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Features Health & Wellness ABCS may be answer to controlling costs of heart disease and stroke

Heart disease and stroke are among the most widespread and costly health problems in North Carolina today. Cardiovascular diseases, which include heart disease and stroke, account for 31 percent of all deaths in North Carolina. Just as staggering are the health care costs of cardiovascular disease in the state. Data provided by “The Burden of Cardiovascular Disease in North Carolina—July 2010 Update” show that total hospital charges for CVD in North Carolina currently exceed $4.6 billion annually. State health experts are suggesting four simple steps, the ABCS, that individuals can take to address the leading risk factors for cardiovascular disease and control rising health care costs.

“The average charge per hospital stay for cardiovascular disease in the state exceeds $28,000,” said Anita Holmes, JD, MPH, Heart Disease and Stroke Prevention (HDSP) branch head and executive director of The Justus-Warren Heart Disease and Stroke Prevention Task Force. “The economic impact of cardiovascular diseases on North Carolina’s health care system will become even greater as our population ages.”

According to Cardiologist Ross Simpson, MD, PhD, MPH, professor of medicine and director of the lipid and prevention clinic at the University of North Carolina at Chapel Hill and principal clinical coordinator at The Carolinas Center for Medical Excellence (CCME), North Carolina is part of the “stroke belt” which makes it important for North Carolinians to control the risk factors that lead to cardiovascular disease.

“Smoking tobacco, a diet high in sodium and cholesterol, and other factors that are common in North Carolina have to be controlled,” Dr. Simpson said. “One of the most effective ways of doing this is to reduce sodium intake, getting people to stop smoking, and helping people to control their diet. Leading a healthy lifestyle can greatly reduce a person's risk of developing heart disease or stroke."

The CDC’s Division of Heart Disease and Stroke Prevention (DHDSP) Program recently released the program guide, Strategies for States to Address the ABCS of Heart Disease and Stroke Prevention, for states across the country to focus on the leading risk factors of high blood pressure, high cholesterol, smoking, and a high sodium diet. The “ABCS” of cardiovascular disease prevention— Aspirin use prescribed by your physician, Blood pressure and Cholesterol control, Smoking cessation, and reduced Sodium intake—uses policies, systems, and environmental changes to impact the general population and groups with increased burden or need.

Using aspirin. Aspirin helps to lower the risk of heart attack and stroke because it prevents blood from clotting. Ask your doctor if you should take aspirin regularly, the dosage of the aspirin, and its use. The risks and benefits of aspirin therapy vary for each person.

Controlling blood pressure. High blood pressure is when the pressure in your arteries is higher than it should be. Blood pressure is always given as two numbers, like “120 over 80,” or 120/80 mm Hg. Your blood pressure is high if the first number is more than 120 or the second number is more than 80. The guide recommends regular blood pressure checkups by your doctor.

Controlling cholesterol. Researchers estimate that a 10 percent decrease in total blood cholesterol levels among the U.S. population would lead to a 30 percent decrease in the nation's heart disease stroke rate.

Stopping smoking. Studies show that cigarette smoking is the leading cause of preventable death in the U.S., accounting for approximately one of every five deaths a year. The ABCS program guide promotes strategies to increase the number of smokers receiving counseling in an effort to quit. Consult with your doctor about options available for quitting, such as medication, support groups, and state quit lines.

Reducing sodium consumption. High blood pressure is the single most important risk factor for heart disease and stroke. The USDA’s new guidelines have defined the range of recommended daily sodium intake as no more than 2,300 mg of sodium daily for Americans at lower risk for hypertension and no more than 1,500 mg for African Americans, individuals with hypertension, diabetes, or chronic kidney disease and individuals ages 51 and older. Strategies to lower sodium intake include promoting the availability of low sodium foods at worksites, eating more fresh produce, and expanding the visibility of consumer information labeling initiatives.

For more information about the ABCS program guide, visit the CDC’s Division of Heart Disease and Stroke Prevention website at Also visit the Start With Your Heart website at to receive more information about cardiovascular disease prevention.

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