Top Things to Know: Self-Care for the Prevention and Management of Cardiovascular Disease and Stroke
Published: August 31, 2017
- Worldwide, by 2050, the population of 60 and older will double; 25% of the population will be older than 60; 20% older than 65; and close to 5% will be older than 85 years.
- Aging is a major risk factor for non-communicable chronic conditions, especially cardiovascular disease (CVD) and stroke, and will result in large numbers of elderly individuals with multiple chronic conditions. This trend has been called the “silver tsunami”.
- When considering a “life course” approach to CVD management, it is understood that the seeds of most non-communicable diseases, such as CVD, are planted very early in the life course, requiring a massive shift in the focus on treatment of acute events to an early emphasis on self-care.
- Self-care behaviors at the individual, family and community levels are described in this paper.
- Individual level self-care behaviors include patient autonomy, understanding self-care and selfcare responsibility. Knowledge of health status, diet, weight control, physical activity and exercise, smoking cessation, alcohol use, medication adherence encompass self-care responsibilities.
- Family level self-care includes the notion of family support as a part of self-care.
- Community level self-care describes how the environmental factors impact health and the ability of people to perform self-care.
- This statement explores several disease states where self-care modalities have shown change in patient outcomes: hypertension (self-care monitoring of blood pressure), coronary heart disease (lifestyle modification), peripheral artery disease (homebased exercise programs for better walking ability), stroke (improvement of activities of daily living), atrial fibrillation (self-monitoring of anticoagulation), and HF (self-care associated with improved outcomes and self-efficacy).
- Factors influencing self-care are discussed and include depression, poor self-efficacy (lack of confidence), cognitive decline, and multimorbidity. Lack of social support influencing self-care and lack of social capital limits access and affordability of care are other factors.
- Interventions to enhance self-care at the individual level include building knowledge and skill with education with the goal of improved knowledge and understanding about CVD and all associated selfcare practices.
- Technology is growing rapidly to support self-care maintenance, monitoring and management of disease.
- This scientific statement describes the importance of self-care in the American Heart Association mission and vision of building healthier lives free of CVD and stroke.
- To be maximally effective, self-care to optimize healthy lifestyle and prevent chronic CVD must become part of the culture of society. Self-care must be practiced by all individuals at all ages and should not be focused on only those that already have CVD.
Citation
Riegel B, Moser DK, Buck HG, Dickson VV, Dunbar SB, Lee CS, Lennie TA, Lindenfeld J, Mitchell JE, Treat-Jacobson DJ, Webber DE; on behalf of the American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Quality of Care and Outcomes Research. Self-care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American Heart Association. J Am Heart Assoc. 2017;6:e006997. DOI: 10.1161/JAHA.117.006997.