high cholesterol through treatment. In addition, making sure people who experience a cardiovascular emergency (stroke, heart attack, or cardiac arrest) get timely recommended treatment can reduce their risk for long-term disability and death. Teaching people to recognize symptoms is key to helping more people get the treatment they need. Diabetes is a disease that can prevented with early detection and lifestyle modifications. It is a public health priority to prevent manage, and treat heart disease, stroke, and diabetes in the Greater Nashua Public Health Region (GNPHR) to improve overall health.

Heart Disease, Stroke, & Diabetes Data Overview

Check out the points below for the main takeaways from this page. 

• Southeast Nashua and West Milford had the highest rates of heart attack mortality in the region, 61.6 and 37.4 heart attack deaths per 100,000, respectively. 

• Southeast Nashua and southwest Nashua had the highest heart attack hospitalization rates in the region, 249.6 and 212.8 hospitalizations per 10,000, respectively. 

• 3.1% of New Hampshire (NH) adults have experienced a heart attack, and 2.2% of New Hampshire adults have experienced a stroke. 

• 9.2% of NH adults have ever been diagnosed with diabetes, 0.8% of which is pregnancy-related diabetes. 

Heart Disease

Heart disease refers to several types of heart conditions that include diseased vessels, structural problems, and blood clots. Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the U.S., accounting for approximately 655k American deaths each year. Nearly half of all Americans (47%) have at least one of the three key risk factors for heart disease which include high blood pressure, high cholesterol, and smoking. From 2014 to 2015, heart disease cost the U.S. about $219 billion each year in health care services, medicines, and lost productivity due to death.

Coronary Heart Disease

Coronary heart disease is the most common type of heart disease, seen nationally in approximately 18.2 million adults 20 years of age and older. This disease develops when the arteries of the heart do not deliver enough oxygen-rich blood to the heart. Coronary heart disease is often caused by the buildup of plaque, a waxy substance, inside the lining of larger coronary arteries. This buildup can partially or totally block blood flow in the large arteries of the heart. Symptoms of coronary heart disease may be different from person to person even if they have the same type of coronary heart disease. However, because many people have no symptoms, they do not know they have coronary heart disease until they have chest pain, a heart attack, or sudden cardiac arrest. If you have coronary heart disease, your doctor will recommend heart-healthy lifestyle changes, medicines, surgery, or a combination of these approaches to treat your condition and prevent complications.

Coronary Heart Disease Risk Factors

There are many risk factors associated with coronary heart disease. Dependent on the number of risk factors, some people may be at higher risk for developing coronary heart disease and having more serious complications. The build-up of cholesterol in the artery walls puts one at risk for heart disease and stroke, but steps can be taken to control cholesterol levels. Since there are no signs and symptoms to detect high cholesterol, the only way to know if you are at risk is to check your cholesterol by having a blood test. 

Other risk factors, such as sex, older age, family history and genetics, and race and ethnicity, cannot be changed. Air pollution in the environment can also increase risk by causing or worsening other conditions that increase risk for coronary heart disease.

Source: Mobile Physiotherapy Clinic

Myocardial Infarction

A myocardial infarction, more commonly known as a heart attack, occurs when part of the heart muscle is deprived of oxygen due to blockage of a coronary artery. This is caused due to a buildup of fatty plaque. Every 40 seconds, someone in the U.S. has a heart attack (CDC). Each year, 805k people experience a heart attack, and of that number, 200k of those people have already had a heart attack. Early action is important because the more time that passes without treatment, the greater the damage to the heart muscle, with irreversible damage beginning within 30 minutes of blockage. The goal of treatment is to preserve the heart muscle while relieving pain.

Source: CDC

Call 9-1-1 if you notice symptoms of a heart attack.

Stroke

A stroke occurs when there is a blockage preventing the supply of blood to the brain (ischemic) or when a blood vessel bursts within the brain (hemorrhagic). When a stroke occurs, portions of the brain either become damaged or die within minutes, causing life-long brain damage, long-term disability, or even death. Signs of stroke are sudden and include body numbness or weakness, confusion, difficulty speaking or understanding speech, trouble seeing, trouble walking, dizziness, loss or coordination, and severe headache. Even though they are preventable and treatable, stroke is the fifth leading cause of death in the U.S. and is a major cause of serious disability for adults. Every 40 seconds, someone in the U.S. has a stroke.

Source: CDC

Diabetes

Diabetes is a chronic disease where the body’s capacity to create or react to the hormone insulin is compromised resulting in an irregular metabolism of carbohydrates. The majority of food consumed is converted into glucose, or sugar, that the body uses as fuel to function. Normally, the pancreas makes a hormone called insulin which guides glucose into cells so it can be utilized. People with type-1 diabetes do not make enough insulin while people with type-2 cannot use insulin correctly leading glucose to build up in the blood. High blood sugar levels can lead to heart disease, stroke, blindness, kidney failure, and amputation of toes, feet, or legs. Losing weight, eating healthy foods, being active, taking medication as needed, education and support, and keeping regular health care appointments can help people manage their diabetes to live a healthy, normal life.

There are three main types of diabetes outlined below. 

Type 1 Diabetes

Seen in approximately 5 to 10% of people with diabetes, type 1 is caused when your body stops producing insulin on its own. Symptoms develop quickly and it’s usually diagnosed in children, teens, and young adults. People living with type 1 diabetes need to take insulin every day to survive and there is no way to prevent it. 

Type 2 Diabetes

Seen in approximately 90 to 95% of people with diabetes, type 2 is caused when your body doesn’t use insulin well and can’t keep blood sugar at normal levels. It develops over many years and is usually diagnosed in adults. Type 2 is usually present without symptoms, making blood sugar testing important for those at risk. Type 2 diabetes can be prevented by healthy lifestyle changes.

Gestational Diabetes

Gestational diabetes occurs in pregnant women who have never had diabetes. Although this type of diabetes usually goes away for the mother after birth, infants of women with gestational diabetes are put at risk for additional health complications, including developing type 2 diabetes later in life. 

Diabetes Risk Factors 

For type 1 diabetes, risk factors family history, such as having a parent or sibling with type 1 diabetes, and age, as people are more likely to develop type 1 diabetes at a younger age. If you have prediabetes, you can control your risk of developing Type 2 diabetes, but your risk increases if you are over 45 years of age, not physically active, have family history of diabetes, have high blood pressure, or are overweight.

Source: CDC

Health Equity & Heart Disease/Stroke/Diabetes

A person's health can be seriously impacted by their race, ethnicity, gender, income level, education, and other socioeconomic factors. 

In regards to heart disease...

• Heart disease is the leading cause of death for people of most racial and ethnic groups in the U.S. (CDC).

• In general, Asian American adults have lower rates of being overweight or obese, lower rates of hypertension, and they are less likely to be current cigarette smokers (Office of Minority Health, HHS).

In regards to stroke...

• African Americans are 50 percent more likely to have a stroke (cerebrovascular disease), as compared to their white adult counterparts (NH DHHS).

• Black men are 60 percent more likely to die from a stroke as compared to non-Hispanic whites (NH DHHS).

• African American women are twice as likely to have a stroke as compared to non-Hispanic white women (Office of Minority Health, HHS).

In regards to diabetes...

• Diabetes and prediabetes are more common among older adults, minorities, and those with lower income and education. Compared to non-Hispanic white adults, the risk of diagnosed diabetes was 18% higher among Asian Americans, 66% higher among Hispanics, and 77% higher among non-Hispanic blacks (NH DHHS).

• The rate of diabetes-related hospitalizations increases steadily with age. Compared to non-Hispanic white adults, the risk of diagnosed diabetes was highest among  Hispanics, and non-Hispanic Blacks in New Hampshire (NH DHHS).

• From 2013 to 2015, Asian American women were almost 3 times more likely to be diagnosed with diabetes, as compared to non-Hispanic white women (Office of Minority Health, HHS).

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