February 2019, Volume XXXII, No 11
The “Million Hearts” initiative
Addressing heart attacks and strokes
reventing one million heart attacks and strokes over five years is a powerful call to action—one that was taken on in 2012 by the U.S. Department of Health and Human Services, and co-led by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) under the Million Hearts initiative.
While Minnesota is known as a heart-healthy state, heart disease and stroke are still among our leading causes of death. That’s why the Minnesota Department of Health (MDH) is a partner in the Million Hearts initiative, to further the state’s efforts to promote healthy lifestyles and behaviors, create healthy environments and communities, and increase access to early and affordable detection and treatment.
Minnesota is working alongside 120 official Million Hearts partners, 20 federal agencies, the remaining 49 states, and the District of Columbia. More than 12,000 individuals and organizations have pledged their support to reduce heart attacks and strokes, and more than 50 public and private organizations have made specific, actionable commitments to fight cardiovascular disease.
The initiative scales up proven clinical and community strategies, bringing together existing efforts and adding new programs to improve health across communities—and, ultimately, to help Americans live longer, healthier, more productive lives.
For the first five years, the initiative had two primary goals:
Our focus on ABCS is turning the curve on the impact of cardiovascular disease here in Minnesota. In 2014, CDC and Million Hearts recognized two of the project’s health practices—St. Luke’s P.S. Rudie Medical Clinic and Essentia Health, Duluth—that achieved blood pressure control for at least 70 percent of their adult patients with hypertension.
The state’s smoking rate is slightly lower than the national average.
The national impact
According to the Million Hearts Meaningful Progress 2012–2016 report, during the first two years of the initiative, about 115,000 cardiovascular events were prevented. That number is relative to the expected number of events if 2011 rates had remained stable.
Although final numbers will not be available until 2019, CDC estimates that up to half a million events may have been prevented from 2012 through 2016. These outcomes were fueled by these achievements by Million Hearts and health care advocates:
Seven million fewer people smoked cigarettes in 2015 than in 2011. Quitting smoking immediately reduced their risk for a heart attack or stroke.
Guidance was drafted and issued in June 2016 for the food industry to voluntarily reduce sodium in processed and commercially prepared food. The intention of this step is to help Americans gradually reduce their sodium intake to the recommended level of less than 2,300 mg per day, which will improve their blood pressure.
Although daily sodium intake has not dropped significantly in the past five years, widespread implementation of healthy food purchasing policies and voluntary industry adoption of recommendations for lower sodium food choices are expected to help all Americans eat healthier in the years ahead.
Partially hydrogenated oils will be removed from the food supply in 2018. This action is expected to prevent thousands of fatal heart attacks every year.
Million Hearts mobilized health care systems to deliver high value care for people at risk of cardiovascular diseases by focusing on the ABCS in clinical quality measures.
A focus on the ABCS has generated slow but steady improvement in aspirin use, blood pressure control, and statin use among people who are eligible, based on current guidelines.
Electronic health records have helped to identify more than half a million people who may have hypertension.
Clinicians and health care systems have an integral role to play.