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The American Heart Association® has dedicated itself to "Fighting Heart Disease and Stroke." Their mission is one of instruction. That instruction is targeted not only at rescuers but patients and the general public as well, because the best cure is prevention (to borrow a phrase.) For that reason, every CPR class starts with information regarding Prudent Heart Living. The first topic of discussion in any lecture concerning Prudent Heart Living would have to be an explanation of the Chain of Survival. A concept developed by the American Heart Association®, it is an illustration of the events that occur when an individual activates the Emergency Medical Services system. Graphically, it is a chain, with four links, each link representing another step in the process for the patient involved in the system.
The links are:
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Early Access - The sooner the system is activated, the more likely it becomes that the outcome will be positive.
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Early CPR - If the patient's heart has stopped, minutes (even seconds) count. The rescue team that will be dispatched can not possibly be on the scene of every cardiac arrest in a timely fashion. It is therefore imperative that members of the general population learn CPR, consequently increasing the likelihood that a trained individual will be present when some unfortunate person experiences cardiac arrest. Even prior to cardiac arrest, a properly trained individual might actually help avert the arrest by performing "rescue breathing" for the patient that is in respiratory arrest. At even an earlier stage, a properly trained individual might be able to help avert any damage to the heart muscle, at all, by recognizing the signs and symptoms of an impending heart attack or a "budding" heart attack, accessing the system and getting this patient to the proper health care facility. And, if this "properly trained" individual is a real "nudge," he/she might be able to avert the entire problem by encouraging the prospective "patient" to change their ways (smoking, diet, sedentary lifestyle) and the need for CPR (or an ambulance, or medics) is eliminated.
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Early Defibrillation - Prior to the development of affordable and reliable home-based/public access automatic external defibrillators (AED,) this link in the chain of survival was "fused" to the next link. Paramedics were the only ones carrying external defibrillators in the public sector. This new technology (AED's) has placed the power of direct current defibrillation into the hands of Basic Life Support Providers, Police Officers, Firefighters, and Citizens, with an acceptable degree of safety.
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Early Advanced Life Support - With all of the preceding activity, one would think that Paramedics are not needed to complete this patient's care. All we need to do is get the patient to the Emergency Department at the local hospital. Well, the Paramedics are the Emergency Department from the local hospital and all the preceding activity has actually helped to now "offer" a viable patient to the street medics who will continue the "magic" and under most circumstances stabilize the patient so that the trip to the local hospital is of a more leisurely nature which puts everyone at ease and creates a safer environment for the patient, medics and the general public.
Moving along, the next subject in any Prudent Heart Living lecture would be all of those things that are NOT prudent (there is so much time spent on these aspects of daily living (in the "live" lecture,) that the lecture should actually be called, "Un-Prudent Heart Living.)
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Smoking - The number one cause of heart disease. We can think of no redeeming medical, or social factors associated with the use of tobacco (in any form.)
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Diet - There's been much discussion of late regarding diet. No fat/some fat, no eggs/eggs , no dairy products/milk is okay, "Where's the beef?"/"The other white meat." It's enough to really confuse an avid reader of "the latest information." Our feelings regarding food? We support the See-food-diet (If we need to explain that......... we're in trouble.) We believe that a diet of moderation that is well rounded with representation from the three major food groups (that's sugar, caffeine, and junk) is enough to secure the jobs of the emergency medical workers of the world for the next millennium. Seriously folk, enjoy food, moderate your diet with appropriate representation from the major food groups, avoid junk food and snacking, and try not to "eat on the run" (like most medics do.) Just about anything in moderation.
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Sedentary Lifestyle - Inactivity leads to the couch potato syndrome. The more you sit - the more time you have to think, the more time you have to think - more you'll think about food, the more you think about food - the more you eat, the more you eat - the less you feel like moving, the less you feel like moving - the more you sit. If you get up and get active, not only will you have less time to sit, but you will also encourage the body to stimulate the natural mechanisms that will process food into energy which will encourage you to remain active. That activity will stimulate the other systems in the body to function so that the respiratory system will oxygenate blood more efficiently, the cardiovascular system will circulate that blood more effectively so that the necessary fuels and nutrients can be delivered to the other systems of the body where defense mechanisms are initiated, or waste products are processed, or growth hormones are produced. When the "machine" runs well, the front office (the brain) is happy and the entire organism operates at peak efficiency. Become a couch potato and the entire system becomes sluggish, blood may even thicken, circulation is hampered, emotions run "low," and at times like these things go wrong. "Getting active" is the hard part, once active it's easy to stay active. Get there. Stay there. Be happy.
The next section deals with factors that have been shown to contribute greatly to the occurrence of heart disease. We have labeled them "Contributing Factors."
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Sex - No...not the over indulgence in, nor the absence of. We refer here to gender. It seems that men are more at risk for sudden cardiac death (an event where the heart just seems to stop, for no immediately apparent medical reason, like electrical shock) than women. During child bearing years, a woman's body secretes hormones that actually block the likelihood of sudden cardiac death (although we doubt those hormones would have much effect if this woman's body were suddenly "hooked-up" to a 220v line.) The head start that these hormones give the women, when it comes to biological causes of sudden cardiac death, keeps their "numbers" lower than the men, and consequently, the men are hailed as the leaders in this regard. As "time" progresses, however, and the hormonal secretions, in women, abate, the "numbers" even-up, and the women 'catch-up.'
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Age - Hey listen, as the plant get older, the systems within the plant do not operate as efficiently. The "pump" (heart) gets older, the air purification system (lungs) gets older, the product dispersal system (vascular) gets older, the product (blood) gets older. Things that should be happening easily, just seem to require more effort or time.
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Heredity - The numbers say that Blacks are at a greater risk for heart disease than Whites. We personally don't understand how a "heart" sitting on the inside of a chest (incidentally, on the inside we DO all look alike) could possible "know" what color the skin is on the outside and wonder if the "numbers" really indicate something else. Maybe it's not skin color (or simple heredity) that leads to heart disease, but a combination of lifestyle, diet & personal habits. You see, these things are sometimes inherited traits and in that respect it's probably appropriate to say that "heredity" can lead to heart disease, but we don't believe that people are genetically doomed to contracting heart disease, as a result of their ethnic background. This is not in contradiction to recent findings that there may by a genetic link to heart disease, just that the link (if, indeed it exists) is probably not the result of ethnic background.
