TRIP

'Million Hearts' Initiative Aims at Stroke, Too

MedPageToday, 2012

In the presidential advisory called "What the Million Hearts Initiative Means for Stroke," Sacco and colleagues, including Thomas Frieden, head of the CDC, emphasized the current high rate of stroke in the U.S.
(800,000 a year), the racial and ethnic disparities in stroke rate and care, the high rate of permanent disability associated with stroke, and projections that the prevalence of stroke will increase by 25% by 2030.
Stroke is often preventable and could be reduced by as much as one-third with improved implementation of feasible interventions," Sacco and colleagues wrote.
They noted the similarity of Million Hearts to the 2020 Health Impact Goal established by the AHA/ASA last year.
The aim of the Health Impact Goal is to improve the cardiovascular health of all Americans by 20% while reducing deaths related to cardiovascular diseases and stroke by 20%.
"It's always been our implicit goal to improve cardiovascular health, but now we're making it explicit," Gordon Tomaselli, MD, president of AHA/ASA, told MedPage Today .
"Improving cardiovascular health doesn't just mean primary prevention but also improving the implementation of secondary prevention measures so people don't have a second event," Tomaselli said.
A key component of Million Hearts is improving care by focusing on the ABCS -- aspirin, blood pressure, cholesterol, and smoking cessation.
Specifically, the initiative calls for the following: Increase aspirin use among those at high risk from 47% to 65% in the population and 70% in clinical systems Increase hypertension control from 46% to 65% in the population and 70% in clinical systems Increase cholesterol control from 33% to 65% in the population and 70% in clinical systems Reduce smoking prevalence from 19% to 17%
Sacco and colleagues pointed out that ischemic stroke and myocardial infarction share most of the same risk factors, and that many of them are modifiable.
"However, effective clinical and community prevention strategies are underutilized; complementary efforts at the clinical and community levels are needed to achieve optimal prevention of stroke and its associated risk factors," they said.