Screening To Help Find Families At Risk Of Cardiovascular Disease

By Kaaren Valenta

When Laurel Halloran was asked to participate in the planning for the June 24 Heart Health Day at Edmond Town Hall in Newtown, she jumped at the opportunity.

An advanced practice registered nurse (APRN) with a doctorate in education, Dr Halloran knew the grim statistics for cardiovascular disease.

 “Fifty-eight million Americans – almost one-fourth of the nation – live with some form of cardiovascular disease,” she said. “It is the leading cause of disability in non-working adults. Cardiovascular disease cost the nation $287 billion in 1999 in health expense and lost productivity from illness and death.”

“About 960,000 Americans die of cardiovascular disease each year,” the Newtown resident added.

What many people do not realize is the risk they face if someone in their family, such as a parent or grandparent, had high blood pressure, a heart attack, or a stroke. Add diabetes, smoking, lack of exercise, or obesity, and the risks begin to multiply.

So when Dr Halloran learned that Dr Joseph Buchman, a retired cardiologist who had an office in Newtown, was planning to hold a repeat of the 1994 Heart Health Day at Edmond Town Hall, she wanted to help.

“It is very important for people to recognize that cardiovascular disease is the number one killer in the United States – it outstrips cancer,” she said. “People think it is a disease of old age, but it is not. It strikes people in middle age. It is a huge killer of women, especially after menopause. The morality is much worse for women, too.”

Dr Halloran said studies of cardiovascular disease have been done mostly on the male population. Women tend to get it later in life and don’t always have the same symptoms as men. They often don’t get the classic crushing pain in the chest, or pain radiating down the arm. They might get shortness of breath, fatigue, or nebulous symptoms, so they don’t seek treatment, she said.

And she believes that nurse practitioners could play a significant role in preventing heart disease.

“Nurse practitioners are educated with a focus toward prevention and patient education, which differentiates us from other health care providers,” she said. “They can now write prescriptions. Also we’ve been much more involved in the follow-up and treatment of people diagnosed with cardiovascular disease. We try to help patients reach the goals: lower blood pressure, lower cholesterol, stop smoking, increase exercise, and decrease obesity.”

As more studies of cardiovascular disease are done, the target for blood pressure, triglycerides, keeps dropping.

“It used to be that 140/90 was the target for blood pressure, but research showed the number needed to be reduced to maintain good health,” Dr Halloran said. “The goals now have been lowered to 135/85.”

“We need to really look at a person’s family history, especially if someone in the family had a heart attack before the age of 50. That’s a very bad template,” she said. “We are now looking at cholesterol levels even in children and trying to manage them at younger and younger ages. It is so important to know your family history.

“If individuals know their family history, if they know their mother or father had high cholesterol, we know to look for it earlier in them. When the patient comes in complaining of something else, we might want to screen them more carefully,” she explained.

Dr Halloran has been the coordinator of the nurse practitioner program at Western for the past year, but she has worked for the university for 14 years, teaching in both the undergraduate and master’s degree nursing programs. She graduated from the nurse practitioner program at Pace University five years ago. She holds a doctorate in education and psychology from the University of Connecticut and has lived in Newtown for 17 years. She lives with her husband, Bob Giacolone, who took early retirement from Duracell when it moved its local personnel to Massachusetts two years ago, and their sons, Chris, 15, and Steve, 13, who attend the Newtown schools.

Dr Halloran also works part-time as a nurse practitioner at Family Health Care in Newtown.

Over the years she has been involved in four different research studies on cardiovascular health.

“Cardiovascular disease is a huge problem,” she said. “Cardiovascular disease tends to impact the working adult population. If a person has a heart attack, they can be out of work four to six months. A stroke can take a year, or forever. The economic cost is horrific. As people are working longer now, it will extend the numbers even more.

“The Center for Disease Control in fiscal 2000 is committed to a big push against cardiovascular disease across the country. But Connecticut isn’t the worst state; we don’t die in as large numbers as other states, so it isn’t likely that we will get CDC grants,” she said.

Dr Halloran said Dr Buchman has applied for other grants to bring screenings like the one planned for Newtown on June 24 to other cities throughout the state. Through Roger Clark, a local resident who works for the pharmaceutical company Parke-Davis, Dr Buchman also was able to obtain an unrestricted grant to underwrite the cost of the Newtown program.

  Dr Halloran said the screening, which will be held in the gymnasium at Edmond Town Hall, will be “very painless and noninvasive.”

“Blood pressure readings take two and a half seconds,” she said. “We also will do a simple finger-stick to get a drop of blood and test it for the cholesterol level, HDL and LDL – good and bad cholesterol – and blood glucose for diabetes. That takes only takes four minutes. Then we will look at the family history. In 20 minutes we can see [the participant’s] risks and tell them what they can do to reduce them.

“It is meant to be very empowering to the individual,” she said. “These are things you can do. It may involve medications, or it may not. It might mean diet and lifestyle adjustments. Studies have shown that the loss of just five pounds of body mass will reduce blood pressure.

“The goal is not to have everyone look like Kate Moss but to be healthier. Individualize treatment and empower the person,” she said.

Dr Halloran said anyone who needs follow-up will be referred back to their family physician after the screening.

Nurses from Visiting Nurse Associations from all across the state have been invited to attend the health screening. During the morning they will observe, to see how the screening was organized and operated. In the afternoon they will attend an educational program. Then they will go back to their own facilities and set up screenings there. The intent is to have a ripple effect, to throw a stone in the water in Newtown and have the ripples go outwards across the state, Dr Halloran said.

“We hope to get people cycled into using community resources. Most people ‘fall off the wagon’ so there is a need to ‘control to goal,’ which is the name of our program,” she said. “I tell people to think ahead of what you want your health to be in 10 to 15 years, and change your lifestyle accordingly.”

Newtown, Monroe, and Southbury residents aged 35 to 65 with high blood pressure, or those with a family history of high blood pressure, stroke, or heart disease below age 65, are eligible to attend this free screening. Call 426-5524 for an appointment time.