Cardiovascular Risk Factors: Patient Case Study

Cardiovascular Risk Factors: Patient Case Study 

The primary focus of this paper is to discuss and perform an in-depth analysis of several cardiac risk factors exhibited by a 55-year-old patient interviewed by the author, a student nurse. This paper will also go over ways to modify either the risk factors themselves, or ways to change other components of the patient’s lifestyle in ways that may decrease the likelihood of a cardiovascular disease, such as through the creation of healthy habits, due to the unmodifiable nature of certain risk factors. By showing the risk factors, corresponding ways to mitigate them, and rationales linked to each, this paper aims to paint a picture of a road to a healthier lifestyle for the patient subject. The patient will be referred to by the initials “AR” throughout this paper, and the author as “student nurse.”

Risk factors

Upon first review of the patient’s demographic information, two risk factors were immediately apparent; AR is 55-years-old, and a male. Two common risk factors are dependent on age and sex of the patient. AR also suffers from obesity, with a BMI of 39.3 he is at risk for reaching morbid obesity, defined as a BMI of 40 or above, putting significant stress on his heart, lungs, and joints. At age 8, AR was diagnosed with aortic valve disease due to an enlarged aorta deemed to have been present since birth, yet another risk factor, which required surgical intervention. AR also suffers from hypertension which, although mitigated by medications, has been a known and studied risk factor for cardiovascular disease. In conjunction with asthma, AR was a smoker of approximately one-half to one pack of cigarettes a day for five years in his early 40’s and successfully stopped after health concerns were raised by his primary care provider. Lastly, AR revealed during the interview that he leads a sedentary lifestyle, stating he is unable to properly exercise due to his difficulty ambulating and several comorbidities.

Rationales for risk factors

According to Ignatavicius, Rebar, and Workman; hypertension, obesity, and smoking (or history of, in AR’s case) are major contributors to cardiovascular disease and heart failure and should thereby be modified as a preventative measure (Ignatavicius, Workman, & Rebar, 2017). The same source tells us that “a sedentary lifestyle is also a major risk factor for heart disease” (Ignatavicius, et al., 2017). Although age 65 and up is seen as the most common time period for heart disease to manifest, a study published by Harvard Health stated that 4-10% of heart attacks can happen before age 45, and that number begins to rise steadily with age (Harvard Health Publishing, 2009). At AR’s age and with his history, comorbidities, and risk factors, he is at a much higher risk than many others. Congenital heart defects, such as AR’s enlarged aorta causing aortic valve disease, are considered to be major risk factors, even with corrective action (Mayo Clinic, 2018). Finally, a risk factor that cannot be changed, which encompasses half the global population, is AR’s sex. Harvard Health published an article stating that “throughout life, men are about twice as likely as women to have a heart attack” (Harvard Health Publishing, 2016).

Healthy habits

In order to significantly reduce the chances of cardiovascular diseases, it is advisable for AR to begin making radical changes to mitigate or remove these risk factors entirely. If the patient is able to make significant changes to current lifestyle habits that create modifiable risk factors it may help provide moderate compensation for the aspects that cannot be modified, such as age, sex, and chronic illness. The most prolific of AR’s lifestyle habits which need changing are those surrounding his sedentary lifestyle. A sedentary lifestyle is a breeding ground for obesity and hypertension as the three often come together, creating a plethora of potential for cardiac disease. Reducing weight through proper diet and exercise can help bring the patient to a healthier BMI, thereby lowering the stress that his heart, lungs, and joints undergo to support him daily. Due to AR’s difficulty mobilizing, he will likely have to choose alternative methods to running in order to exercise properly. Being unable to run does not mean AR cannot exercise, many substitutes to running exist, such as stationary use of weights, and when combined with a proper diet this can bring his weight down to a healthier level. This may also help with his hypertension. Choosing low sodium and low saturated fat foods is a start, and in conjunction with regular exercise can be a good way to lower blood pressure. High blood pressure is an incredibly common precursor to heart disease, and lowering it through more than just pharmacological means is a great way to reduce risk for disease. AR cannot change his history of smoking, only choose not to take it up again. He also cannot change his history of aortic valve disease, only make choices to prevent further cardiac diseases from developing. By forming these healthy habits, he will be well on his way to those goals.

Rationales for healthy habits

Starting with AR’s sedentary lifestyle, innumerable studies have shown the detriment and comorbidities that come along with it. Regular exercise should be a priority task for AR, as Ignatavicius, et al. state “regular physical activity promotes cardiovascular fitness and produces beneficial changes in blood pressure and levels of blood lipids and clotting factors” (Ignatavicius, et al., 2017). Along with exercise, an improved, heart-healthy diet will help AR work towards reducing and removing modifiable risk factors. Ignatavicius, et al. quote an American Heart Association study from 2015 that laid out heart-healthy guidelines, which included “ingesting more nutrient-rich foods that have vitamins, minerals, fiber, and other nutrients but are low in calories” (Ignatavicius, et al., 2017). Fewer calories and sodium, more nutrients and plenty of exercise will help AR reduce his weight, shed his sedentary lifestyle, and lower his blood pressure, all of which will otherwise form a deadly cocktail of risk factors for cardiovascular diseases if something is not done soon. Lastly, AR should never take up smoking again as it is a quick and sure way to contribute to heart disease. In an article published by the United States Centers for Disease Control, they stated that “smoking is a major cause of cardiovascular disease (CVD) and causes approximately one of every four deaths from CVD” (CDC, 2014).

Conclusion

In conclusion, AR’s diagnoses, comorbidities, and general risk factors warrant significant changes in order to decrease chances of cardiovascular disease from developing. Although he has several risk factors that cannot be modified, if he is diligent and dedicated, he can compensate for this in other ways. Diet, exercise, and avoiding the formation or reversion to poor habits can mean all the difference in the world, all of which become increasingly more important as AR ages due to the fact that risk will continue to increase with age. Everyone should occasionally take a step back and review their lifestyle habits and make changes to those that put them at a greater risk for chronic illness, and AR is no exception.

References

•  Rebar, C., Ignatavicius, D., Workman, M. L. (2017). Medical-surgical nursing. [CoursePoint]. Retrieved from https://coursepoint.vitalsource.com/#/books/9780323461580/.
• Harvard Health Publishing (2009). Retrieved from https://www.health.harvard.edu/heart-health/premature-heart-disease
• Mayo Clinic (2018). Retrieved from https://www.mayoclinic.org/diseases-conditions/heart-valve-disease/symptoms-causes/syc-20353727
• Harvard Health Publishing (2016). Retrieved from https://www.health.harvard.edu/heart-health/throughout-life-heart-attacks-are-twice-as-common-in-men-than-women
• Centers for Disease Control (2014). Retrieved from https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_smoking_CVD_508.pdf