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American Heart release: much has been done on prevention yet seems not enough

Regarding global health

American Heart Association (AHA) President Robert A. Harrington says life expectancy has increased in recent years. However, he points out, the improvement in life expectancy does not translate into improved health in all cases. According to him, not all those years are healthy as the effects of chronic diseases are increasingly affecting the quality of life of people at a much younger age than in the past. The answer to these awkward AHA statistics is advice from its president, published in the journal Circulation, which recommends goals for which national and international health organizations and ministries should strive. These are titled the 2030 Impact Goals and the goal is to empower healthy living for a larger portion of life span, for all people in the United States and around the world. A new report from AHA – the Heart & Stroke Statistics – 2020 Update – shows an encouraging decline in the number of deaths due to stroke and heart disease (grouped together as cardiovascular disease (CVD)), but also reveals that the steepness of this recession it has become more superficial in recent years. A more puzzling finding is that after nearly 100 years of efforts to improve cardiovascular health, ill health is currently more prevalent and is starting younger, due to mismanagement of risk factors for cardiovascular disease.

This is in the face of the prevention and control of heart disease and stroke, better medical treatments and healthier lifestyles and behaviors. It is in this context that the Impact Goals are seen. The international goal is an increase in the world expectancy of healthy life years from the current 64 to 67 or more years by 2030, in a fair way. The advisory recommends the use of the health measure called Health-Adjusted Life Expectancy (HALE), also called Healthy Life Expectancy, which measures the number of healthy years an individual can expect to live. This includes the impact of physical and mental health conditions and captures the overall health status throughout the person’s life, depending on environmental and other risk factors. Across the United States, adults are becoming more active, eating healthier foods, smoking less, and controlling their cholesterol better. However, at the same time, other areas show a negative trend. Young people are showing unhealthy trends, which means that future generations will be at a higher risk for major health problems. Just to think about obesity, around 40% of adults and 19% of young people are obese and the rates are on the rise.

Statistics and facts at hand

These are the other main proofs:

Smoking: The smoking rate in the United States is at an all-time low for teens and has also declined among adults. However, more and more young people are taking to vape and, globally, there were over 930 million smokers in 2015, higher than before. When delimited by gender, income and location, it turns out that 80% or more of smokers are found in the least industrialized and least developed countries of the world, and most are male.

Exercise and physical activity: Not even one in three students has a physical education class every day. Only about a quarter (26%) are moderately or vigorously physically active each day.

High blood sugar: in the period 1990-2017, despite the wealth of drugs and equipment for regulating glucose, the number of diabetic males increased by 130%, which means that their number has more than doubled; for women it is slightly lower, but still 121%.

Hypertension: despite the latest upgraded AHA 2017 Guidelines for Hypertension, the current prevalence of the condition is still in the range of 15-20% of the general population.

This demonstrates the existence of a basic inequality in the level of health enjoyed by different populations based on age, race, location and sex.

A matter of choices

In theory, many people want to make choices that will help them live a longer, healthier life. No less than 93% of people in a recent Harris survey conducted on behalf of the AHA said a long, healthy life was an important goal and that everyone deserved it. On the other hand, many of them don’t know how their behavior affects their health. Only less than half of the people surveyed said their behavior certainly paid off on their health and well-being. And only a third firmly believed that their health choices were influenced or supported by their surroundings. On the other hand, Harrington firmly believes that to make healthy life a reality, it should be easier and more convenient to choose healthy behaviors and lifestyles: “We need to help people better understand the impact their communities have in leading choices for health and well-being. Sometimes parents are more concerned about whether they can feed their children, much less whether it is healthy or not. If you are living with high blood pressure, you shouldn’t worry about whether to pay the rent or buy the medicine”.

Harrington says teamwork is needed between many stakeholders to lead this process of achieving the 2030 healthy lifespan goals – including local neighborhoods and governments around the world. In addition, it is necessary to work towards the prevention of chronic diseases at both primary and secondary levels. Public health administrators must work towards population-level policies. Furthermore, health systems must be established that are not only effective, but also user-friendly and accessible. And most importantly, individuals must take ownership of their lifestyle and behavior. In addition to measuring trends in healthy behavior, accurate and useful reporting and analysis of health data will be crucial to track progress towards these goals. For this reason, the AHA has already published its advice on how to carry out CVD surveillance globally. Many of these efforts are already underway, but recruiting new blood will be key to improving the program’s reach and effectiveness.

He concluded in a very practical way: “To improve individual health, we must make the environments in which we live, work, learn and play equally in support of healthy behaviors. We need to make healthy choices easier, make healthcare accessible and affordable, and we need to get better at stopping preventable diseases before they start. We will invite more people to the table, but more importantly, we are asking stakeholders like them to invite us – we help be a catalyst that brings together elements that can create a healthier world for all. In every country, in every city and village, we want everyone, of all ages and backgrounds, to be healthy. This is much more than just wanting people to live in old age, we want them to live healthier and longer”.

edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.

Scientific references

Alyabsi M et al. BMJ Open 2020 Dec 31; 10(12):e041973.

Hosseinzadeh-Shanjani Z et al. ARYA Atheroscler 2019; 15(1):38-43. 

Hudspeth B. Am J Manag Care. 2018; 24(13 Suppl):S268-S272.

Jackson SL, Safo S et al. Am J Prev Med. 2017 Apr; 52(4):459-468. 

Dott. Gianfrancesco Cormaci
- Laurea in Medicina e Chirurgia nel 1998 (MD Degree in 1998) - Specialista in Biochimica Clinica nel 2002 (Clinical Biochemistry residency in 2002) - Dottorato in Neurobiologia nel 2006 (Neurobiology PhD in 2006) - Ha soggiornato negli Stati Uniti, Baltimora (MD) come ricercatore alle dipendenze del National Institute on Drug Abuse (NIDA/NIH) e poi alla Johns Hopkins University, dal 2004 al 2008. - Dal 2009 si occupa di Medicina personalizzata. - Guardia medica presso strutture private dal 2010 - Detentore di due brevetti sulla preparazione di prodotti gluten-free a partire da regolare farina di frumento immunologicamente neutralizzata (owner of patents concerning the production of bakery gluten-free products, starting from regular wheat flour). - Responsabile del reparto Ricerca e Sviluppo per la società CoFood s.r.l. (leader of the R&D for the partnership CoFood s.r.l.) - Autore di un libro riguardante la salute e l'alimentazione, con approfondimenti su come questa condizioni tutti i sistemi corporei. - Autore di articoli su informazione medica e salute sui siti web salutesicilia.com, medicomunicare.it e in lingua inglese sul sito www.medicomunicare.com
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