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Every February 14th we celebrate Valentine's Day and express our love for the significant people in our lives. The symbol of Valentine's Day is, of course, the heart. So it seems appropriate to focus this issue of Home Healthcare Nurse on cardiovascular diseases.


Since 1963, February has been designated "American Heart Month." The American Heart Association works with the President of the United States and his administration each year to draft and sign the annual proclamation. All Americans are urged to learn more about heart health and how to reduce risk factors. While this issue is focused on the care of the patients that we serve, think also about caring for yourself. As nurses, we know that we should reduce modifiable risk factors by exercising regularly, not smoking, maintaining a healthy blood pressure, and eating "heart healthy," but do we actually practice what we instruct our patients to do? We know that we need regular medical care, including basic screening for blood pressure and lipid levels, but do we take the time in our busy lives to do it? Do yourself a favor and go to the American Heart Association (AHA) Web site ( and take a free, interactive quiz to learn about your risk for heart disease.


Cardiovascular diseases, including stroke, remain the number-one killer of all Americans and the number-one killer of American women (AHA, Understand your enemy: quick facts). The Agency for Healthcare and Research reports that cardiac-related conditions accounted for 4 of the 5 most common principal diagnoses for hospitalized elderly patients in 2004 (Nagamine et al., 2006). When we look at the clientele we serve in home care, approximately one third of Medicare home health patients have a circulatory system disease as the primary diagnosis for home health services (National Association for Home Care, 2004). When you consider secondary diagnoses, it is likely that a majority of home health patients have at least one cardiovascular disease.


In this issue, various aspects of cardiovascular care are addressed. The Hispanic population is the largest minority in the country, and high cholesterol, obesity, and hypertension are prevalent risk factors. Ann Marie Knoerl discusses Hispanic culture in the context of the patient with cardiac disease, recognizing that culturally sensitive care will improve the nurse-patient relationship and improve our ability to help patients self-manage their condition. There is growing evidence that providing more frequent visits and more care at the beginning of home care are effective in reducing risk of rehospitalization. Joanne Rogers and coauthors describe the impact of frontloading home visits, with a focus on patients with heart failure and diabetes. Collaboration between nursing and therapy to improve patient outcomes, including those with heart failure, is tackled by Barbara Samson and Lisa Anderson. Venous thromboembolism is a common yet preventable condition. While acute care organizations work to do a better job of implementing preventive interventions to reduce the occurrence of venous thromboembolism, in home care we must do a better job of identifying patients at risk and early signs or symptoms, because most patients will develop symptoms after hospitalization.


Happy Valentine's Day to all of you, and I hope you enjoy the content of this issue.


Lisa A. Gorski, MS, APRN, BC, CRNI, FAAN




American Heart Association. Learn and live quiz. Retrieved October 10, 2006 from


American Heart Association. Understand your enemy: quick facts. Retrieved January 3, 2007 from


Nagamine, M., Jiang, J., & Merrill, C. T. (2006). Trends in elderly hospitalizations, 1997-2004. Statistical Brief #14. Retrieved October 18, 2006 from[Context Link]


National Association for Home Care. (2004). Basic statistics about home care 2004. Retrieved October 10, 2006 from[Context Link]