Queensland University: HLN004 Coronary Artery Disease Report

This report examines Coronary Artery Disease (CAD), a major chronic condition contributing to the global burden of disease. It begins with an introduction to CAD and its impact on the circulatory system, followed by an analysis of statistics and data related to prevalence and mortality rates worldwide, with a focus on the United States, the UK, and Australia. The report then explores the public health significance of CAD, detailing its impact on individuals, families, and communities, as well as its financial implications. Various risk factors such as age, gender, ethnicity, family history, smoking, and abnormal cholesterol levels are discussed. The determinants including behavioral, psychological, socioeconomic, and environmental factors are also analyzed. The report then introduces and critically reviews the Chronic Care Model (CCM) as a framework for the prevention and management of CAD, examining its key components: community resources and policies, healthcare organization, self-management support, delivery system design, decision support, and clinical information systems. The report concludes by summarizing the key findings and implications of the analysis.

Running Head: CAD
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Coronary artery disease
Essay
student
9/6/2019

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Table of Contents
Introduction.................................................................................................................................................2
Statistics and data....................................................................................................................................3
Public health significance........................................................................................................................4
Risk factors..............................................................................................................................................4
Determinants...........................................................................................................................................5
Framework..................................................................................................................................................7
Chronic care model..................................................................................................................................7
Conclusion.................................................................................................................................................11
References.................................................................................................................................................13

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Introduction
The cardiovascular or the circulatory system of the human body supplies the blood to the
body it comprised of heart, arteries, the veins and capillaries. When there is impairment happen
in the system, it results in the cardiovascular abnormal functioning of the heart (American
Diabetes Association, 2016). Cardiovascular disease is now considered as the most common
reason of death world-wide. Cardiovascular heart disease defines as the range of conditions that
impacts the heart. The term cardiovascular is commonly used interchangeably with the heart
disease. Cardiovascular disease includes different conditions like coronary heart disease, angina,
congenital heart disease, stroke, hypertension, heart valve illness, and cardiomyopathy (Lonn et
al., 2016). The four main coronary arteries that are situated on the heart surface include right
chief coronary artery, left chief coronary artery, left circumflex artery, and the left anterior
descending artery. Coronary artery illness is a health issues that causes impaired flow of blood in
the arteries that transport the blood to the person’s heart. It is also named coronary heart disease.
Some of the symptoms associated with this health issues comprise chest pain, heaviness,
tightness and burning, squeezing, pain in the arms or shoulder, breath issues, sweating, and
faintness. It is the most usual type of heart illness. In United States, It is the foremost cause of
death for both male and female. Coronary Herat disease can also deteriorate the heart muscles
and subsidize to the heart failure and other conditions like arrhythmias. The coronary artery
disease becomes the worldwide problem and affected many people (Dawber, Moore & Mann,
2015). This particular health issue can be liked to other health issues like diabetes, obesity etc. In
this particular essay the statistics and data about the burden of the disease, prevenance,
community health significance, risk factors, and wide range of health determinant of this health

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issue will be discussed. The avoidance and managing of this health issue will be discussed in this
essay.
Statistics and data
Cardiovascular disease are the top most reason of death worldwide, an estimated nearly,
17.9 million individuals died because of CVDs in 2016, accountable for 31 per cent of all the
worldwide death. Coronary heart disease is the utmost common kind of circulatory disease
killing nearly 370,000 individuals yearly (Sanchis-Gomar, Perez-Quilis, Leischik & Lucia,
2016). Meanwhile the CAD causes a projected yearly total of four million deaths particularly in
Europe and on around 1.9 million expiries in the European Union, mainly because of coronary
heart disease, representing around 47 per cent and 40 per cent of all expiries in Europe and the
European Union, correspondingly (Townsend et al., 2016).
Prevalence
An estimated nearly 3.8 million males and nearly 3.4 million women die every year from
CAD (CHD). Particularly in UK it became the most common reason of deaths and estimated one
in five male and 1in 6 females die from this health issues every year, and in 2003 coronary artery
disease caused around 114000 deaths (Bhatnagar, et al., 2015). Death rate due to CHD were
higher in Scotland and northern England, where the early death rate among males is 67 per cent
higher than the South West of the England and 84 per cent higher for females (Luengo-
Fernandez, Leal & Gray, 2015). In Australia, in 2014-15 around 643, 000 adults were diagnosed
with CHD, and among all the diagnosed individuals, 281000 experienced angina, 428 had heart
attack, 55,000 experienced other forms of CHD. CHD in Australia occurred mostly among older
people aged 45 to 54 years. An estimated 149, 000 hospitalizations have been reported where

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CHD was the main diagnosis. In 2013 coronary artery disease was the main cause of death in
Australian region accounting for 19,800 expiries, which represents 13 per cent of all expiries,
and the utmost 1 in two cardiovascular deaths (Sahle et al., 2016).
Public health significance
CAD also described as the ischemic heart disease is the development of the fatty deposits
in the inner walls of the coronary arteries. This development of atheroma, called atherosclerosis,
can simply go unnoticed takes many years to develop. It can affect individuals, family and
community. CHD can cause premature death, incapacity and abridged activities of everyday
living (frequently due to pain in the chest and breathlessness), loss of incomes and individuality,
anxiety, depression, and stress. All of these aspects might have a harmful impact on a person’s
life quality (Khera et al., 2016). Having a CHD patient in the family can be problematic for the
family as the management of this disease is long lasting and the family members have to provide
continuous care and invest money that might pose both financial and metal problems to the
family. Coronary heart disease also has a significant financial impact on the community there is
an upsurge cost to a community healthcare system in addition to to the broader economy (due,
for example, to loss of productivity among the people suffering from coronary artery disease and
their informal health carers). The huge majority of these prices were because of hospital inpatient
upkeep, which accounted for 73 per cent of the total coronary artery disease associated health
care costs (Hla et al., 2015).
Risk factors
There different risk factor of coronary artery disease such as age and gender, ethnicity,
family history, smoking, abnormal cholesterol levels, increased BP, physical indolence, being
overweight, and other health issues. Risks of developing coronary artery disease upsurges with

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age this is because the plague established over time. The risk of developing this health issues is
high among women after the age of 55 and men after the age of 45. White men aged between 35
and 44 are six times more likely to be diagnosed with this health issue then women (Koene,
Prizment, Blaes & Konety, 2016). The difference is quite less among the non-white people.
African-American people are 30 per cent more probable to develop heart disease like CAD than
non-Hispanic white male and females. Coronary heart disease can run in generations, as the risk
of this health issues increase if there is close family member has CHD. Smoking tobacco
products (first or secondary) can also increase the risk of CAD, and it is specifically harmful if
the individuals have a family history of heart disease. Abnormal levels of cholesterol (LDL and
HDL cholesterol) also the risk factor of CAD as it increases plaque development in the arteries
(Yusuf et al., 2016). Risk factors frequently take place in collections and may form on one
another, for example obesity resulting in type 2 diabetes and increased blood pressure. When
gathered together, definite risk aspects put the patient at an even bigger risk of coronary artery
disease. For instance, metabolic syndrome ; a bunch of illnesses that includes raised blood
pressure, increased triglycerides.
Determinants
Behavioral factor
Personal behaviors play an important role in their health outcome. Health connected
behaviors for example cigarette smoking, consumption of alcohol, physical activities, and diet
have a main influence on mortality and morbidity associated with CAD (Marmot & Mustard,
2017). Nations have the residents which consume more cholesterol rich diet; alcohol, tobacco,
and overweight have an increased number of CAD cases. Healthy individuals have a high quality

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of life and pose fewer loads on the health care and societal system, and subsidize less to
cardiovascular diseases like coronary artery disease (Staniute et al., 2015).
Psychological Determinant
There are different studies exposed that perceived type of stress, depression, annoyance,
and anxiety can create the various reactions which can upsurge the probabilities of CAD. The
mental factor is interconnected with side effects, augmented morbidity, and death rate threat
among CAD patients. Each individual is a sole character and has dissimilar desires,
requirements, and insight of thoughts and things. These bring alterations in person’s life that can
outcome in stress and the depression which can subsidize to CAD, and the massive number of
literature previously showed that there is an link of depression, worry, and stress with the CAD
(Chauvet-Gelinier & Bonin, 2017).
Socio-economic factor
The socio-economic factor is massive area and several sub-factors come underneath the
headline i.e., socialization, earnings, and learning. Though, WHO describes it “the conditions in
which individuals are born, develop, live, do their job, and the systems introduce to address
illness and sickness”. The socio-economic factors subsidize or reduce the health of persons and
societies (Puckrein, Egan & Howard, 2015). This aspect has recurrently been established to be
linked with CAD it either straight or indirect influence the load of the CAD or CHD. The study
presented that societal isolation significantly upsurges the risk of the deceases from CAD, and
the advanced mortality rate was detected among the nations where no societal support happens.
Social factors of health effect an individual's cardiovascular health aspects and behaviors. For

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instance, an individual's neighborhood and how harmless it senses can have an influence on the
capability to both workout and consume healthy (Kumar, 2017).
Environmental factor
Environmental factor of CAD is the terrestrial location, contact, entrance to health
facilities, and resources. Research Studies have specified that atmosphere in which people live
(for example existence of the footpath, green places, food obtainability, and fitness center)
frequently denoted as the constructed environment. It is linked with the habits related to CAD
risks for example physical activity, nourishment, and tobacco consumption and these
environmental determinants play a role in stopping and growing the CAD issues (Tillmann, et
al., 2017).
Task 2
Framework
Chronic care model
The Chronic Care Model abbreviated as CCM is a multilayered, evidence-based structure
for improving care delivery by recognizing important constituents of the health care system in
the community that can be adapted to help high-quality; patient-focused chronic illness
management. The CCM delivers a methodical approach to apply transformation. This framework
is widely accepted for cardiovascular diseases like coronary heart disease. Some of the elements
of this framework that can be used to guide the systematic and individual improvement in
coronary artery disease are; community possessions and policies, healthcare organization, self-

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managing support, the delivery system design, support in decision, and clinical info systems
(Gee, et al., 2015).
Community resources and policies
Community possessions and polices can play a key role in prevention and management of
the CAD. The healthcare settings like hospital can collaborate with the local community health
providers in order to educate the healthy people about the disease and its preventions strategies
so that it can be eliminated from the community. The hospital professional like community
nurses can educate the patient about the management of disease, by adhering to the medication,
performing recommend exercises, and eating suggested diet (Kadu & Stolee, 2015). For example
in the people belongs to the Aboriginal and Torres Strait islander community in Australia have
their own culture and belief which must be respected by the healthcare providers and they must
have the knowledge about the cultural background. To do so they must work with the local
healthcare providers, this will also help the community nurses or team to gather as much as
possible people in the education sessions about the disease prevention and management. They
nurses can also educate the school and college student so that they can understand the problem
can takes part in the prevention program. The newly married couples can also be educated about
the genetic factors of this disease (Davy et al., 2015).
Healthcare organisation
The government and non-government organization must also be included in the program
as they can support in the financial resources. The government and other organisation can be
included as the stakeholders and main member of the programs. The community members must

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also be educated about the government services o health promotion programs already being
provided for patient with cardiovascular diseases like CAD (Adams & Woods, 2016).
Self-management support
Self-management is the most essential Task to manage the disease at home which can be
done with the complete support from the hospital and community healthcare centres. The health
care provided must educate the patients and their family to follow the recommendations of the
physician. The patient must be taught about improving their cholesterol levels as it can worsen
the health condition. They must also be educated to quit smoking and avoid second-hand
smoking (Higa & Davidson, 2017). Checking their own blood pressure is another skill that must
be taught to the patient so that can assess their BP regularly and report to the physician and nurse
if any complication observed. To control the blood pressure the patient can perform exercise at
home with the support of public health nurses or family member as the people who do not
exercise are more likely to develop heart diseases. They must also avoid salt content in the food.
Other different things to educate the patient are reducing the dietary sodium intake, decreasing
alcohol use, taking medicine according to the prescription, attending cardiac rehabilitation,
knowing the common sign and symptoms of heart attack and heart failure, and maintaining the
weight (Coleman, Austin, Brach & Wagner, 2009).
Delivery system design
The health care teams should be created to prevent and manage the coronary heart
disease. The health care team must include public health nurses, social worker, pharmacist,
physiotherapist, and a cardiac care nurse. The social worker will help in the ethical concern
related to the treatment, nutritionist, and the public health nurses can help in developing a

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therapeutic relationship with the patient who can help in the assessment, management and
prevention of the disease. Physiotherapist can support the patient with the essential exercises.
The nutritionist are specialised in the implementing the strict diet plan as recommended by the
physician, this can help the patients to learn about the healthy diet. The cardiac care nurses are
specialized in provided service to the cardiac patient about the disease, its progression, and
complications. The vision and objectives must be shared with the team so that they can
understand tier responsibility better for the particular patient or community. The team members
must follow up the patient regularly assess their health conditions and to know about their
specific needs.
Decision support
This element of the framework model can help the patient I providing the support in the
decision making process about the treatment and management of the disease. The decision
support system will provide the clinician with proper knowledge about the coronary heart
disease, and patient information to augment the patient care decisions (Siminerio, 2010).
Clinical information systems
A clinical info system (CIS) is an information system intended specially for use in the
critical care atmosphere. It can link with the several computer systems in a contemporary
hospital, for example pathology and radiology. It contains figures from all these systems into an
electric patient record, which physicians can get at the patient’s bedside (Leykum et al., 2011).
To prevent and manage the CAD issues the system can be effective as it improves the interaction
between different health provided caring for the CAD patient, provide complete information
about the patient, making it effortless for the patient to have the examination reports when the

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needed, and retrieving the information whenever needed in other cases and for authorized
research purposes (Nundy et al., 2012).
Conclusion
Cardiovascular diseases are the diseases affect the blood circulatory system of the patient
can cause different complications. It is recognised that this health issue affected peopled form all
around the world, around 4 million people died due to CAD particularly in Europe. Nearly 3.8
million males and 3.4 million females die annually due to this health issue. CHD has the public
health significance as it affects the individual, family and the community. Some of the risk
factors associated with this health issue include age and gender, ethnicity, having close family
member with this disease, smoking, high BP, abnormal cholesterol levels, obesity, and physical
inactivity. Some of the determinants of this health issues are behavioural factor, psychological
factors, socio economic determinant, and environmental factor. The framework model can be
used to address coronary artery disease is the Chronic care model, which is the multifaceted, an
evidence based strategy to improve the care delivery by identifying the essential component of
an community’s health care system. The elements of this framework are community resources
and the policies, organizations, self-regulation support, delivery of the system design, supporting
in decision, and clinical information system. Community resources and policies includes
collaboration between the healthcare team, public and local health care providers, health care
organisation like government and non-government organisation can provide funds to support the
programs, self-management support can help the patient to learn about managing the disease.
The delivery system design includes making a team of healthcare professionals and supports the
patient to reduce the CAD problems. The decision support will help the patient in decision

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making about the treatment by assigning a clinician who is specialist in coronary artery disease.
The clinical information system is the computerized system which collects the information of the
patient, the information than can he used to assess the hisotry of the patient and use it in other
cases.

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