Cardiovascular Disease In Australian Aboriginal Population

Introduction

Cardiovascular diseases generally mean conditions of narrowed or blocked blood vessels that lead to heart attack, chest pains or even stroke. Cardiovascular diseases include coronary artery diseases (CAD) like angina and myocardial infarction (normally called heart attack). Other CVDs include stroke, heart failure, heart arrhythmia, aortic aneurysms, rheumatic heart disease, hypertensive heart disease, congenital heart disease, carditis, peripheral artery disease, thromboembolic disease, cardiomyopathy, valvular heart disease, and venous thrombosis.  According to research cardiovascular diseases are number one cause of deaths and it is predicted to remain the same (Townsend, Nichols, Scarborough, & Rayner, 2015). Cardiovascular disease is common in Australia and especially among the Aboriginal population. The Aboriginal population has much poor health conditions. Australian population in the rural and remote areas are at a higher risk of suffering from cardiovascular disease. It is approximated that 90% of cardiovascular diseases is preventable and people can easily avoid them. Prevention of atherosclerosis encompasses enhancing risk factors through: limiting alcohol intake, exercise, healthy eating, and avoidance of tobacco smoke. Treating risk factors, like diabetes, blood lipids and high blood pressure is also beneficial. Treating victims who have strep throat with antibiotics can reduce the risk of rheumatic heart ailment. My essay will examine the risk factors that have led to increased incidences of cardiovascular disease in the Aboriginal population and the type of education the affected persons require to self-manage heart failure to reduce chances of hospitalisation.

Study of Cardiovascular Disease in the Australian Aboriginal population

Cardiovascular illnesses are the most common diseases that lead to health disparity of the Australian Aboriginal populations.  This is due to the many risk factors that lead to higher chances of cardiovascular disease in the Aboriginal population (Gray, Antoine, Tong, McKinnon, Bessarab, Brown, & Inouye, 2017). These risk factors include hypertension, tobacco smoking, physical inactivity and obesity.

Hypertension is the most common form of cardiovascular disease among the Aboriginal population. Hypertension is the same as high blood pressure which involves continuous increase of blood pressure in the arteries (Sun, 2015).  Hypertension is not a major cause of death but is a risk factor to other fatal diseases such as heart failure and stroke. This condition is associated with habits such as high salt intake, physical inactivity and obesity. Hypertension malady has been a long-term health condition in the aboriginal Australian population.  In the 2004-05 NATSHIS, it was reported that at least 7% of the Aboriginal Australian population suffered from hypertension. The disease is more common among the older indigenous population (Birch, 2015). The study indicated that Aboriginal people are likely to suffer hypertension from their younger stages.

Hypertension is one of the risk factors that lead to development of heart failures and thus should be controlled (Rapsomaniki, Timmis, George, Pujades-Rodriguez, Shah, Denaxas, & Williams, 2014). Although the indigenous people are aware that they have high blood pressure, it was disclosed that only a half of the population take medication. This particular ailment can be prevented trough reduction of fat intake. Hypertension is referred to as the “silent killer” for good reason. This ailment habitually has no symptoms, but is a major risk for stroke and heart disease.

Tobacco smoking is the major factor that leads to the occurrence of cardiovascular disease in Australia. Tobacco smoking results in higher risks of stroke and development of heart failure (Alston, Peterson, Jacobs, Allender & Nichols, 2017). The popularity of cigarette smoking among the Aboriginal people is very high. The prevalence of tobacco smoking is estimated to be about 50% of the 18 years and above individual and this cut across both genders. Cigarettes contain more than five thousand chemical compounds including some metals such as aluminium, Lead and Mercury. Smoking results in damaging of both the heart and blood vessels. Nicotine in tobacco leads to build up of hard substances on the walls of blood vessels leading to a condition called atherosclerosis (Mishra, Chavda, Kumar, & Menaria, 2018). Accumulation of the hardy materials on the walls results in the narrowing of the blood vessels.

Cigarette smoking leads to increased heart beat rate. Increased heart beat rate is as a result of narrowed blood vessels. Reduced radius of blood vessels increases the pressure of the blood passing through them which in turn increases heart rate. Tobacco also includes harmful substances such as tar and carbon monoxide. This increases the risks of occurrence of blood clots in the blood vessels. Carbon monoxide from tobacco reduces the capacity of blood to transport oxygen throughout the body.  A very high percentage of the Aboriginal Australian population are cigarette smoking addicts (Lovett, Thurber, Wright, Maddox, & Banks, 2017). According to results from the 2004-05 NATSIHS, the prevalence of daily smoking among the Aboriginal Australians aged 18 and above years was half the total population not ignoring another 2% who smoke occasionally. Smoking in the Australian Aboriginal population has been a key contributor to the increased suffering from heart failure and stroke. Nicotine in tobacco causes addiction whereby it leads to the situation whereby individuals must smoke daily. Non-smokers are also affected due to passive smoking or second hand smoking. Most of the smoking Indigenous Australians already have cardiovascular as a long-term health condition.

Obesity among the indigenous Australian people is a key contributor to development of heart failure. Obesity is a condition of excess body fat which results from an imbalance in energy over a period (Duncan, & Plaspohl, 2017). From a height and weight measurements survey, it was reported that among Aboriginal peoples aged 18 years and above 61% were overweight and 31% were underweight. Around 29% of the Aboriginal people who are obese were found to suffer from cardiovascular disorder. Obesity increases risks of high blood pressure and heart failure (Lavie, De Schutter, Parto, Jahangir, Kokkinos, Ortega, & Milani, 2016). Having a large body means the heart needs to pump blood at a high pressure to reach all the cells. This increases the risks of high blood pressure and heart failure in the Indigenous Australian population.

Obesity and overweight is in most cases as a result of inactivity. Aboriginal Australians are likely to be less active.  A very high percentage of people suffering from cardiovascular disease in the Aboriginal population are physically inactive (Woodruffe, Neubeck, Clark, Gray, Ferry, Finan, & Briffa, 2015). A high percentage of heart failure incidences in the Aboriginal population have been associated with physical inactivity. Normally, physical activities help in reducing the fats in the body and burning calories. Reduced fats in the body reduce the blood pressure. Individuals who are physically active are not likely to be overweight or obese. Thus, physical activity reduces the risks of suffering from heart failure. Many people in the Aboriginal Australian population are physically inactive something that puts them at risks of heart failure.

For the Aboriginal Australian people to reduce the risk factors they have to observe better living conditions. Use of tobacco should be discouraged to reduce the chances of developing heart failure. Most of the risk factors can be self-managed.

Education for Persons with Heart Failure to Reduce Risks of Hospitalisation

Education at discharge of patients with heart failures is vital at improving the outcomes. Education offered to patients in the heart failure clinics plays an important role in maintaining clinical stability of the patients. This kind of education includes sodium and fluid monitoring, physical activities, weight monitoring, regular medication and observing signs and symptoms of disease worsening.

Daily weight monitoring education to patients with heart failure is required. Research shows that increase in weight is the major cause of increased blood pressure (Zhang, Reichel, Han, Zuniga-Hertz, & Cai, 2017). The education on monitoring weight plays an important role in identification of hypervolemia signs. Patients should be enlightened to measure their weight in the morning immediately after urinating and before breakfast while wearing light clothes. Patients should be advised to monitor their weights daily and in case of a rapid increase to contact a medical professional. In a case of increased weight the patient should either inform a medical team or adjust diuretic dose. Daily monitoring of weight would play a major role in reducing cases of hospitalisation (Gudmundsson, Lyngå, Rosenqvist, & Braunschweig, 2016). There should be constant monitoring and follow-up.

Patients should also be educated on the use of medication. A heart failure medication follows certain guidelines. The guidelines should be simplified and presented in a simpler way to the patients (Albert, Barnason, Deswal, Hernandez, Kociol, Lee, & White-Williams, 2015).  The medication education should emphasize on medication names, doses and possible side effects. Providing adequate education on medication to heart failure patients would reduce risks of hospitalisation.

Education on physical activities and rest would help patients with heart failure in self-management and avoid risks of hospitalisation. Physical activities reduce risks of hospitalisation of people suffering from heart failure (Freedland, Carney, Rich, Steinmeyer, & Rubin, 2015). A home-based walking program works best in avoiding the negative effects that may result from inactivity. The pattern of the physical training should change as goes by for improved outcomes.  The distance covered in the home-base walk should increase day by day. Prolonged rest causes atrophy of skeletal musculature.  Patients with heart failure require physical activity education to self-manage heart failure.

Education on sexual activities is also required for patients to self-manage heart failure and reduce risks of hospitalisation. Heart failure patients who are already stable are advised to maintain sexual activity (Steptoe, Jackson, & Wardle, 2016). In this case sexual activity is done with appropriate adjustments so as to avoid appearance of symptoms. Sexual education to heart failure patients would help in self-management of the patients.

Diet and other social activities education is also required for patients to self-manage heart failure. Diet education should include recommendations of what the patient should eat to stay healthy. Sodium restriction in the diet education is very vital. Incidences of heart failure have been associated with high consumption of sodium (Cogswell, Mugavero, Bowman, & Frieden, 2016). Heart failure patients should be educated on the possible outcomes of high sodium intake. The patients should be enlightened on not adding salt to already prepare food or canned food. Heart failure patients should also be advised to avoid canned food with high concentrations of sodium. This education would help in self-management thus reducing the risk of hospitalisation.

Education on fluid restriction in patients with severe heart failure is also required for patients to self-manage heart failure.  Though this practice is not common due to lack of enough evidence, it is very helpful. A maximum of 1.5Litres per day is advocated for patients with moderate to severe heart failure.  Restriction in fluid intake is recommended to ensure plasma sodium levels do not fall below mEq/L.

Education on alcohol and tobacco consumption should also be done to heart failure patients to avoid incidences of hospitalisation. Alcohol and tobacco use are major contributors of heart failure (Falkstedt, Wolff, Allebeck, Hemmingsson, & Danielsson, 2017). Heart failure patients should be educated on the adverse effects of consuming alcohol and tobacco. Many heart failure deaths have been reported to be caused as by not adhering to alcohol and tobacco restriction.

Heart failure patients also require information about vaccination to self-manage heart failure. All heart failure patients should he enlightened on undertaking annual immunization against influenza. The immunization helps in reducing risks of respiratory diseases which may have adverse effects on heart failure patients.

Nurses in the heart failure clinics should equip patients with information that can help the patients to self-manage the disease (Black, Romano, Sadeghi, Auerbach, Ganiats, Greenfield, & Ong, 2014). Individuals addicted to use of tobacco should be educated on the dangers associated with it and advised to quit. This would help in reducing risks of hospitalisation.

Conclusion

Aboriginal Australian population is likely to have more risk factors that lead to development of heart failure compared to noon-indigenous Australian population. Some of the risk factors in the Aboriginal population include higher use of tobacco. From the analysis it is clear that a very high percentage of individuals aged 18 years and above in the Aboriginal population smoke tobacco. It is also arguable that very many people in the Aboriginal population are either overweight or obese. This has led to a high number of people in the population suffering from heart failure. Physical inactivity has also been a risk factor to development of heart failure in the Indigenous Australian population. Studies done indicate that most of the people in the population are physically inactive. Special education on heart failure is required to enable patients self-manage the disease. This reduces the risks of hospitalisation. This education includes education on weight monitoring, physical activities monitoring, liquid restriction, education on medication, and education on diet and social activities. Besides being equipped with information regarding heart failure, heart failure patients should also be closely monitored. In a case where some symptoms of worsening of the disease are seen, the affected individuals should alert the nurse

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