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Emerging Infectious Diseases Journal
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Volume 5: No. 2, April 2008

ESSAY
Modeling the Local Dynamics of Cardiovascular Health: Risk Factors, Context, and Capacity

The figure is a flowchart that begins with local actions; this element includes eating and activity options, smoking policies, socioeconomic conditions, environmental policies, health care options, support service options, and media and events. These local actions lead to local capacity for leadership and organizing, which further reinforces the local actions. The local actions element also leads to cardiovascular disease (CVD) risk factor prevalence and control; nutrition, physical activity, and stress; and utilization of services.

CVD risk factors include hypertension, high cholesterol, diabetes, obesity, smoking, secondhand smoke exposure, and air pollution exposure. The element of CVD risk factor prevalence and control leads to costs (CVD and non-CVD) attributable to risk factors and estimated first-time events, such as coronary heart disease (myocardial infarction, angina, cardiac arrest), stroke, and total cardiovascular disease (coronary heart disease, stroke, congestive heart failure, peripheral arterial disease). These events also contribute to the costs attributable to risk factors.

The element of nutrition, physical activity, and stress takes into account such factors as salt intake, bad fats intake, fruit/vegetable intake, net calorie intake, physical activity, and chronic stress. This element also affects CVD risk factor prevention and control. The element of utilization of services — including behavioral change, social support, mental health, and preventive health — affects nutrition, physical activity, and stress and CVD risk factor prevalence and control.

Figure. A policy framework for cardiovascular risk in context

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