Improving Cardiac Outcomes and Decreasing Health Care Costs Kristin E. Smith, DNP, RN, FNP-C
n A bstract Objective: Although the norm in the United States is to prescribe multiple pharmaceutical agents for patients with coronary heart disease (CHD), this article will propose that health care providers should discuss with all patients the benefits of following a plant-based diet as an alternative or supplementary approach. Research has shown plant-based diets will prevent CHD through mitigation of risk factors as well as reverse stenosis and improve flow-mediated dilatation. Methods: An extensive literature search was completed using Cochrane, CINAHL, and PubMed. Results: Twenty-five articles were chosen for review, including three randomized controlled trials. Studies that were greater than five years old were kept when considered classics in the field of plant-based medicine. Conclusion: Research consistently demonstrates that dietary changes have a greater benefit than pharmaceutical interventions, thus resulting in dramatically lower costs; discussing the plant-based solution with patients should become one of the gold standards of care.
Purpose of Study
Background and Significance
The purpose of this article is to bring several decades’ worth of high-quality research that highlights an alternative approach to the prevention and reversal of coronary heart disease to the attention of the primary-care provider. This alternative approach involves intensive lifestyle changes, including the adoption of a whole-foods, plant-based diet. The argument proposed is that not only is this diet evidencebased in its success, but it also is well accepted and adhered to by patients, improves quality of life, and is a more cost-effective approach to managing heart disease and its risk factors. Furthermore, this diet has the benefit of protecting against and/or reversing several other diseases including cancer and diabetes.
According to the Centers for Disease Control and Prevention (CDC), coronary heart disease (CHD) takes the life of 600,000 individuals each year in the United States and is responsible for health care expenditures of $108.9 billion each year. Direct and indirect costs in 2008 for both heart disease and stroke were nearly $300 billion and were reported by the American Heart Association to be greater than any other diagnostic group (CDC, 2012). Put another way, 2,200 Americans die each day from this disease and approximately 150,000 of those annual deaths occur before the age of 65 (Roger et al., 2012). There are both geographic and ethnic variances, with certain populations disproportionately affected by CHD. Heart-disease-related deaths in 2008 were 25% of the overall total;
Dr. Kristin E. Smith is a Nurse Practitioner at Trillium Health, Rochester, NY. 32
Journal of the New York State Nurses Association, Volume 44, Number 2
