Cardiovascular Diseases in Australian Women: Risks and Management
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This report provides a comprehensive analysis of cardiovascular diseases (CVD) in Australian women, highlighting its significant impact as a leading cause of mortality. It delves into the various social and behavioral determinants that increase the risk of CVD, including gender, family history, socioeconomic status, lack of physical activity, unhealthy diets, and stress. The report also examines the specific case of Jan, a client at risk of CVD, and outlines how motivational interviewing principles can be applied to encourage behavioral changes and reduce her risk. The discussion covers expressing empathy, developing discrepancies between behavior and goals, and providing personalized feedback to help women adopt healthier lifestyles and manage their risk factors effectively. The report emphasizes the need for tailored interventions to address the unique challenges faced by Australian women in preventing and managing CVD.
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Cardiovascular Diseases in Australian Women
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Cardiovascular Diseases in Australian Women
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CARDIOVASCULAR DISEASES IN AUSTRALIAN WOMEN
Introduction
Cardiovascular disease also referred to as heart disease is among the leading causes of
mortality in Australia. The National Heart Foundation indicates that heart disease leads to more
deaths in women as compared to their male counterparts. There are different risk factors that are
more particular for women in regard to heart disease. These include lack of physical exercise,
being post-menopausal, family stress for single mothers, excess intake of fatty food, and high
salt intake among others (Cho 2016). Social determinants that influence the risk of acquiring
heart disease include; coming from disadvantage areas and being indigenous Australian, having a
family history of the disease, and minimal social amenities within one’s residential areas for
exercising and finding immediate medical attention (Zeigler, 2016). Registered Nurses need to
use tailor-made motivational interviewing principles in order to help women take up
personalized approaches to reduce the risk of heart disease. The following discussion outline the
impacts of CVD on Australian women, the social and behavioral risk factors, and the principles
of motivational interviewing for Jan, a client who is at risk of acquiring heart disease.
Impact of CVD on Australian Women
CVD impacts negatively on Australian women. The first impact of CVD in Australian
women is that it leads as a cause of premature death. According to National Heart Foundation
about 45,392 deaths in Australia in the year 2015 was caused by heart disease (Kay et al, 2017).
This means that in each 12 minute, Australia records one death as a result of CVD. Therefore,
the year 2015 experienced 30% of deaths resulting from CVD in Australia. More specifically,
27% of male deaths and 30% of female deaths in the same year resulted from CVD (Kay et al,
2017). It is thus clear that Australian women are more likely to die from CVD than their male
counterparts. While Australian males suffer twice the number of heart attacks, their female
Introduction
Cardiovascular disease also referred to as heart disease is among the leading causes of
mortality in Australia. The National Heart Foundation indicates that heart disease leads to more
deaths in women as compared to their male counterparts. There are different risk factors that are
more particular for women in regard to heart disease. These include lack of physical exercise,
being post-menopausal, family stress for single mothers, excess intake of fatty food, and high
salt intake among others (Cho 2016). Social determinants that influence the risk of acquiring
heart disease include; coming from disadvantage areas and being indigenous Australian, having a
family history of the disease, and minimal social amenities within one’s residential areas for
exercising and finding immediate medical attention (Zeigler, 2016). Registered Nurses need to
use tailor-made motivational interviewing principles in order to help women take up
personalized approaches to reduce the risk of heart disease. The following discussion outline the
impacts of CVD on Australian women, the social and behavioral risk factors, and the principles
of motivational interviewing for Jan, a client who is at risk of acquiring heart disease.
Impact of CVD on Australian Women
CVD impacts negatively on Australian women. The first impact of CVD in Australian
women is that it leads as a cause of premature death. According to National Heart Foundation
about 45,392 deaths in Australia in the year 2015 was caused by heart disease (Kay et al, 2017).
This means that in each 12 minute, Australia records one death as a result of CVD. Therefore,
the year 2015 experienced 30% of deaths resulting from CVD in Australia. More specifically,
27% of male deaths and 30% of female deaths in the same year resulted from CVD (Kay et al,
2017). It is thus clear that Australian women are more likely to die from CVD than their male
counterparts. While Australian males suffer twice the number of heart attacks, their female
CARDIOVASCULAR DISEASES IN AUSTRALIAN WOMEN
counterparts are a higher chance of dying from them. More women also die from stroke as
compared to men.
Secondly, CVD being a major cause of death in Australia, it is costly in terms of
treatment. The National Health Foundation indicates that CVD accounts for about 18% of
Australia’s total burden of disease. Recent research also indicates that the condition is the most
expensive group of diseases to treat in Australia. Between 2008 and 2009, the CVD cost an
approximate $7.47 billion to treat where more than half of this went to paying for patients who
were admitted in hospital (Kay et al, 2017). It is thus expensive especially for poor indigenous
communities in rural Australia.
CVD as an illness has social implications including long hospital stays and hospital
separations. Between 2014 and 2015, CVD contributed to 490,000 hospitalizations in Australia.
More than half of these included women (Kay et al, 2017). The long stays in hospitals and the
separations from families for hospitalization negatively impact on families both emotionally and
psychologically. The National Heart Foundation indicates that there was an increase of hospital
separations from 2004 to 2015 by 8% (Kay et al, 2017). Understanding the role of women in
homes especially among indigenous Australians who live in families, it is clear that their families
suffer emotionally while bearing the burden of responsibilities.
Social Determinants Increasing risk of CVD
Different social determinants influence the risk of CVD among women in Australia. One
of these include gender as indicated above that women are at a higher risk of developing and
even dying from CVD as compared to men in Australia. This is because there are higher chances
of a woman at post-menopausal age to develop CVD due to deteriorated levels of estrogen
production (Kay et al, 2017). Further, women like Jan, are more likely to be obese due to
counterparts are a higher chance of dying from them. More women also die from stroke as
compared to men.
Secondly, CVD being a major cause of death in Australia, it is costly in terms of
treatment. The National Health Foundation indicates that CVD accounts for about 18% of
Australia’s total burden of disease. Recent research also indicates that the condition is the most
expensive group of diseases to treat in Australia. Between 2008 and 2009, the CVD cost an
approximate $7.47 billion to treat where more than half of this went to paying for patients who
were admitted in hospital (Kay et al, 2017). It is thus expensive especially for poor indigenous
communities in rural Australia.
CVD as an illness has social implications including long hospital stays and hospital
separations. Between 2014 and 2015, CVD contributed to 490,000 hospitalizations in Australia.
More than half of these included women (Kay et al, 2017). The long stays in hospitals and the
separations from families for hospitalization negatively impact on families both emotionally and
psychologically. The National Heart Foundation indicates that there was an increase of hospital
separations from 2004 to 2015 by 8% (Kay et al, 2017). Understanding the role of women in
homes especially among indigenous Australians who live in families, it is clear that their families
suffer emotionally while bearing the burden of responsibilities.
Social Determinants Increasing risk of CVD
Different social determinants influence the risk of CVD among women in Australia. One
of these include gender as indicated above that women are at a higher risk of developing and
even dying from CVD as compared to men in Australia. This is because there are higher chances
of a woman at post-menopausal age to develop CVD due to deteriorated levels of estrogen
production (Kay et al, 2017). Further, women like Jan, are more likely to be obese due to
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CARDIOVASCULAR DISEASES IN AUSTRALIAN WOMEN
inadequate physical exercise as compared to men and this increases their risk to CVD. This is the
reason why while twice the number of men gets heart attacks; more women actually die from it
than men.
Secondly according to Vaccarino & Bremner (2017), having a family history of CVD as
is the case for Jan puts one at risk of developing CVD. Studies indicate that parents who have
heart disease are most likely to have children with the condition. Even so, the older one gets, the
higher the risk of the condition (Zeigler, 2016). Therefore Jan having had a mother with CVD,
she is most likely going to develop the disease if she does not reduce the risk factors.
Another social risk factor is poverty and a lack of access to proper health care. According to
the National Heart Foundation, women who come from the most disadvantaged regions of
Australia have 29% death rates due to CVD, above other women who come from least
disadvantaged regions (Vissers et al, 2016). Women from rural areas are exposed to more risk
factors as they have no facilities to exercise, carry out regular health check-ups and participate in
their own healthcare. This is the case for Jan, who is in rural Queensland with limited access to
counseling and/or facilities for exercise as could be the case for those in urban areas (Vissers et
al, 2016). Further, women who are Aboriginal and/or Torres Strait Islanders are at a higher risk
of CVD than their non-indigenous counterparts. They are also more likely to have higher
diabetes and obesity rates. Jan is thus at a higher risk of acquiring CVD, as she comes from the
rural areas where healthcare services are poorer as compared to those in urban areas.
Behavioral Determinants Increasing risk of CVD
There are several behavioral risk factors that Jan in the case study faces, which can make
her develop cardiovascular diseases. Unhealthy diet is one of the major behavioral factors
contributing to development of cardiovascular diseases (Alley et al, 2017). Diets which are
inadequate physical exercise as compared to men and this increases their risk to CVD. This is the
reason why while twice the number of men gets heart attacks; more women actually die from it
than men.
Secondly according to Vaccarino & Bremner (2017), having a family history of CVD as
is the case for Jan puts one at risk of developing CVD. Studies indicate that parents who have
heart disease are most likely to have children with the condition. Even so, the older one gets, the
higher the risk of the condition (Zeigler, 2016). Therefore Jan having had a mother with CVD,
she is most likely going to develop the disease if she does not reduce the risk factors.
Another social risk factor is poverty and a lack of access to proper health care. According to
the National Heart Foundation, women who come from the most disadvantaged regions of
Australia have 29% death rates due to CVD, above other women who come from least
disadvantaged regions (Vissers et al, 2016). Women from rural areas are exposed to more risk
factors as they have no facilities to exercise, carry out regular health check-ups and participate in
their own healthcare. This is the case for Jan, who is in rural Queensland with limited access to
counseling and/or facilities for exercise as could be the case for those in urban areas (Vissers et
al, 2016). Further, women who are Aboriginal and/or Torres Strait Islanders are at a higher risk
of CVD than their non-indigenous counterparts. They are also more likely to have higher
diabetes and obesity rates. Jan is thus at a higher risk of acquiring CVD, as she comes from the
rural areas where healthcare services are poorer as compared to those in urban areas.
Behavioral Determinants Increasing risk of CVD
There are several behavioral risk factors that Jan in the case study faces, which can make
her develop cardiovascular diseases. Unhealthy diet is one of the major behavioral factors
contributing to development of cardiovascular diseases (Alley et al, 2017). Diets which are
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CARDIOVASCULAR DISEASES IN AUSTRALIAN WOMEN
highly saturated with cholesterol, fats and trans-facts bring about heart disease including related
conditions like atherosclerosis. Studies also indicate that foods with too much salt lead to
hypertension. From the case study, it is clear that Jan is likely to develop cardiovascular diseases
due to her consumption of food with excess salt. High sugar intake is risky as it leads to obesity
and high insulin levels. This leads to insulin resistance, a precedence of diabetes and eventually
CVD (Chockalingam et al, 2016). Jan drinks 4 to 5 full-sugar Cola drink daily and this puts her
at risk of CVD in the long-term.
Lack of physical exercise also puts one at the risk of CVD. This is because it increases
the likelihood of obesity, hypertension and diabetes, which are major contributors to CVD
causation (Wise, 2014). From the case study, Jan has opted to avoid walking exercises and
considering that she likes cooking and eating, she is likely to be obese in the short-run.
Inadequate exercise means that excess fats and cholesterol are not broken down and can end up
blocking arteries including coronary arteries to cause heart attacks.
Stress as a behavioral aspect also contributes to the development of heart disease. From
the case study, Jan is stressed as she is currently unemployed single mother who separated with
her husband recently. She is apparently worried about how she will manage to care for her 13
and 15-year old children single-handedly. Stress puts one at a higher risk of getting strokes
and/or heart attacks (Bartrop, 2017). Anxiety and depression that comes with stressful events are
major behavioral risk factors as well.
Motivational Interviewing Principles
The first principle I will use, is expressing empathy while avoiding arguments with the
client (Miller, 2015). In order to discuss about exercising for instance, I will tell Jan “I honestly
understand that it must been hard for you being a mother to exercise so as to maintain a healthy
highly saturated with cholesterol, fats and trans-facts bring about heart disease including related
conditions like atherosclerosis. Studies also indicate that foods with too much salt lead to
hypertension. From the case study, it is clear that Jan is likely to develop cardiovascular diseases
due to her consumption of food with excess salt. High sugar intake is risky as it leads to obesity
and high insulin levels. This leads to insulin resistance, a precedence of diabetes and eventually
CVD (Chockalingam et al, 2016). Jan drinks 4 to 5 full-sugar Cola drink daily and this puts her
at risk of CVD in the long-term.
Lack of physical exercise also puts one at the risk of CVD. This is because it increases
the likelihood of obesity, hypertension and diabetes, which are major contributors to CVD
causation (Wise, 2014). From the case study, Jan has opted to avoid walking exercises and
considering that she likes cooking and eating, she is likely to be obese in the short-run.
Inadequate exercise means that excess fats and cholesterol are not broken down and can end up
blocking arteries including coronary arteries to cause heart attacks.
Stress as a behavioral aspect also contributes to the development of heart disease. From
the case study, Jan is stressed as she is currently unemployed single mother who separated with
her husband recently. She is apparently worried about how she will manage to care for her 13
and 15-year old children single-handedly. Stress puts one at a higher risk of getting strokes
and/or heart attacks (Bartrop, 2017). Anxiety and depression that comes with stressful events are
major behavioral risk factors as well.
Motivational Interviewing Principles
The first principle I will use, is expressing empathy while avoiding arguments with the
client (Miller, 2015). In order to discuss about exercising for instance, I will tell Jan “I honestly
understand that it must been hard for you being a mother to exercise so as to maintain a healthy
CARDIOVASCULAR DISEASES IN AUSTRALIAN WOMEN
in the recent past. A lot of my patients have also reported of this difficulty. Even so, I think it
remains imperative for us to attempt to find how you can work on this. Jan, what do you think
can make you eat less but exercise more?” From this discussion, the patient will understand that
as the nurse I am empathetic but at the same time she will give out direct answers without
arguments.
Secondly, development of discrepancies where nurse and/or physician helps a patient to
understand the variation between their behavior and their goals is paramount (Schumacher,
2013). This will enable the patient to strive to take part in their own care. In this case for
instance, I would tell Jan "You just informed me that you want to feel better, reduce the risk of
CVD having a family history of the same, and reduce the potential amount you might use for
CVD medication. I believe you understand that exercising, avoiding depression, maintaining
proper diet and losing weight would be of good help in preventing CVD. Jan, what are the
reasons you think make it hard to find sufficient time for yourself to exercise and practice these
healthy behavior?” The patient can then compare her health goals and the direction she wants to
take in preventing CVD in future.
Further, there is need for a nurse and/or physician to approach the patient with resistance
and then provide a feedback that is personalized (Schumacher, 2013). When the patient
expresses the reasons as to why they cannot achieve their goals, it is important a nurse and/or
physician to assist them find successful ways. For instance I will tell Jan "I am aware that you
are tired from taking your routine walking exercise, is it possible for you to create time to resume
this?” This will help the patient consider revisiting and working on her health goals.
Summary and Conclusion
in the recent past. A lot of my patients have also reported of this difficulty. Even so, I think it
remains imperative for us to attempt to find how you can work on this. Jan, what do you think
can make you eat less but exercise more?” From this discussion, the patient will understand that
as the nurse I am empathetic but at the same time she will give out direct answers without
arguments.
Secondly, development of discrepancies where nurse and/or physician helps a patient to
understand the variation between their behavior and their goals is paramount (Schumacher,
2013). This will enable the patient to strive to take part in their own care. In this case for
instance, I would tell Jan "You just informed me that you want to feel better, reduce the risk of
CVD having a family history of the same, and reduce the potential amount you might use for
CVD medication. I believe you understand that exercising, avoiding depression, maintaining
proper diet and losing weight would be of good help in preventing CVD. Jan, what are the
reasons you think make it hard to find sufficient time for yourself to exercise and practice these
healthy behavior?” The patient can then compare her health goals and the direction she wants to
take in preventing CVD in future.
Further, there is need for a nurse and/or physician to approach the patient with resistance
and then provide a feedback that is personalized (Schumacher, 2013). When the patient
expresses the reasons as to why they cannot achieve their goals, it is important a nurse and/or
physician to assist them find successful ways. For instance I will tell Jan "I am aware that you
are tired from taking your routine walking exercise, is it possible for you to create time to resume
this?” This will help the patient consider revisiting and working on her health goals.
Summary and Conclusion
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CVD stands as the major cause of mortality in most industrialized countries including
Australia. Even so, it contributes to more deaths in women than in men in Australia. The above
discussion outlines the impacts of CVD on Australian women including death, high cost of the
disease burden, hospitalization and emotional problems to families. The discussion also
highlights the social and behavioral determinants of CVD including gender, family history of
disease, social amenities, physical exercise, and dieting, high stress levels among others.
Further, the discussion provides different motivational interviewing principles that are
appropriate for handling Jan the patient in the case study. These principles include the need to;
be empathetic but minimize arguments with the patient, create discrepancies between the
patients’ health goals and their current behavior and further; approaching the patient with
resistance yet providing them with feedback that is tailor-made for them.
CVD stands as the major cause of mortality in most industrialized countries including
Australia. Even so, it contributes to more deaths in women than in men in Australia. The above
discussion outlines the impacts of CVD on Australian women including death, high cost of the
disease burden, hospitalization and emotional problems to families. The discussion also
highlights the social and behavioral determinants of CVD including gender, family history of
disease, social amenities, physical exercise, and dieting, high stress levels among others.
Further, the discussion provides different motivational interviewing principles that are
appropriate for handling Jan the patient in the case study. These principles include the need to;
be empathetic but minimize arguments with the patient, create discrepancies between the
patients’ health goals and their current behavior and further; approaching the patient with
resistance yet providing them with feedback that is tailor-made for them.
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CARDIOVASCULAR DISEASES IN AUSTRALIAN WOMEN
References
Alley, S., Duncan, M., Schoeppe, S., Rebar, A., & Vandelanotte, C. (2017). 8-year trends in
physical activity, nutrition, TV viewing time, smoking, alcohol and BMI: A comparison of
younger and older Queensland adults. PLOS ONE, 12(3), e0172510.
http://dx.doi.org/10.1371/journal.pone.0172510
Bartrop, R. (2017). Cardiovascular risk following widowhood. Coronary Artery Disease, 28(2),
93-94. http://dx.doi.org/10.1097/mca.0000000000000446
Cho, K. (2016). Women, Stress and Heart Health: Mindfulness-Based Stress Reduction and
Cardiovascular Disease. Kosin Medical Journal, 31(2), 103.
http://dx.doi.org/10.7180/kmj.2016.31.2.103
Chockalingam, P., Vinayagam, N., Vani, N., & Chockalingam, V. (2016). PM084 Modifying
Behavioral Risk Factors: A Key Component in Coronary Heart Disease Prevention. Global
Heart, 11(2), e84. http://dx.doi.org/10.1016/j.gheart.2016.03.290
Kay, S., Scalia, G., Seco, M., Vallely, M., Celermajer, D., & on behalf of the Board of Structural
Heart Disease Australia. (2017). Structural Heart Disease Australia (SHDA). Heart, Lung
And Circulation. http://dx.doi.org/10.1016/j.hlc.2017.04.003
Miller, W. (2015). Celebrating Carl Rogers: Motivational Interviewing and the Person-Centered
Approach. Motivational Interviewing: Training, Research, Implementation, Practice, 1(3),
4-6. http://dx.doi.org/10.5195/mitrip.2014.54
Mitchell, J., Donovan, R., & Straveski, B. (2014). PM350 New directions to address heart
disease in Australian women. Global Heart, 9(1), e133.
http://dx.doi.org/10.1016/j.gheart.2014.03.1701
References
Alley, S., Duncan, M., Schoeppe, S., Rebar, A., & Vandelanotte, C. (2017). 8-year trends in
physical activity, nutrition, TV viewing time, smoking, alcohol and BMI: A comparison of
younger and older Queensland adults. PLOS ONE, 12(3), e0172510.
http://dx.doi.org/10.1371/journal.pone.0172510
Bartrop, R. (2017). Cardiovascular risk following widowhood. Coronary Artery Disease, 28(2),
93-94. http://dx.doi.org/10.1097/mca.0000000000000446
Cho, K. (2016). Women, Stress and Heart Health: Mindfulness-Based Stress Reduction and
Cardiovascular Disease. Kosin Medical Journal, 31(2), 103.
http://dx.doi.org/10.7180/kmj.2016.31.2.103
Chockalingam, P., Vinayagam, N., Vani, N., & Chockalingam, V. (2016). PM084 Modifying
Behavioral Risk Factors: A Key Component in Coronary Heart Disease Prevention. Global
Heart, 11(2), e84. http://dx.doi.org/10.1016/j.gheart.2016.03.290
Kay, S., Scalia, G., Seco, M., Vallely, M., Celermajer, D., & on behalf of the Board of Structural
Heart Disease Australia. (2017). Structural Heart Disease Australia (SHDA). Heart, Lung
And Circulation. http://dx.doi.org/10.1016/j.hlc.2017.04.003
Miller, W. (2015). Celebrating Carl Rogers: Motivational Interviewing and the Person-Centered
Approach. Motivational Interviewing: Training, Research, Implementation, Practice, 1(3),
4-6. http://dx.doi.org/10.5195/mitrip.2014.54
Mitchell, J., Donovan, R., & Straveski, B. (2014). PM350 New directions to address heart
disease in Australian women. Global Heart, 9(1), e133.
http://dx.doi.org/10.1016/j.gheart.2014.03.1701
CARDIOVASCULAR DISEASES IN AUSTRALIAN WOMEN
Schumacher, J. (2013). Motivational Interviewing Step By Step. Motivational Interviewing:
Training, Research, Implementation, Practice, 1(2), 24-25.
http://dx.doi.org/10.5195/mitrip.2013.37
Vaccarino, V., & Bremner, J. (2017). Behavioral, emotional and neurobiological determinants of
coronary heart disease risk in women. Neuroscience & Biobehavioral Reviews, 74, 297-309.
http://dx.doi.org/10.1016/j.neubiorev.2016.04.023
Vissers, L., Waller, M., van der Schouw, Y., Hebert, J., Shivappa, N., Schoenaker, D., & Mishra,
G. (2016). The relationship between the dietary inflammatory index and risk of total
cardiovascular disease, ischemic heart disease and cerebrovascular disease: Findings from
an Australian population-based prospective cohort study of women. Atherosclerosis, 253,
164-170. http://dx.doi.org/10.1016/j.atherosclerosis.2016.07.929
Wise, J. (2014). Lack of exercise outweighs obesity among heart disease risk factors, says
Australian study. BMJ, 348(may08 7), g3182-g3182. http://dx.doi.org/10.1136/bmj.g3182
Zeigler, V. (2016). Women’s Heart Health: Differences in Heart Disease in Women Compared to
Heart Disease in Men. International Journal Of Women's Health And Reproduction
Sciences, 4(3), 87-88. http://dx.doi.org/10.15296/ijwhr.2016.22
Schumacher, J. (2013). Motivational Interviewing Step By Step. Motivational Interviewing:
Training, Research, Implementation, Practice, 1(2), 24-25.
http://dx.doi.org/10.5195/mitrip.2013.37
Vaccarino, V., & Bremner, J. (2017). Behavioral, emotional and neurobiological determinants of
coronary heart disease risk in women. Neuroscience & Biobehavioral Reviews, 74, 297-309.
http://dx.doi.org/10.1016/j.neubiorev.2016.04.023
Vissers, L., Waller, M., van der Schouw, Y., Hebert, J., Shivappa, N., Schoenaker, D., & Mishra,
G. (2016). The relationship between the dietary inflammatory index and risk of total
cardiovascular disease, ischemic heart disease and cerebrovascular disease: Findings from
an Australian population-based prospective cohort study of women. Atherosclerosis, 253,
164-170. http://dx.doi.org/10.1016/j.atherosclerosis.2016.07.929
Wise, J. (2014). Lack of exercise outweighs obesity among heart disease risk factors, says
Australian study. BMJ, 348(may08 7), g3182-g3182. http://dx.doi.org/10.1136/bmj.g3182
Zeigler, V. (2016). Women’s Heart Health: Differences in Heart Disease in Women Compared to
Heart Disease in Men. International Journal Of Women's Health And Reproduction
Sciences, 4(3), 87-88. http://dx.doi.org/10.15296/ijwhr.2016.22
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