This document provides background information on cardiovascular disease (CVD) and outlines plans for a community program to address CVD. Key points:
- CVD is the leading cause of death worldwide and is preventable through lifestyle changes like diet, exercise, and not smoking.
- The program will aim to educate at-risk community members on CVD risks and prevention strategies.
- A planning committee is proposed that includes medical professionals, CVD survivors, and community leaders to influence participants.
- A needs assessment found CVD costs the US hundreds of billions annually and could be reduced by over 60% through optimal prevention activities.
- The program goals are to provide resources/information to participants and encourage behavioral changes to lower risk
4. 4
Introduction (Elizabeth)
Cardiovasculardisease(CVD) isthe numberone killerthroughoutthe world.Specifically,
coronary arterydisease isthe additionof plaque inthe arteries.Thisisatotallypreventable disease.The
AmericanHeartAssociationisagood reference forthistopic.
Heart disease isatermusedin reference tomultiple differentproblemsrelatedto plaque
buildupinthe arteriesof the heartmakingthemlesseffective.Cardiovascularrelateddiseaseisthe
numberone killerthroughoutthe world.Cardiovasculardisease isseenmore inpeople the olderthey
get,menare at greaterriskthan pre-menopausal women,andfamilyhistoryof heartdisease orstoke
increasesonesrisk(Mendis,2011).Heart disease doesnotdiscriminate againstanyone,anyone canbe
at risk.There are some choicesindividualscanmake to leada healthylifeavoidingCVDbyincreasing
physical inactivity,maintainahealthydiet,limitedtonotobacco use,withpredispositionstohighblood
pressure,highcholesterol,diabetes,overweight,andobesity(Mendis,2011).
Male,female,old,oryoungare all to riskof CVD.Thisis worldwideissue butwe willfocuson
the UnitedStates.In2012, the World HealthOrganization(WHO) published136,000 people diedto
cardiovasculardiseasesalone.Forthe USthishas causeda real financial burden.Accordingtothe
AmericanHeartAssociation (AHA),from2010 and 2030 the total medical costof CVDwill triple to
approximately$200 billiondollars(Roger,2012).This increase incostisa resultof the agingpopulation
withlossproductivityfromthose wholossthere joborbecame toosickto work.The AHA studyquotes,
“Estimatesusingthe ArchimedesModel foundthatif everyone receivedthe 11 recommended
preventionactivities,myocardial infarctionsandstrokeswouldbe reducedby63% and 31%,
respectively,inthe next30years. At more feasible levelsof performance,myocardial infarctionsand
strokeswouldbe reducedby36% and 20%. Unfortunately,the currentuse of these preventionactivities
issuboptimal”(Kahn,2008). There ishope forthose whostruggle withCVD.Preventionprogramsare
the bestanswerthiscountyhas rightnow to hopeful getaheadand change our future.
5. 5
Highbloodpressure isthe biggestriskfactorfor stroke andit can be fullytreated.High
cholesterol,alongwithhypertension,canbe treatedwithstrictmanagementof physical activity,diet,
and medication.Theyall intertwine sowellit’shardtodo one withoutthe other.These are all personal
choicesthatare not lefttocircumstance.I chose exercise andtobaccouse interchangeablebecause if
someone isnota smokerthanwe will workonphysical activity.If theyare a smokerthenwe can work
on reducingoreliminatingtobaccouse.
6. 6
Planning Committee (Elizabeth)
Making choicestolive acardiovascularhealthylifestyle isaloteasierwithsupportandeasyaccess
to positive choices.A like-mindedcommunityisakeyingredientinasuccessful behaviorchange. Fora
prioritypopulationof three thousandwe woulduse aroundthree hundred.Theseindividualswillchange
for everypopulationbutthere isacertaingroup or categoryof people.
SpecificallyforCVD,the medical communitywouldbe essential.Doctors,nurses,andspecialistare
goodresourcesbutalso expensive.Theirtime isbestspentdoingwhattheydointhe hospitalsnot
talkingtopeople withapossibilityof future heartissues.Insteadpossiblyusingretiredmedical
professionalsandorthose doingthere residency.The illusionof powerfromthe white coatalone will
attract the attentionandprovide astampof authenticitytoourprogram.
Anotherstronginfluence forthe intendedcommunitywouldbe hearthealthpatientsurvivors.
Those whohave had openheartsurgeries,heartattacks,and/ortransplantsbecause of lifestylechoices
or lack of medical assistance.These storieswouldreallyhithome forourintendedcommunitybecause
these are people theycanrelate to.Real people talkingabouthow theycouldlive there lifedifferently,
howtheiractionshurt theirfamily,andwhattheyhave togo throughnow to sustainthe yearsof life
theyhave left.Ialsowant some childrentospeakabouthow theirparent’spoorchoicesaffectedthem
and offertheirperspective onlife.
The communityhealthdepartmentisalwaysagoodresource but notall healthdepartmentsare as
involvedinthe communityasothers.Soinadditiontothe healthdepartmenthave representativesfrom
local charitable organizationsandinvolvedcommunitymembers.Theseindividualscancontribute there
inside accesstothe community.The communitytruststhem, soif we getthemon boardthentheywill
influencetheircommunitymembers.Theseneedtobe peoplewhowanttosee thisprogram succeed.
7. 7
Needs Assessment (Elizabeth)
Cardiovasculardisease(CVD) isthe numberone killer throughoutthe world.Specifically,
coronary arterydisease isthe additionof plaque inthe arteries.Thisisatotallypreventable disease.In
orderto reduce the numberof deathsinthe UnitedStatespeople needtounderstandthe riskof their
actions,lifestylechanges,andmeasurestoreduce the damage alreadydone.
Heart disease isatermusedin reference tomultiple differentproblemsrelatedtoplaque
buildupinthe arteriesof the heartmakingthemlesseffective.Cardiovascularrelateddiseasesare the
numberone killerthroughoutthe world.Cardiovasculardisease (CVD) isseenmore inpeople the older
theyget,menare at greaterriskthan pre-menopausal women,andfamilyhistoryof heartdisease or
stoke increasesonesrisk(Mendis,2011). Heartdisease doesnotdiscriminateagainstanyone,anyone
can be at risk.Some choicesindividualscanmake toleada healthylifeavoidingCVDbyincreasing
physical inactivity,maintainahealthydiet,limitedtonotobacco use,withpredispositionstohighblood
pressure,highcholesterol,diabetes,overweight,andobesity(Mendis,2011).
Male,female,old,oryoungare all to riskof CVD.Thisis worldwideissue butwe willfocuson
the UnitedStates.In2012, the World HealthOrganization(WHO) published136,000 people diedto
cardiovasculardiseasesalone.Forthe USthishas causeda real financial burden.Accordingtothe
AmericanHeartAssociation(AHA),from2010 and 2030 the total medical costof CVDwill triple to
approximately$200 billiondollars(Roger,2012).This increase incostisa resultof the agingpopulation
withlossproductivityfromthose wholossthere joborbecame toosickto work.The AHA studyquotes,
Estimatesusingthe ArchimedesModel foundthatif everyone receivedthe eleven
recommendedpreventionactivities,myocardial infarctionsandstrokeswouldbe reducedby63% and
31%, respectively,inthe next30years. Atmore feasible levelsof performance,myocardialinfarctions
8. 8
and strokeswouldbe reducedby36% and20%. Unfortunately,the currentuse of these prevention
activitiesissuboptimal (Kahn,2008).
There ishope for those whostruggle withCVD.Preventionprogramsare the bestanswerthis
countyhas rightnow to hopeful getaheadand change our future.
Highbloodpressure isthe biggestriskfactorfor stroke andit can be fullytreated.Highcholesterol,
alongwithhypertension,canbe treatedwithstrictmanagementof physical activity,diet,and
medication.Theyall intertwine sowellitishardto do one withoutthe other.These are all personal
choicesthatare not lefttocircumstance.
Knowledge,attitudes,beliefs,andvaluesthatexistbefore abehaviorthateffectsone’shealthis
a predisposingfactor(Hodges,2005).These factorsare alsothingsinone’slife thattheycannotchange.
In regardto CVD,age, gender,ethnicity,familyhistory,andcultural diethabitsare predisposingfactors.
Personal lifestyle choicesandthere consequencesonourbodysuch as smoking,overeating,obesity,
and type 2 diabetes.These behaviorsare all relyonthe accessibility,cost,andavailability(Hodges,
2005). Enablingfactorsare personal choicesthatindividualscanchange.Reinforcingfactorsallowusto
continue ournegative behaviors.Reinforcingfactorsare how we justifyouractionsorpushthe blame
on to others.‘McDonaldsmade me fat’or ‘I am so stressed,Ineedacigarette,’these are reinforcing
examples.Ease of accesstoa bad dietand stressare the top reasonsmostpeople saytojustifytheir
negative behaviors.
ReducingCVDisextremelyexpensive.There are 11 recommendedways/activitiestoprevent
CVDrelateddeaths.If everypersoninAmericacouldaffordthe costforall the preventative activities
that theyqualifiedfor,thaninover30 yearsthe numberof heart attacks peryearwould reduce more
than 60%, strokesperyearwouldbe down30%, and the general life expectancywouldincreasebyan
average of 1.3 yearswitha greaterqualityof life thancurrentlyexperienced(Kahn,2008).Accordingto
9. 9
researchall 11 areas of riskshowimprovementbutindividualsmustconsidervaryingresultsfor
themselvesbecauseof the variouscombinationsof riskone mighthave.The effectivenessof thisstudies
interventionoveraspanof 30 yearsassuming100% of people didasinstructed100% of the time,you
couldspendupto 1.8 dollarsonmedical expensesforall 11 factorsto reduce (Kahn,2008). Overall all
thisstudystatesabout75% of adultsinthe U.S. wouldbenefitfromatleastone recommended
preventionactivity,alsothiswill prevent66% of heart attacks,33% of strokes,butfor these benefitsthis
preventionactivitieswill greatlyincrease ourhealthcare rates(Kahn,2008).
In the UnitedKingdom,arecentstudyrecommendsanew riskcalculatorthat providesaten
yearrisk score, your‘Heart Age’,and‘CVDevent-free survival’.‘The HeartAge’isanevidence based
conceptto expressandestimate risks.Itissimilartothe tenyearriskscore butit relatesittoa person’s
chronological age.Soa 30 year oldsmokercouldhave the 'heartage' of a 50 yearold while a45 yearold
athlete couldhave a‘heartage’of 25. The ‘CVD event-freesurvival’score showshow longapersoncan
expecttolive withoutaheartattack or stroke,assumingtheydonotdie of anythingelse inthe
meantime.The resultsshowedthatusingthe ‘HeartAge’toraise awarenesspromotedbehavior
changesand reducedthe riskof the group and decreasedthere ‘HeartAge’(Haw,2014).
Currently,the U.S.Departmentof HealthandHuman Services,alongwithanumberof
nonprofitsandprivate organizations,launchedaprogramcalledMillionHearts.Theirgoal istopreventa
total of one millionheartattacksandstrokesduringa five yearspan.MillionHeartsfocusesonfour
mainpoints,the ABCS.ABCSstandsfor aspirin,bloodpressure,cholesterol,andsmoking.Statisticsshow
there isno significantchange inthe use of aspirininadditiontoothermedicationsbutthere wasagreat
increase of bloodpressure control andcholesterol management.Quittingsmokingwillhelpyour
vascularsystemnotto constrictnor harden. “MillionHeartshasfocusedonimprovingperformance in
specificclinical andcommunity-level CVDriskfactorsbecause interventionsinthese areashave been
shownto be effectivewaystogreatlydecrease CVD morbidityandmortality”(Ritchey,2014).The data
10. 10
showsthat youngeradultswere lesslikelytoreceivethe propersmokingcessationopportunitiesand
had a highersodiumdailyintake whichputthatat greaterriskto developaCVDrelatedillness.The
betteryourhealthisby the age of 50 yearsoldreducesyourriskten timesfromdeveloping
atheroscleroticCVD(Ritchey,2014).
Whenconfrontingobesityandoverweightriskfactorsintensebehavioral counselingisvery
effective.Althoughthe changesmaybe small,theyare critical totheirsuccess.Forbestresults,
counselingsessionsneedtocontinue foraboutone totwoyears.As a resultof these behaviorchanges,
cholesterol level decrease,the patientlosesweight,andreducestheirrisk of CVDrelatedillness.
Increase inmoderate-intensityexerciseforatotal of twoand a half hoursspreadthroughoutaweek,
improvementincholesterol,bloodpressure,andbloodsugarlevelscandecrease onesoverall riskof
CVD(LeFevre,2014). There are a lotof studiesdone toconsiderthe Mediterraneandietasuperiorform
of weightandhealthmanagement.The diethasproventoreduce highbloodpressure,badcholesterol,
and bloodglucose levels(Robson,2014).
In summary,CVDisa bighealthrisk indevelopedcountries.There hasbeenlotsof researchand
studiesdone tomeasure the mosteffective waystoreduce one riskandinreturnlengthenone’slife.
We knowthatCVD isdirectlyrelatedtoanindividual’sweight,cholesterol,diabeticstatus, nutrition
intake,tobaccouse,andmedication.CVDisa preventable disease.If we startteachingthe next
generationswhentheyare youngthentheywill nothave toendure the harshfinancial costof CVD. The
annual cost of someone whohadnot takencare of theirbodyisastronomical.Inretaliationtothis
pandemicwe caneducate ourselvestothe wayswe can reduce the damage we have done sofar. There
are manynonprofitandgovernmentagencyoutthere willingandreadytohelpthe willing.Personal
motivationtostayon the righttrack can be hard so have a group or a partnerto change theirlifestyle
withyouor holdyou accountable forthe changesyouwant to make inyourlife.There isalwaystime to
change your oldhabitsandtechnologyhasmade iteasierthaneverto accessthe informationand
11. 11
provide answerstoindividualsineverysituation.Todaywe have appthatprovide age appropriate
exercise routines,stretches,recipes,andtipsonhow as well aswhat toorder at restaurants.The sheer
numberof tobacco cessationprogramsandthe strong initiativepushbythe medical communityhas
providedmanyoptionsforpeopletoquit.Weightlossisthe hardestfactorto deal withbecause there is
not healthyweightchartthat everyone fitsin,soIfocus on healthyinput.The nutritionof whatisgoing
inour bodiesisimportant.A side effectof propernutritionisweightlossbecause youare nolonger
eatingeverythinginsightbecause youhave foundthe rightmixture yourbodywascallingfor.With
these changesthe UnitedStatescanget a handle onitsCVD relateddeaths.
12. 12
Mission, Goals, Objectives (Norah)
The missionof the program isto providedinformationandresourcesforthose atriskor who
alreadyhave cardiovasculardisease.Twogoalsthe programseekstoissue are to give adequate
resourcesandinformationtothose whocome;andto encourage behavioral change inordertoreduce
riskfactors or the consequencesof additional symptomsof cardiovasculardisease.
There are a numberof objectivesthatthe programseekstoaccomplish. Theyare as follows:
To provide resources. Resourceswill be giveninregardstoriskfactors,behavioral issues,and
cardiovasculardisease.
To encourage preventative healthcare. Resourcesforhealthcare in the Middle Tennessee areawillbe
given,includingrepresentativesfromMedicaid,andrepresentativesfromsliding-fee andlow cost
medical clinics. Preventativecare andinterventionsare helpful inreducingthe risksof cardiovascular
disease,aswell asrepeatheartattacks,strokes,etc.
To help assessrisk factors by providinginformation,aswell asofferingbloodpressurescreening.
To spread awareness regardingcardiovascular disease, includingwhatsymptomsare,how
cardiovasculardisease happens,the riskfactorsinvolved,andbehavioral changesthatcanrisk
cardiovasculardisease.
To help individualscreate behavioral changes through the use of individualizedprogramplanning
worksheetsandhelpful representatives,aswell aspositive motivation.
13. 13
Intervention (Norah)
Communicationmessageswill be throughthe use of PowerPoint,expertguestspeakers,a
questionandanswertime,aconfidential questiontime (the use of papermessagestobe readaloudand
answered,forthose thatare not comfortable askingquestionspublically),posters,flyers,and
informationgiventoparticipants.
The curriculumwill be asfollows:
PowerPointtodetail whatCardiovasculardisease is
Riskfactors of cardiovasculardisease
How familyhistorycanincrease riskfactors
Riskfactors thatare modifiable
Behavioral changestoreduce the riskfactors
There are several environmentalchangesthatwill be lobbiedfor. Thisincludesprovidinghealth
care to those whocannot afforditthroughthe use of resourcesavailable,especiallytothose who
are uninsured,underinsured,orare consideredlow income.
The program will alsofocusonenvironmental changessuchaswhere toexercise,how toreduce
riskfactors,and communitymeasuresthatcanbe helpful increatingamore healthycommunity
that isaware of the risksof cardiovasculardisease.
14. 14
Resources/Budget (Norah)
The cardiovasculardisease programwill needavarietyof resources,whichwill include
personnel,curricula,instructional resources,facultyspace,equipmentandsupplies.
Personnel will be workersfromthe RutherfordCountyHealthDepartment,variousvolunteer
doctorsand nursesrepresentingtheirclinics,healthprofessorsfromMTSU,and volunteerworkers.
These will all be ona volunteerbasis,whichwillbe helpful intermsof savingmoneythroughthe budget.
Curriculawill be developedbythe programplannersthroughthe healthdepartmentandwill
include avarietyof paneliststoevaluate saidcurriculaandimplementit. Curriculawillfocuson
teachingriskfactorsas well aspreventativemeasuresof avoidingcardiovasculardisease. There willbe
informationinthe curriculaaboutwarningsignsof cardiovasculardisease,aswell as treatmentand
lifestyle changesinordertoavoidfuture complicationsof those alreadydiagnosedwithhaving
cardiovasculardisease.
Instructional resourceswill includeashortvideo,PowerPoint,handouts,andaresource packet
for participantstotake home withthem. Thiswill alsoinclude how toknow the warningsigns,risks,and
complicationsof cardiovasculardisease. A self-assessmentwill alsobe givensothatpeople can
understandtheirownriskfordevelopingorcontinuingtosufferfromcardiovasculardisease.
Facultyspace will be at the healthfair,whichwill be locatedatthe MTSU campus. Plentyof
parkingwill be availableforthe event,aswill areaforfacultytosetup in. This isa large space,which
will be helpfulforthe large numberof facultymembersandparticipants.
The cardiovasculardisease PreventionProgramwillinclude avarietyof suppliesandequipment.
Thiswill include aprojectorformovie andPowerPoint,printoutsof resources,aswell asbloodpressure
15. 15
cuffsand readersfornurses to offerfree bloodpressure screenings. Thisequipmentisimperative for
successinthe programand iscentral to the curriculaand goalsof saidprogram.
Budget
Equipment:Donated
Faculty:$3,500
Salaries
Printouts:$300.00
Curriculadevelopment:$700.00
Advertising:$3000.00
PublicService Announcements:$900
Space Rental:Donated
The resourcesand budgetwill be essential tothe successof the program. Withcareful
spending,planning,andoutlining,the programwill be able tomeetitsobjectivesandgoalsthroughthe
fundsavailable forthe project.
16. 16
Implementation (Norah)
Implementationisimperative inprogramplanning. There are five phasesof implementation,
whichwill be apart of thisprogram. These include 1) adoptionof program; 2) identifyingand
prioritizingthe taskstobe completed;3) establishingasystemof management;4) puttingthe plansinto
action;5) endingof sustainingaprogram.
Adoptionof the programis imperative. Itisnecessarytocreate interestinthe programinorder
to ensure thatthe participantswill be interestedinthe programinorderto ensure attendance. The
more interestthata personhas forthe program; the more he or she islikelytoparticipate fullyinthe
program. Thisis imperativeforthe successof the program.
Identifyingandprioritizingtaskstobe completedisnecessarytoensure asuccessful program.
Many tasks needtobe completed. Thiswill includerentingthe space,securingequipment,hiringstaff,
securingvolunteers,andorganizingequipment.
The third phase isto create a systemof management,whichisnecessaryforsuccess. Itis
necessarytoassemble anduse setsof resourcesina goal-directedmannertoaccomplishtasksinthe
situation. Thisincludeshuman,technical,andfinancial resources.
As part of implementation,itisnecessarytodophase 4, whichisputtingplansintoaction. First,
thiswill be pilottesting,whichistotry the program outwitha small groupfrom the prioritypopulation
inorder to identifyanyproblems. This will be done withtenparticipants. Then,the programwill also
have a focus group,followedbyatotal program
Then,the final phase isto endthe program. The endedof the programwill be done with
participantshavingresourcestofindmore informationorreceive healthcare forcardiovasculardisease.
18. 18
Evaluation (Norah)
The program evaluationwill be basedonanon-experimental designsince there will notbe a
comparisongroup. The evaluationwillassessparticipants’knowledgeaboutdiet,physical activityand
riskfactors fordeveloping(orworseningthe symptomsof) cardiovasculardisease. The twoevaluation
measureswill be impactandprocessevaluation
A surveywill be issuedtothese participants.
Are you aware of the riskfactorsof developingcardiovasculardisease?
Describe the foodsyoueaton a typical day.
How aware of youon the impactof physical activityandhealthyheart?
What changes,if any,do youplanon makinginorder to preventcardiovasculardisease?
ProcessEvaluation
Was your riskfactor assessed?
How satisfiedwere youwiththe information(amountandrelevance) presentedtoyoutoday?
Do you believe thisprogramwaseffective?
What wouldyouchange aboutthe program?
These questionswill helpevaluate the effectivenessof the program. Questionswillbe issuedatthe end
of the program.
19. 19
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“Cardiovascular Health.” Retrieved March 10, 2015 from healthfacts.org
AHA. (4 January 2011). Cost to Treat Heart Disease in United States Will Triple by 2030:
American Heart Association Policy Statement. American Heart Association.
CDC (2015). Heart Disease and stroke Prevention. Center for Disease Control.
CDC. (2014). Cardiovascular facts. Center forDisease Control. Cdc.gov
From realscience.com
Haws,J. M. (2014). CVD Masterclass:A Lifetime Approachtothe Preventionof Cardiovasculardisease.
Practice Nurse,44(9), 26-30.
HeidenriechPA,TrogdonJG,KhavjouOA,ButlerJ,Dracup K,EzekowitzMD, etal.Forecastingthe future
of cardiovasculardiseaseinthe UnitedStates:apolicystatementfromthe AmericanHeart
Association.Circulation.2011; 123(8):933–44.
Hodges,B.C.& Videto,D.M.(2005). AssessmentandPlanninginHealthPrograms.Sudbury,MA:Jones
and Bartlett,ISBN:9780763790097.Hodges, B.C. & Videto,D.M.(2010). Assessmentand
PlanninginHealthPrograms,2ndedition.Sudbury,MA:JonesandBartlett,ISBN:
9780763790097.
KahnR, RobertsonRM, SmithR, EddyD. The impactof preventiononreducingthe burdenof
cardiovasculardisease.Circulation.2008; 118:576–585.
LeFevre,Michael L.2014. “Behavioral CounselingtoPromote aHealthful DietandPhysicalActivityfor
CardiovasculardiseasePreventioninAdultswithCardiovascularriskFactors:U.S.Preventive
ServicesTaskForce RecommendationStatement. Annalsof InternalMedicine,161(8), 587-593.
doi:10.7326/M14-1796.
20. 20
March 2015.
Mayo Clinic. Cardiovascular Risks and Health Concerns. Mayoclinic.gov. Retrieved 14
MendisS,PuskaP, NorrvingB.ed.Global Atlason CardiovasculardiseasePreventionandControl.World
HealthOrganization(incollaborationwiththe WorldHeartFederationandWorldStroke
Organization),Geneva2011.
National CommissionforHealthEducationCredentialing,Inc.(NCHEC),SocietyforPublicHealth
Education(SOPHE),AmericanAssociationforHealthEducation(AAHE).(2010a).A competency-
basedframeworkforhealtheducationspecialists - 2010. Whitehall,PA:Author.
Retrieved 23 March 2015 from cdc.gov
Retrieved 23 March 2015 from http://newsroom.heart.org/news/1241
Ritchey,MatthewD,et al.“MillionHearts:Prevalence of LeadingCardiovasculardisease RiskFactors—
UnitedStates,2005-2012.” MMWR.Morbidity and Mortality Weekly Report 63, no.21 (May 30,
2014): 462-467. MEDLINE withFull Text,EBSCOhost(accessedMarch14, 2015).
Robson,D. (2014). Positive Effectsof the MediterraneanDietinthe PreventionandManagementof
Cardiovasculardisease:A Literature Review. Journalof theAustralian Traditional-Medicine
Society,20(3), 200-205.
RogerVL, Go AS,Lloyd-JonesDM,BenjaminEJ,BerryJD,BordenWB, et al.Heart disease andstroke
statistics—2012update:a reportfrom the AmericanHeartAssociation.Circulation.2012;
125(1):e2–220.
Sanders, Robert. (2015). “Cardiovascular Statistics 2014.” Retrieved 5 March 2015
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SteinerC,BarrettM, WeissA.HCUP Projections:Cardiovascular/CerebrovascularConditionsand
Procedures2001 to 2012. 2012. HCUP ProjectionsReport#2012-02. ONLINEJuly10, 2012. U.S.
AgencyforHealthcare ResearchandQuality.Available: http://www.hcup-
us.ahrq.gov/reports/projections/2012-01.pdf.
Top 5 LifestyleChangestoReduce Cholesterol.(2012, September6).RetrievedFebruary26,2015, from
http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/reduce-
cholesterol/art-20045935
WorldHealthOrganization(WHO).Cardiovasculardiseases,Deathsper100 000 Data byCountry.Global
HealthObservatoryDataRepository.2012.
22. 22
Appendix A (Elizabeth)
Appendix A showsall the predisposingfactorsof cardiovasculardisease.136,000 people diedfromCVD
in2012. These are the differentaspectsinone’slife theyhave ahighprobabilityof changing.