As long as the heart beats, as long as body and soul keep together

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As Jules Verne discusses the perseverance necessary to face great adversities in his famous novel Journey to the Center of the Earth, he echoes the mantra of many cardiologists, who must remain focused on how to keep their patients healthy, despite the multitude of complications.

An analysis in Health Affairs frames the extreme costs associated with treating the growing population of diabetics in the U.S., as well as burgeoning (almost uncontrollable) patient population. In fact, the authors estimated that by age 60, a reported one in five adults has diabetes and two in five have pre-diabetes.

While the authors noted that some diabetes disease management programs have reduced diabetes burden through preventing high-cost complications, the costs are still skyrocketing, as the costs associated with care for diabetes patients accounted for 7 percent of the $2.24 trillion healthcare expenditure in 2007.

These “sobering statistics” may underscore the urgency of better understanding the cost-mitigation potential of prevention and treatment strategies.

In a major success for preventive care, the FDA has approved a new indication for AstraZeneca’s cholesterol lowering drug Crestor to be used preventively in people with particular risk factors but no clinically evident heart disease.

However, one adversary to standardized care is regional differences. The CDC released a survey of nearly 450,000 adults from across the U.S., on such topics as the rates of diabetes, high-blood pressure, cardiovascular disease and cholesterol awareness, and found these factors significantly vary on a state-by-state basis.

For instance, West Virginia exhibited the highest number of those with coronary heart disease. Of the metropolitan/micorpolitan areas, the highest rate was conveyed in Homosassa Springs, Fla., at 13.5 percent and the lowest in Boulder, Colo., at 2.8 percent.

Much like those adventurers in Verne’s stories, a plethora of economical and practical challenges often confront administrators and physicians who are attempting to employ best practices. Yet, to end on such a negative note would not be suitable during this Valentine’s Day week, where the heart will garner much attention. The image of the heart will morph into various forms of delectable sweets and jewelry, to exemplify where people have always speculated that love originates. However, maybe Verne also can provide guidance into matters of love, and its intangibility: “He believed in it…by faith, not by reason.”

On these topics, or any others, please feel free to contact me.

Justine Cadet