REACH®
Risk Evaluation in Action for Cardiovascular Health

Cardiovascular disease (CVD), heart disease and stroke, is the leading cause of death among adults in the United States. Almost one million Americans die from CVD, accounting for 39% of all deaths in the United States. For the majority of people, a heart attack, stroke or sudden cardiac death is the first sign of cardiovascular disease. People will benefit from strategies that identify and treat risk factors. These risk factors include the following:

• obesity
• diabetes
• increase waist circumference
• hypertension
• smoking
• high cholesterol
• other factors (age, gender, family history)

• history of cardiovascular disease
• congestive heart failure (CHF)
• stroke
• heart attack (myocardial infarction)
• circulation problems in legs (peripheral vascular disease)
• diabetes
• metabolic syndrome

Physicians are notified if their patients are at risk for cardiovascular disease and appropriate risk-reduction therapies, like lifestyle changes and medications, are included in the treatment plan while the patient is in the hospital. Patients do not have to be in the hospital for a cardiac problem to participate in this program. For example, an orthopedic patient can have any of the risk factors and benefit from a risk assessment that, if indicated, can trigger the risk reduction process.

It's especially important to identify people with diabetes and metabolic syndrome, because many are unaware that they are at risk for heart disease and so do not take preventive steps. Metabolic syndrome is diagnosed by a group of risk factors that include cholesterol levels, high blood pressure, waist circumference and high blood sugar. Individuals with metabolic syndrome are at increased risk for developing diabetes. People with diabetes or metabolic syndrome are at the same high-risk for a heart attack or stroke as someone who has already had an event.

During the discharge process from the hospital, a nurse completes a cardiovascular risk reduction assessment and discusses the summary with the patient. Cardiovascular disease educational materials and healthy living guidelines are also provided to the patient. To ensure that the patient's care is coordinated, each of their physicians receives a copy of the assessment, treatment guidelines and information about any new recommended medications. In this way, all members of a patient's treatment team, including the physicians and nurses, as well as the patient and family, are familiar with the risk reduction recommendations.

The REACH� program assist in identifying high-risk individuals and ensuring that risk reduction therapies (lifestyle changes and medications) are started in the hospital. Linking the inpatient plan with the outpatient setting provides physicians with additional information to enhance follow-up care.