Million hearts--where population health and clinical practice intersect.

Abstract

More than 2 million heart attacks and strokes occur each year, resulting in > 800 000 cardiovascular deaths. Despite declining trends in mortality, cardiovascular disease is still the leading cause of death in the United States, and the prevalence of hypertension, dyslipidemia, and tobacco use can still be greatly improved.1 Of US adults aged ≥18 years, 31% have hypertension, and this prevalence has shown little improvement in the past decade. Of these adults, 70% receive pharmacological treatment, but only 46% are controlled.2 We see similar trends in hypercholesterolemia.3 Although there has been a long-term trend toward declining cardiovascular disease mortality because of both improvements in risk factors and treatments,4 much additional progress is needed in both clinics and communities. Million Hearts is a population-health initiative, jointly led by the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services. Million Hearts is committed to improving the cardiovascular health of the nation through policy and systems-level changes that impact both community and clinical practice interventions. Doing so will require a common agenda from which all partners can work and focused outcomes by which all progress can be measured. It is a time-limited, concerted effort from public health, clinical, community, and advocacy stakeholders to improve risk factors for and subsequent outcomes of cardiovascular disease. Million Hearts complements a number of existing public and private initiatives, including Healthy People 2020,5 Let’s Move!6 and Life’s Simple 7.7 The initiatives' community-based interventions will focus on tobacco cessation, sodium reduction, and artificial trans fat elimination. These community interventions will be carried out in conjunction with a network of public health practitioners, including state and local departments of health, advocacy groups, and community-based organizations. Clinical practice policy and systems changes will improve performance on the delivery of …