Wednesday, June 20, 2012

Helping Vets with Coronary Issues

The Veterans Administration is working with the University of Iowa on a pilot program to survey patients as to their behaviors related to the management of heart disease and how the veterans should make healthy lifestyle changes.

Coronary Heart Disease (CHD) is a significant health threat among veterans. Compared to their civilian counterparts, veterans experience greater disability, reinfarction, and mortality following Myocardial Infarction (MI) and other Acute Coronary Syndromes (ACS). High rates of hypertension, diabetes, cardiac risk behaviors, and low socioeconomic status further increase veterans’ CHD-related morbidity and mortality.

The Veterans Administration’s proposed pilot study will look at whether it is feasible to provide nursing intervention to help veterans with CHD who are recovering from MI/ACS. The objective is to change veterans and their ideas on how to self-manage heart disease and how to facilitate health behavior changes.

The study will work with two groups of veterans with an estimated enrollment of 50 that have been admitted to an inpatient medicine unit for MI, ACS, and coronary angiography. One group will receive the usual care but the other group will have their treatment tailored to their risk factors. They will be contacted by phone at two weeks after their hospital discharge. The intervention will be administered by a trained research assistant working with each veteran. Each call will last about 15-to 30 minutes. For more information, email Cassie L. Cunningham at or go to

The VA is conducting another pilot intervention to improve blood pressure and cholesterol control among veterans with CAD. If patients with CAD would control their blood pressure and cholesterol, then heart attacks would be reduced and there would be fewer deaths.

A number of factors hinder veterans’ ability to control their behavior. These factors include patients that have difficulty adhering to medications, physician reluctance to increase medication doses to effective levels, and a lack of clinical programs specifically charged with controlling blood pressure and cholesterol.

The VA’s HSR&D study to be completed by June 2016 will take place at the VA Eastern Colorado Health Care System located in Denver. The researchers are examining the number of VA patients that have CAD with uncontrolled blood pressure and high cholesterol with information available to them via electronic patient data. The VA will assess the patient, physician, and program factors that affect the control, and then design a program to improve the factors that are creating health issues.