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Governor Dalrymple Proclaims Heart and Stroke Day in North Dakota

Governor Dalrymple met with AHA volunteers, survivors and staff on Monday, February 9th and proclaimed it Heart and Stroke Day in North Dakota.  Heart and Stroke Day is an opportunity to raise awareness about cardiovascular disease and stroke, and to bring attention to opportunities to improve health and well-being through legislative policy.  During his remarks, Governor Dalrymple reminder legislators and other visitors to the Capitol that while we have made significant strides in improving outcomes for heart disease, it is still our state's number one killer of adults. The Governor also noted that stroke is the leading preventable cause of disability and eighty percent of cardiac events can be prevented with a healthy lifestyle. 

We are proud of the work that has already been done to improve cardiac and stroke care in North Dakota. The Governor noted that North Dakota has championed improved emergency response and newborn screenings for congenital heart defects and has set a standard for other states to follow on strong stroke and cardiac systems of care. 

The Governor concluded his remarks urging all citizens to recognize that living healthier leads to longer, fuller and more active lives with less disease care in the later years and to call 9-1-1 at the first signs of heart attack or stroke symptoms. 


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Advocates Raise Their Voices on Heart and Stroke Issues

The legislative session is well underway in Bismarck.  AHA advocates from across North Dakota recently traveled from all corners of the state to participate in Heart and Stroke Day at the Capitol to raise awareness for heart disease and stroke.  More than 50 volunteer advocates, survivors, spouses, caregivers, emergency responders, and hospital partners participate in the 2-day event in Bismarck. 

We are pleased that our Stroke Bill, HB 1323, passed unanimously out of House committee and on the House floor.  This bill is important to clarify language related to stroke care already being done, and to serve as a model for other states to follow when it comes to stroke response and outcomes. We know our advocates will continue to raise their voices with their Senators when the bill comes before the Senate. 

We are working on several Appropriations requests that are also critical to improving heart and stroke care in our state.  Our Cardiac Systems of Care request will continue to build upon progress that has already been made in cardiac response, and will provide sustainability for statewide training and public education. 

Our work on CPR in Schools last session provided funding support for schools who want to provide CPR training to their students.  Only a small portion of this appropriation was used so we are working to protect those funds to enable more schools to provide this life-saving training.  Knowing CPR is the first response in the system of care for sudden cardiac arrest.

We are encouraging legislative support for Million Hearts funding to address the serious health concern of hypertension.  This funding will provide awareness and education to help to know the risk factors for hypertension and provide prevention strategies. 

We are also supporting HB 1421 which would raise the tobacco tax in North Dakota and reduce tobacco use and the impact tobacco has on chronic disease in our state.  With rising health care costs continuing to dominate the North Dakota health policy agenda, raising the tobacco tax will provide much needed funding to address healthcare needs in our state.

Much work is yet to be done throughout the session, and we need our advocates to continue to engage lawmakers on all these issues.  Together, we can make North Dakota a heart-healthier place to live! 

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Advocate Spotlight: Shelly Arnold

Shelly Arnold North Dakota

As the Chair of the American Heart Association’s Advocacy Committee, I understand the importance of statewide programs and the need to integrate work among all types of healthcare professionals. Heart attack and stroke are two life changing events that can sometimes be prevented by living a healthy lifestyle and visiting with a healthcare provider about your overall health and risk of heart attack or stroke.

The first step towards living a healthy lifestyle starts with you. Living a healthy lifestyle is key to preventing strokes and heart attacks. Make sure you are paying attention to the food you eat and the amount of exercise you get. Just a brief walk every day along with a healthy diet can decrease your risks for a heart attack or stroke. 

If you or a family member experiences any signs or symptoms of a heart attack or stroke, Tertiary hospitals such as Sanford Health along with rural hospitals, local emergency medical services and air medical services all serve a unique role in providing you the best care possible. Don’t hesitate to call 911, these emergency providers are ready and willing to help you, by providing the best possible care and will transport you to the most appropriate healthcare facility in the shortest amount of time.

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More Concerns about E-Cigs

As more research comes available and more studies are being done on the effects of e-cigarettes, today the New England Journal of Medicine raises a new worry about electronic cigarettes – exposure to formaldehyde.  You remember formaldehyde, right?  Who could forget that awful-smelling chemical used in your high school biology class to dissect frogs?  Turns out, formaldehyde is formed when the propylene glycol and glycerol in e-cigarette liquids and oxygen are heated together.   

According to an article in today's Los Angeles Times Science Now, The World Health Organization’s International Agency for Research on Cancer says formaldehyde can cause leukemia and nasopharyngeal cancer. The U.S. Environmental Protection Agency considers the chemical a probably human carcinogen. 

Let's not kid ourselves.  The study coauthor James Pankow, a chemistry professor and expert on cigarette smoke dangers at Portland State University, said the line between e-cigarettes and tobacco cigarettes was growing fuzzier by the day.

“No one should assume e-cigarettes are safe,” he said in a statement. “For conventional cigarettes, once people become addicted, it takes numerous years of smoking to result in a high risk of lung cancer and other severe disease; it will probably take five to 10 years to start to see whether e-cigarettes are truly as safe as some people believe them to be.” 

For more on this story, CLICK HERE.  

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High Blood Pressure causing more Deaths despite Drop in Heart Disease, Stroke Deaths

Fewer Americans are dying from heart disease and stroke, but deaths caused by high blood pressure are on the rise, according to new statistics from the American Heart Association.

Although cardiovascular disease is still the biggest killer in the U.S., deaths fell by nearly a third from 2001 to 2011—a drop scientists say reflects improvements in preventing and treating heart disease and stroke. Doctors are encouraged that the trend will continue as healthcare systems around the country better implement evidence-based prevention and treatment guidelines from the AHA and the American College of Cardiology.

Concerns are growing, however, over a 13 percent uptick in hypertension-related deaths over that same span according to the statistical report, “Heart Disease and Stroke Statistics — 2015 Update: A Report From the American Heart Association,”

“Deaths attributable to cardiovascular diseases have been on the decline in recent decades. Yet in the face of this good news, we have several disturbing observations that we need to pay attention to because we’re at risk of eroding the gains we have made,” said AHA President Elliott Antman, M.D., professor of medicine and associate dean at Harvard Medical School.

High blood pressure is a major risk factor for heart disease and stroke. Although the death rate going up for one while the other is going down may seem contradictory, one reason is that hypertension can directly lead to other deadly conditions such as heart failure or kidney failure if it is not controlled.

The report found that most cases have been detected—nearly 83 percent. But of the 80 million Americans with high blood pressure, only about half have it under control.  The rising hypertension death rate also is probably related to factors plaguing many Americans — lack of physical activity, obesity and too much sodium.

To learn more about understanding and managing blood pressure, CLICK HERE.

To assist worksites in addressing high blood pressure a worksite wellness program targeting blood pressure will launch on Giving Hearts Day, February 12, 2015.    For more information contact Joan Enderle.  or call 701-658-3046.  

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2015 Legislative Priorities

The 64th North Dakota Legislative session has begun, and elected officials are setting policy and funding priorities for the next two years – 2015 – 17.  As you can imagine, with heart and stroke being our leading cause of death in North Dakota, there are a significant number of touch points where AHA volunteers and staff can impact legislation.  While we will monitor and engage on many of these items, we also identify a select number of issues for our leadership focus.  These are highlighted below.  I’m also including some key talking points, in hope that you will find opportunities to connect with your local elected officials.

Why is our work so important?

Life is why.  Heart disease and stroke is our state’s leading cause of death and disability.  That’s impacting our families, our communities and our state. 

As a nation 75% of our healthcare dollars goes to treatment of chronic diseases.

Are we making an impact?

You betcha!  From 2011 to 2012, nationwide, age adjusted death rates decreased significantly for heart disease – 1.8% and 2.6% stroke nationwide.   During the same time period, in North Dakota, age adjusted death rates for heart disease decreased 22.3% and stroke declined 38%.  

So what’s our problem?

While we are showing improvement overall, we are seeing cardiac disease and stroke events increasing within our active workforce – hitting people at the prime of their life for key work and business production.

The state cost to treat cardiovascular diseases cost North Dakota more than $1 billion each year.

How can I help?

Watch for You’re the Cure action requests, and take action right away!  Build the relationship trust with your area legislators, let them know these issues matter to you.  Keep in mind this insight:  Budget leaders find it is easier to take the eggs from the nest of those who don’t squawk, than from the nests of those that do. 

 Core AHA priorities:

SB 2013 – Dept of Public Instruction Budget:  This bill is currently in Senate Appropriations.  We are seeking to insert language that carries over any unspent CPR training funds from the 2013-15 budget to the 2015-17 budget for continued support of teaching students CPR.  We anticipate there will be about $400,000 to carry over.  Why? Fewer than 1 in 3 victims of sudden cardiac arrest outside the hospital receive CPR from a bystander.  CPR can double or triple survival rates.  CPR is a lifelong skill, one that saves lives.

HB 1004 – Dept of Health Budget:  Currently in House Appropriations, Human Services.

  • Optional Request #6:  Cardiac Systems of Care.  $601,400 for expanded stakeholder work on  identifying emergency cardiac care system impact points, target educational efforts to improve the quality of care of patients, data tracking and public awareness. Why? This appropriation further develops ND cardiac capacity to enhance other time sensitive cardiac system of care initiatives which will save lives and improve outcomes.  
  • Optional Request #12: EMS Database.  $480,000 Funding recommendation which includes $448.000 for one-time cost and $32,000 for ongoing maintenance costs.  Why? The current system is outdated and lacks company support.  Inter-connectivity of technology components is essential, as are EMS patient care records to assist with system improvements.  
  • Optional Request #9: Million Heart Initiative. $2,039,573.  Public/Private/Healthcare Initiatives to address two of the state's leading chronic disease risk factors - high blood pressure and smoking.  The initiative will support HBP interventions and standard treatment guidelines through community and health system initiatives; increase health system capacity to provide private and group cessation counseling (Medicaid is adding reimbursement for such).  Why? In North Dakota, 32% of strokes are under age 65, and over 73% have high blood pressure, yet only .1% are being treated for high blood pressure.  A 5mm hG decrease in systolic blood pressure would result in 14% fewer deaths from stroke, and 9% fewer deaths from heart disease. 

Stroke System of Care Legislation.  This will be a policy bill and will be appearing in the coming days.  Why?  Current Century Code language (state law) has old dates.  It was also enacted at a time other standards for stroke system care were not yet available.  This bill updates state law and also reflects the status of system work in North Dakota.  

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Advocate Spotlight: Bonnie Staiger

Bonnie and Stacy, Staiger Consulting Group North Dakota

Question:  You've represented the American Heart Association in the halls of the state Capitol in Bismarck since 1999.  How has your firm grown since that time? 

Bonnie: We actually doubled in size in 2007!  I was pleased when my daughter, Stacy, decided to join the firm and work together with me to represent clients in Bismarck.  Stacy completed her MBA at Florida Gulf Coast University and made the decision to move back to North Dakota.  It's a pleasure working with her on a daily basis.  

Question: With your long history of representing the AHA in the halls of the Capitol, can you reflect upon the AHA's reputation as an organization advocating for health policy in our state?

Bonnie:  AHA's reputation has been built on the values of respect and trust.  No matter how difficult at times, we always respect legislators and agency personnel in their role of policy making and administering those policies. The diversity of Republicans, Democrats, majorities and minorities all bring dissimilar dynamics into the nuances of an issue.  Only from respect can trust be built and it is a fragile commodity.  We avoid polarizing factions and situations knowing the only currency we have is trust.  Our biggest gains have often come from volunteers touching base with their own legislators.  Then, when we chat with legislators at the Capitol, they often mention that a constituent has contacted them on a particular issue.  

Question:  You've observed many organizations and volunteers come to Bismarck to raise their voice on an issue.  Based on your experience, how can advocates be effective while being respectful, learn while educating at the same time? 

Bonnie: Step One, Advocates must first know their legislators.  Meet them and talk with them back in their home district.  Introduce yourself. Never barrage a legislator with your issues.  Keep it simple.  Legislative advocacy is built on relationships.  Step Two, We urge advocates to know the issues and be prepared to craft different talking points that will resonate with dissimilar groups.  Experience develops instincts and instincts often dictate when to press forward or back of on an issue.  The most noble issue is unlikely to move forward if outside factors are off - including timing.  A unified team effort is critical and lone rangers almost always cause problems.  

That's really good advice, Bonnie.  Finally, can you share with our advocates any final words of wisdom as they prepare to be effective advocates during the session this year?

Bonnie:  Every legislative session has 2 tracks going on simultaneously.  One is the legal track or How a Bill Becomes a Law.  That information is available on our state's website.  The other track is the political track which runs concurrently with the first.  The second track can speed up or slow down the first track.  Often advocacy is a chess game played in 3-D.  While it may seem glamorous from the outside, it's simply hard work and not for the faint of heart. But it can be very rewarding if gains are assessed in the long term. 

We'd like to thank Bonnie for taking some time to share her perspective and thoughtful advice on how to be an effective AHA advocate.  

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Plan Now to Go Red for Women

Women are strong. We are smart. We solve problems. Women can do anything men can do. And, there are some things we’re even better at – dying of heart disease and stroke. Like breaking barriers? Go Red! And help break the one against heart disease.

It’s not just a man’s disease. Each year, 1 in 3 women die of heart disease and stroke. But we can change that because 80 percent of cardiac events can be prevented with education and lifestyle changes.

When it comes to beating heart disease and stroke, change can be the cure. Make a change at

Go Red For Women is about extending the reach. It’s about making a change.

Here are a few ways you can make a change today:

  • Go to to learn what you can do to reduce your risk of heart disease and stroke.
  • Encourage your family and friends to take small steps toward healthy lifestyle choices to reduce their risk for heart disease and stroke, too.
  • Explain “What it means to Go Red” by sharing the following acronym:

Get Your Numbers: Ask your doctor to check your blood pressure, cholesterol and glucose.

Own Your Lifestyle: Stop smoking, lose weight, be physically active and eat healthy.

Raise Your Voice: Advocate for more women-related research and education.

Educate Your Family: Make healthy food choices for you & your family. Teach your kids the importance of staying active.

Donate: Show your support with a donation of time or money.

National Wear Red Day, February 5, 2015.  Get your free downloadable materials for companies, organizations, schools and individuals at

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Raise Your Voice During 2015 Legislative Session

A strong cardiac system of care is essential for our diverse, rural state. North Dakota has the unique opportunity to invest our resources in the most up-to-date system and technology improvements and reduce the devastating impact of heart disease and stroke on North Dakota families and reduce the cost of healthcare across our state. 

Throughout the upcoming legislative session, AHA volunteers will be advocating for several appropriation requests that can strengthen our system of care and the chain of survival for victims of heart attack. 

When the time comes, advocates can help by activating on alerts and messaging their state elected leaders on the following appropriation requests:

  • Cardiac System of Care which will sustain and enhance our investment in STEMI system platform and improve outcomes for STEMI heart attack.
  • Million Hearts to provide education and resources to address 2 of North Dakota’s leading chronic disease risk factors – high blood pressure and smoking.
  • CPR Training in Schools to help build a community of CPR ready citizens and engage our youth in healthcare careers.
  • EMS Database System to bring technology and system improvements up to date and improve outcomes. 

Your voice is an important part of improving outcomes for victims of heart attack and stroke.  Survival is why your voice is needed during the 2015 Legislative session. 

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Advocate Spotlight: Lynette Anderson

Lynette Anderson North Dakota

Lynnette Anderson, is a registered nurse, and like many AHA volunteers has an extensive background in heart attack care.  She was a Critical Care Nurse for 20 years, currently working in the quality department where she monitors and collects data on heart attack patients in addition to 15 years as EMT on the Page Ambulance squad.   Lynnette knew the importance of receiving quick and timely care for a heart attack.

Never did she think at the age of 47, that she would be the one that needed to be cared for.  Her symptoms were vague and atypical, as they often can be for women her age.  Lynnette’s left arm simply ached and she was fatigued while doing yard work and gardening. Nothing relieved the persistent achy feeling.  She rationalized to herself that it could not be a heart attack with no family history of heart disease, good blood pressure and cholesterol and no shortness of breath or sweatiness.

Lynette’s husband, Rick, mentioned on several occasions over the weekend that maybe they should go in to the Emergency Department just in case it was something.  Rick had heard on the radio how young women have atypical symptoms when they have a heart attack.  Lynnette assured Rick she was fine and told him there was no way this was a heart attack – she was too young and didn’t have enough symptoms or risk factors.

A clinic visit Monday morning identified an acute heart attack.   After a quick ambulance ride to the hospital and a procedure to open an artery that was 99% blocked, Lynnette is doing well, back to her life as a mom, farm wife, and nurse.   

Lynette knows how lucky she is to be alive without permanent heart damage.  Fewer woman than men survive their first heart attack.    She has been given a second chance at life and wants others to have the same opportunity.   Lynnette has become a volunteer for the AHA and shares her story in the hope that it may help one woman or one family to seek care immediately and to realize the importance of owning their lifestyle: stop smoking, lose weight, be physically active and eat healthy. 

Lynnette encourages others to become an advocate, to volunteer and become involved.  Your voice can make a difference!

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