Between 2012 and 2016 the Million Hearts program brought together 120 official partners (including the ACC), 20 federal agencies, and all 50 states and the District of Columbia around the shared goal of preventing one million deaths from cardiovascular disease over a five-year period. In its recently published “Meaningful Progress 2012-2016: A Final Report,” early data show that the novel public/private initiative has helped prevent an estimated half a million cardiovascular events, while also making significant headway in reducing cardiovascular risk factors like smoking and hypertension.

Co-led by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS), Million Hearts is focused on keeping people healthy and optimizing quality care through its ABCS approach: Aspirin when appropriate, Blood pressure control, Cholesterol management and Smoking cessation.

Among the patient-focused goals, Million Hearts saw substantial reductions in its initial five years in tobacco use, improving cardiovascular health for millions, including those experiencing secondhand smoke. In fact, the initiative estimates it will surpass its target (reduce tobacco use by 23.6 percent) by the end of 2017. Among the health care system-focused goals, CMS Electronic Health Record (EHR) Incentive Programs helped identify half a million patients with hypertension through a 53 percent increase in EHR use in outpatient care between 2011 and 2015 (from 34 percent to 87 percent).

The Million Hearts report also highlights two specific programs for notable achievements over the past five years: Million Hearts Hypertension Control Challenge and Million Hearts Cardiovascular Disease Risk Reduction Model. The competition recognized 59 doctors, health care practices and health systems, including ACC members and medical groups reporting via the CMS Group Practice Reporting Option, for achieving blood pressure control rates at or above 70 percent for more than 13.8 million patients.

Meanwhile, 516 organizations across 47 states, the District of Columbia and Puerto Rico now use the Risk Reduction Model, which tests how financial incentives impact the identification and management of risk for cardiovascular disease among eligible Medicare beneficiaries. To assist practices participating in the Risk Reduction Model, the ACC partnered with CMS and the American Heart Association (AHA) on a risk assessment tool to help predict the 10-year risk of developing atherosclerotic cardiovascular disease (ASCVD). The Million Hearts Model Longitudinal ASCVD Risk Assessment tool launched in November 2016 as an extension of the ASCVD Pooled Cohort Equation, which was first published in the 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk.

“Progress was clearly made in improving CV care and health by more than 120 partners, including ACC and its members, during the first five-year phase of Million Hearts. However, the pace of improvement is far too slow and the cumulative effect of decades of obesity, physical inactivity and diabetes threatens further progress in cardiovascular disease prevention,” states Janet Wright, MD, FACC, executive director of Million Hearts.

For example, while the Million Hearts Hypertension Control Challenge demonstrates that the initiative’s target blood pressure control target is achievable, overall blood pressure control has only increased by 4.3 percent between 2009-2010 and 2015-2016 (53.4 percent vs. 57.7 percent) across the U.S.

Looking ahead, Million Hearts 2022 will continue to improve its ABCS approach, focusing primarily on decreasing sodium intake, while increasing physical activity. New efforts for Million Hearts 2022 will focus on prioritizing improvement outcomes for highly affected populations, particularly African-Americans and Hispanics between the ages of 35 and 64.

“With a strong foundation of powerful private and public sector partners, Million Hearts 2022 is designed to accelerate the implementation of strategies that work to prevent cardiovascular disease and improve heart and brain health. We look forward to working with the College and all members of the cardiovascular team to get to at least a million by 2022,” says Wright.

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Keywords: Smoking Cessation, Smoking, Tobacco Smoke Pollution, Centers for Medicare and Medicaid Services, U.S., American Heart Association, Cardiovascular Diseases, Blood Pressure, Aspirin, African Americans, Risk Factors, Hypertension, Medicare, Risk Reduction Behavior, Risk Assessment, Diabetes Mellitus, Electronic Health Records, Obesity, Centers for Disease Control and Prevention, U.S., Hispanic Americans, Cholesterol, Group Practice, Ambulatory Care, Exercise, Primary Prevention, Secondary Prevention, Cardiology Magazine, ACC Publications

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