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Cardiovascular Health In the Community

 Why Teen Take Heart?


bicyclesAdolescent Cardiovascular Health in Washington State

2012 Healthy Youth Survey

  • About 10 percent students in grades 8, 10, and 12 were obese and another 13-14 percent were overweight (Washington State Department of Health, 2013a)
  • In 2012, 58 percent of grade 6, 56 percent of grade 8, 51 percent of grade 10, and 47 percent of grade 12 students were physically active for at least 60 minutes per day 5 or more days a week (which is consistent with 2010 estimates) (Washington State Department of Health, 2013a)
  • Smoking is down at all grade levels and rates of smoking in youth have dropped by more than half since 2000 (the launch of the Tobacco Prevention and Control Program) (Washington State Department of Health, 2013b)
  • About 17 percent of American Indian/Alaska Native youth report smoking whereas only 9 percent of white or Caucasian youth report smoking (Washington State Department of Health, 2013b)


  • More than 300,000 people in Washington State have diagnosed diabetes, almost 127,000 are estimated have undiagnosed diabetes, and almost one million people have pre-diabetes
  • Age-adjusted percent of Washington State adults with diabetes has increased from 1994-2006 from 4% to 7% (Washington State Department of Health, 2007a)
  • American Diabetes Association

 Coronary Vascular Heart Disease

  • Coronary heart disease (CHD) is the second leading cause of death in Washington
  • Older adults, men, American Indians, Alaska Natives, Native Hawaiians, and other Pacific Islanders, and people in lower socioeconomic positions experience higher rates of CHD
  • Modifiable risk factors for CHD include: cholesterol, blood pressure, tobacco use, physical activity, obesity, and diabetes
  • Age-adjusted CHD death rates in Washington State have declined from 291 to 95 deaths per 100,000 between 1980 and 2011.(Washington State Department of Health, 2013c)
  • American Heart Association


  • In 2005, approximately 25% of Washington State adults reported eating fruits and vegetables five or more times each day
  • In 2003, nearly 10% of Washington adults reported concern about having enough food in the past month
  • Asian, Pacific Islanders, and whites were most likely to report eating fruits and vegetables five or more times daily, whereas people of Hispanic origin were least likely to
  • Academy of Nutrition and Dietetics

(Washington State Department of Health, 2007b)


American Heart Association. (2013). American Heart Association 2020 Impact Goal 2013 Statistical Fact Sheet: American Heart Association.Lloyd-Jones, D. M., Hong, Y., Labarthe, D., Mozaffarian, D., Appel, L. J., Van Horn, L., . . . Rosamond, W. D. (2010). http://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319831.pdf.

Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation, 121(4), 586-613. doi: 10.1161/circulationaha.109.192703. http://circ.ahajournals.org/content/121/4/586.abstract

Washington State Department of Health. (2007a). The Health of Washington State, 2007- Diabetes: Washington State Department of Health. http://www.doh.wa.gov/Portals/1/Documents/5500/CD-DIAB2014.pdf.

Washington State Department of Health. (2007b). The Health of Washington State, 2007- Nutrition: Washington State Department of Health.http://www.doh.wa.gov/Portals/1/Documents/5500/RPF-Nut2007.pdf

Washington State Department of Health. (2013a). 2012 Healthy Youth Survey Fact Sheet- Obesity and Risk factor Summary: Washington State Department of Health. http://www.doh.wa.gov/Portals/1/Documents/5500/RPF-Obs2013.pdf.

Washington State Department of Health. (2013b). 2012 Healthy Youth Survey Fact Sheet- Youth Cigarette Smoking: Washington State Department of Health. http://www.doh.wa.gov/Portals/1/Documents/5500/RPF-Tob2012.pdf

Washington State Department of Health. (2013c). The Health of Washington State- Coronary Heart Disease: Washington State Department of Health.http://www.doh.wa.gov/Portals/1/Documents/5500/CD-HRT2013.pdf. 




Guidelines for Improving Cardiovascular Health in the Community

School and Youth Education:

Goal: All schools should have a research-based comprehensive and age-appropriate culturally sensitive curricula about cardiovascular health and ways to improve healthy behaviors and reduce cardiovascular disease risks.

Goal: All schools should implement age-appropriate curricula on changing dietary, physical activity, and smoking behaviors.

Goal: All schools should provide teaching of early warning signs of MI and stroke and appropriate initial steps of emergency care.

•School curricula should include lessons about risk factors for CVD and stroke and the extent of heart disease and stroke in the community.

•Research-based curricula about effective methods of changing health behaviors should be implemented.

•Students should learn skills needed to achieve regular practice of healthful behaviors, and parents should learn how to support their children’s healthful behaviors.

•Specific curricular materials for healthy nutrition and physical activity should be offered.

•Quality physical education should be required daily in kindergarten through 12th grade, with an increasing emphasis on lifetime sports/activities. Implementation of research-based curricula is recommended.

•Meals and other foods provided at schools should provide healthy foods conducive to cardiovascular health, including competitive foods, vending machines, and the elimination of easy access to sugar-sweetened beverages.

•Students should know how to activate the emergency medical system.

•CPR instruction should be available to students at appropriate ages.

•Training in CPR should be a requirement for graduation from secondary schools.

  • Evidence suggests that community-level interventions can change community-wide health promotion behaviors.
  • Underserved populations have high rates of obesity, which is a significant risk-factor for coronary vascular disease and should be targeted for school-based programs.

How Can My Community Get Involved?

  • neighborhood or family walks
  • jump rope after school with your neighborhood friends
  • family bicycle ride
  • family blood pressure screenings (check with your local pharmacy)
  • Inquire about Teen Take Heart curriculum for your school
  • Identify organizations and institutions in the community that can provide services and resources in prevention and care of CVD and stroke.
  • Create opportunities for citizens of all ages to become involved in community activities for CVD and stroke prevention.
  • Educate community organizations about effective research-based materials and services and make these available.

AED indicates automatic external defibrillator; AHA, American Heart Association; CPR, cardiopulmonary resuscitation; CVD, cardiovascular disease; EPA, Environmental Protection Agency; MI, myocardial infarction; and TIA, transient ischemic attack

Pearson, T. A., Palaniappan, L. P., Artinian, N. T., Marnethon, M. R., Criqui, M. H., Daniels, S. R., …Turner, M. B. (2013). American heart Association Guide for Improving Cardiovascular   Health at the Community Level, 2013 Update: A Scientific Statement for Public Health     Practitioners, Healthcare Providers, and Health Policy Makers. Circulation,126:1733. http://www.mrc.umn.edu/prod/groups/med/@pub/@med/@mnrc/documents/content/med_content_441308.pdf.

Victor RG, Ravenell JE, Freeman A, Leonard D, Bhat DG, Shafiq M, Knowles P, Storm JS, Adhikari E, Bibbins-Domingo K, Coxson PG, Pletcher MJ,Hannan P, Haley RW. Effectiveness of a barber-based intervention for improving hypertension control in black men: the BARBER-1 study: a cluster randomized trial. Arch Intern Med. 2011;171:342–350.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365537/

Ingram M, Torres E, Redondo F, Bradford G, Wang C, O’Toole ML. The impact of promotoras on social support and glycemic control among members of a farmworker community on the US-Mexico border. Diabetes Educ.2007;33(suppl 6):172S–178S.http://www.ncbi.nlm.nih.gov/pubmed/17620398

Centers for Disease Control and Prevention. Racial and Ethnic Approaches to Community Health (REACH): REACHing across the divide: finding solutions to health disparities. 2007. http://stacks.cdc.gov/view/cdc/12108/.

Reinschmidt KM, Hunter JB, Fernández ML, Lacy-Martínez CR, Guernsey de Zapien J, Meister J. Understanding the success of promotoras in increasing chronic diseases screening. J Health Care Poor Underserved.2006;17:256–264. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469583/


 American Heart Association Recommended Guidelines

Metric Poor Intermediate Ideal Metric  Poor Intermediate Ideal
Blood Pressure >95th   percentile 90-95th   percentile or SBP >=120 mmHg or DBP >=80 mmHg <90th   percentile BMI >95th   percentile 85-95th   percentile <85th   percentile
Physical Activity none >0   and <60min of moderate or vigorous physical activity everyday >60   minutes of mod or vig physical activity daily Smoking status Tried   prior 30 days Never   tried; never smoked whole cigarette
Cholesterol >=200mg/dL 170-199mg/dL <170   mg/dL Fasting plasma glucose 126   mg/dL or more 100-125mg/dL Less   than 100 mg/dL
Healthy diet 0-1   components 2-3   components 4-5   components Definitions   of Poor, Intermediate, and Ideal Cardiovascular Health as defined by the   American Heart Association 2020 Goals. (Lloyd-Jones et al., 2010)