The Crisis of Heart Disease and Failure in West Texas

• By School of Health Professions
• May 17, 2024
• Health

According to the CDC, heart disease is the leading cause of death for men, women and people of most racial and ethnic groups in the United States.

A CDC map shows the concentrations of counties with the highest heart disease death rates –the top 20% are located primarily in Mississippi, Louisiana, Arkansas, Oklahoma, Texas, Kentucky, Tennessee, Indiana, Illinois and Wisconsin.

This CDC map is interactive and will show any county’s data in the US for heart disease and strokes.  If you select the vertical column on the left-hand side of the screen, you can see that many of the counties of West Texas are in the top 40% or even top 20% for death rates from heart disease per 100,000 persons.  For heart failure, it is even more concerning: much of West Texas ranks in the top 20% for deaths from heart failure per 100,000 persons.

Texas, and West Texas specifically, is facing what TTUHSC Assistant Professor in the Doctor of Physical Therapy program Josh TenBensel, DPT, would classify as a “crisis” of heart disease and heart failure.

“I don’t know that West Texans are aware of where they stand related to heart disease, heart failure and its prevalence.” TenBensel says.

TenBensel teaches TTUHSC students across three campuses – Lubbock, Amarillo and Odessa. His primary focus is cardiopulmonary physical therapy and rehabilitation. He shares with us some fascinating, yet alarming statistics on heart disease across the nation, its growing prevalence in the West Texas area, and what West Texans can and should be doing to take charge of their cardiovascular health.

The CDC Breakdown

Heart Disease Death Rate (Age-Standardized Deaths per 100,000 persons, All Races/Ethnicities, Genders, Ages 35+, 2018-2020): 

• Ector County: 422  (ranks 80-100%)
• Midland County: 317.5  (ranks 20-40%)
• Lubbock County: 411.9  (ranks 60-80%)
• Potter County: 550  (ranks 80-100%)

Heart disease death rate quintiles:

• 9 - 282 (644)  0-20%
• 282 - 323 (644) 20-40%
• 323 - 364 (644) 40-60%
• 364 - 422 (645)  60-80%
• 422 - 821 (643)   80-100%

Heart Failure Death Rates

(Age-Standardized Deaths per 100,000 persons, All Races/Ethnicities, Genders, Ages 35+, 2018-2020):

• Ector County: 316.6  (ranks 80-100%)
• Midland County: 193.8  (ranks 20-40%)
• Lubbock County:  296.1  (ranks 80-100%)
• Potter County:  340  (ranks 80-100%)

Heart failure death rate quintiles:  

• 6 - 179 (645) 0-20%
• 179 - 206 (645) 20-40%
• 206 - 229 (643) 40-60%
• 229 - 259 (643) 60-80%
• 259 - 563 (644) 80-100%

TenBensel explains that ranking in the lowest 20% is a good thing, meaning you have low amounts of disease. However, ranking in the 80-100% quintile indicates you’re in the top 20% of highest death rates in the United States per population. 

Potential Causes for This Crisis

TenBensel says the causes are multifactorial. While it is difficult to pinpoint any specific cause, there are common, modifiable and non-modifiable risk factors of cardiovascular disease (CVD).  These include:

• Behavioral and lifestyle factors 
• Physical inactivity
• Obesity (BMI >30 kg/m2; abdominal obesity: men >40 inches, women >35 inches)
• Smoking (including 2nd hand smoke)
• Hypertension (high blood pressure)
• Elevated serum cholesterol (total cholesterol > 200 mg/dL; LDL > 130 mg/dL) 
• Decreased HDL cholesterol (HDL <40 mg/dL for males <50 mg/dL for females) 
• Diabetes 
• Metabolic syndrome: this is a cluster of risk factors found in 1/3rd  of Americans that causes increased risk for CVD, type II diabetes, kidney disease, and hepatic disease 
• Stress (includes job and/or socioeconomic status)
• Investigative (sleep and inflammation)
• Advancing age
• Family history of CVD, genetics and race & ethnicity  

However, there are also some social determinants of health (SDOH), or non-medical factors, that influence health outcomes. Healthy People 2030 sets data-driven national objectives in five key areas of SDOH:

• Health care access and quality
• Education access and quality
• Social and community context
• Economic stability
• Neighborhood built environment

A concerning related statistic:  Texas has the highest percentage of uninsured citizens across the country, at 24.2%.

What can West Texans do?

TenBensel believes the hard working people of West Texas deserve great health care. “These are the people that create the food, the fiber and the fuel for a good part of the United States,” he says. “We have a good economic basis, but we can improve our health care and education and access to that health care.”

He notes that while change is hard, little things over time can really improve outcomes. Here is a quick breakdown of preventative measures West Texans can take for their cardiovascular health:

 

 

 

• Diet and exercise
• Be proactive and seek care (partner with a primary care physician)
• Educate yourself on the disease process and risk factors that underpin heart disease and heart failure
• Maintain a healthy weight
• Take medications (if accessible)
• Don’t smoke 
• Monitor and control high blood pressure 
• Know numbers of your lipid profile and triglycerides 
• Exercise and participate in cardiac rehab or physical therapy as indicated

For patients that are experiencing heart failure, TenBensel shares that Medicare, Medicaid and other health insurances are supporting attending cardiac rehab, but that many cardiac patients think of this treatment as just exercise. In reality, there is an entire team of individuals that analyze and make a plan of action for things like exercise, behavioral and lifestyle counseling, assessment of risk factors, and aggressive interventions for prevention.

TenBensel encourages West Texans to work on changing what they can control by striving for a healthier lifestyle by working to implement ideas from the list above. Working together, we can turn the tide in this crisis.