By Rudy Fedrizzi, MD Director of Community Health Clinical Integration, CMC/DHK
Cardiovascular disease is the major cause of death and disability on our country — and the Monadnock Region is no exception. In the city of Keene alone, there were 32 cardiac arrest calls in 2014 (as reported by the City of Keene Fire Department); in all of Cheshire County, there were 52 reported cardiac arrests in 2010 (the most recent statistic for the region).
Did you know that 95 percent of the deaths from cardiac arrest occur before the victim reaches the hospital, and are witnessed by non-health professional bystanders?
The question is: Would you know what to do if you saw someone having a heart attack? Would you even know the person was suffering from a heart attack?
Early intervention: the difference between life and death
Data shows that immediate bystander cardiopulmonary resuscitation (CPR) and early use of public-access automated external defibrillators (AEDs) have improved survival for those with out-of-hospital sudden cardiac arrest.
The American Heart Association promotes the following “Chain of Survival” framework as critical in improving the survival from cardiac arrest.
- Early Access to Emergency care: Bystanders who recognize signs and symptoms of cardiac arrest and activate the emergency response system (EMS) by calling 9-1-1.
- Early CPR: Making sure that a large pool of individuals in the community are trained in CPR
- Early defibrillation with an AED: Early defibrillation is felt to be the most important element in enhancing survival. Where to get a defibrillator for your company or organization:
- Early advanced life support care and comprehensive hospital-based stabilization.
Communities that have an informed population who can recognize the signs and symptoms of cardiac arrest, know when to call 911, have a large number of residents trained in CPR and the use of AEDs, and have a sufficient number and strategic distribution of AEDs can be designated Heart Safe. In December 2011, the City of Keene and Town of Swanzey were both designated at NH Heart Safe Communities and later Walpole was added to that list. This designation should reflect communities offering the best chance for survival of cardiac arrest.
Access to AEDS alone is not sufficient for an adequate emergency response. Still, the adequate distribution of AEDs is an important component of a community’s cardiac event preparedness. There are currently 62 fixed devices registered at locations throughout in Keene.
Even an optimal response to a catastrophic cardiac event reflects a medical rescue of an individual with severe, advanced disease. Prevention of cardiovascular disease using effective community health strategies offers the opportunity to reduce the burden of disease and the need for CPR/AEDs in the first place. The effective recognition and control of high blood pressure (HBP) has a huge potential to prevent of postpone more serious cardiovascular disease or death.
HBP is the most common chronic heart condition in the US. With our current trends towards unhealthy lifestyles, it is projected that there is a 90% lifetime risk of developing HBP. Therefore, nearly everyone is “at risk.” It is also estimated that more than 50% of people experiencing their first heart attack have poorly controlled HBP.
Better HBP control depends on a comprehensive system for early detection, effective evidenced-based treatment, active self-management and ongoing monitoring to ensure adequate control. Prevention of HBP relies on the following healthy lifestyle approaches with proven effectiveness:
- Engage in regular, moderate physical activity – 30 minutes at least 5 times a week
- Achieve and maintain a normal body weight
- Reduce sodium intake
- Increase potassium intake
- Limit alcohol consumption
- Eat a diet rich in fruits, vegetable, low-fat dairy products and reduce unhealthy fats
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