Best Practice for Assessing Cardiovascular Disease Risk in Asymptomatic Women 35-54 Years

Cardiovascular disease is the leading cause of death for women in the United States, as well as

every major country. Unfortunately, disparities in cardiovascular health continue to be a

significant public health issue. Although the United States has demonstrated a general decline

in cardiovascular mortality over the past few decades, a number of population subgroups

including educational background, ethnicity, geography, race, sex and socioeconomic status

nevertheless demonstrate remarkable disparities in overall cardiovascular health (Mosca et al.,

2011). The purpose of this EBP project was to determine the effect of cardiovascular screening

after implementing and evaluating cardiovascular risk stratification and lifestyle modification.

The implementation of this best practice was compared to current practice for women who were

asymptomatic for coronary artery disease and between the ages of 35 and 54 years. The Stetler

Model and Pender’s Health Promotional Model facilitated the system change. The American

College of Cardiology/American Heart Association Atherosclerotic Cardiovascular (ACC/AHA

ASCVD) Risk Estimator score was calculated on a single cohort of women between the ages of

35 and 54 at a medical clinic for the underserved in Northwest Indiana. The 2013 ACC/AHA

Lifestyle Guideline was used to educate participants regarding therapeutic lifestyle changes.

Paired-sample t tests were run to analyze the means of pre-scale data compared to post-scale

data on each participant in the cohort (n = 34). Statistically significant differences were noted in

four different variables. Results were statistically and clinically significant in modifiable risk

factors including triglycerides (p = 0.043), weight (p = 0.006), and body mass index (p = 0.004).

Marginal significant difference from pre-ASCVD lifetime risk score to post-ASCVD lifetime risk

score (t(33) = 1.975, p = 0.05. In summary, this EBP project supported the best practice

recommendation for assessing cardiovascular risk utilizing the ACC/AHA ASCVD Risk Estimator.

This recommendation promotes primary and secondary prevention by identifying and targeting

patients at increased risk for cardiovascular disease and improving patient outcomes. In

conclusion, primary and secondary prevention must start as early as age 21 years in order to

make a dramatic impact on CV risk (Lopez-Jimenez et al., 2014). After actively engaging with

each patient in order to screen respective cardiovascular risk, the patient understands his or

her individual modifiable risk factors. As a result, healthcare providers can empower their

patient to adapt healthy lifestyles. As healthcare providers, engage the conversation, and

construct the change to make a difference toward a healthier population for 2020.

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