"Heart disease" is the common term for cardiovascular diseases, which affect the heart and blood vessels. They are conditions that affect your heart's ability to work. The cardiovascular conditions that are the focus of this report are coronary artery disease and stroke. Coronary artery disease, also called coronary heart disease (CHD), is the narrowing of the vessels that supply blood to the heart. This is usually caused when fatty material and plaque build up on the walls of the vessels called arteries, which carry blood to organs and tissues, including the heart muscle. When too much build-up blocks blood flow to the heart muscle, this causes a heart attack. When a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts, this causes a stroke, which can damage the brain.

In Washington state in 2005, coronary heart disease caused 7,734 deaths and is the second leading cause of death. Stroke caused 3,167 deaths and represents the third leading cause of death and a leading cause of serious long term disability in Washington. More than 71 million Americans have some form of cardiovascular disease. Of these, approximately 65 million have high blood pressure (hypertension), 13 million have coronary artery disease, 5.5 million have had a stroke, and 5 million suffer from heart failure. Despite the large number of people affected by heart disease and the high costs of treating someone with a serious heart condition, many people do not get the best known care to avoid and manage these problems. Sources: American Heart Association, Washington State Department of Health, National Committee on Quality Assurance (NCQA)

The estimated direct and indirect costs associated with cardiovascular disease in the United States in 2005 were $393.5 billion, with heart disease accounting for $254 billion, and coronary artery disease alone $131 billion. Source: NCQA

Patients and Caregivers

• Eat a lower-fat diet and get and stay active.
• Don't smoke or use tobacco.
• Get regular blood pressure checks.
• Get a flu shot every year.
• Take medications your doctor prescribes, including drugs to lower your cholesterol.
• If you have been in the hospital for a heart attack, ask about a prescription for a "beta blocker" to help manage pain and prevent future heart attacks.

Doctors and Other Health Care Professionals

• Use a patient registry to track care for all of your patients with heart disease.
• Send reminders to patients to encourage them to come in for needed care.
• Regularly check your patients' cholesterol and blood pressure and given flu shots yearly.
• Help patients learn how to control their conditions with diet, exercise, and if necessary, medication.
• Strongly advise patients to stop smoking.
• Help patients who have had a heart attack get the right medication to ease pain and help avoid another heart attack.
• Coordinate follow-up care for patients who have been hospitalized.

Employers and Other Health Care Purchasers

• Provide health coverage with low or no co-payments on required medications such as cholesterol-lowering drugs and beta blockers.
• Provide health benefits that cover smoking cessation programs.
• Promote workplace wellness with options for employees make healthy food choices and engage in physical activity.
• Encourage employees to take a health risk assessment or other screening test for heart disease risks.
• Offer health risk screenings at the workplace.

Health Plans

• Help physicians track whether their patients with heart disease have received recommended services or routinely refilled their prescriptions for important medications.
• Ensure benefits cover smoking cessation services.
• Reduce or eliminate co-payments which create cost barriers for recommended heart disease services, supplies and medication for patients diagnosed with heart disease.
• Include in benefits coverage for diabetes education between patients and providers.
• Provide members with online health risk assessments and follow-up services.

American Heart Association
Centers for Disease Control and Prevention
Hypertension Diagnosis and Treatment Resources for Patients
Puget Sound Health Alliance Clinical Improvement Team Report on Heart Disease