September 13th, 2011
HHS Announces Initiative to Prevent One Million Heart Attacks and Strokes
Larry Husten, PHD
The U.S. Department of Health and Human Services is launching a campaign to prevent one million heart attacks and strokes in the next 5 years. The announcement was published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) and in a perspective published in the New England Journal of Medicine by Thomas Frieden, director of the CDC, and Donald Berwick, administrator of the Centers for Medicare and Medicaid Services.
In an analysis of NHANES data, nearly half (49.7%) of U.S. adults in 2007-2008 had at least one of the three main risk factors for CV disease: uncontrolled hypertension, uncontrolled high levels of LDL cholesterol, and current smoking. This represents a significant decline from the 57.8% prevalence reported in 1999-2000. The decrease, according to the CDC, “might, in part, reflect improved treatment and control of hypertension and high levels of LDL-C and implementation of effective smoking interventions.”
Frieden and Berwick write that “it’s time to take the next big step.” In conjunction with other government and private-sector partners, HHS is launching Million Hearts, described by the CDC as “a multifaceted combination of evidence-based interventions and strategies aimed at preventing 1 million heart attacks and strokes over the next 5 years.” Frieden and Berwick state that the Million Hearts initiative will not require new public spending; instead it “will leverage, focus, and align existing investments.”
CV prevention, they write, takes place in the clinic and the community. In the clinical realm, the new initiative will focus on the “ABCS”:
- aspirin therapy for people at high risk
- blood pressure control
- cholesterol management
- smoking cessation
In the community, the Million Hearts initiative will “encourage efforts to reduce smoking, improve nutrition, and reduce blood pressure.”
this is a very important Initiative.
in my opinion there are (at least) two important messages:
1/ These ABCS’ measures can by applied in every country, they are simple to perform, efficient, easy to remember and “cheap”. There are evidence based data which show that they work (as it is written by the authors in their paper: between 1980 and 2000 mortality of CVD decreased of 50% mainly by following theses preventive rules).
2 the cornerstone in this Initiative is the clinician: he explains to the patient, gives the recommendations to the diet and exercise, advises and help to stop tobacco.
Clinician will be an important part of”the next big step” and this is very nice to receive.
Competing interests pertaining specifically to this post, comment, or both:
none